Awareness of current research is a big component of staying up to date in nursing and healthcare and providing evidence-based care. Here’s a look at a selection of the latest studies and practice-changing recommendations.
Nursing
Nurse Work Environment Affects Patient Outcome
AACN Advanced Critical Care
Anna Krupp, Ph.D., R.N., from the University of Iowa in Iowa City, and colleagues estimated the association between hospitals’ nurse work environment and patient likelihood of ICU admission and mortality after surgery. This cross-sectional study involved 269,764 adult surgical patients in 453 hospitals.
COVID-19 Proning Teams Benefit from Wound Care Specialist Nurse
American Journal of Critical Care
Connie Johnson, R.N., from Penn Medicine Princeton Health in Plainsboro, NJ, and colleagues evaluated the association between including a certified wound and skin care nurse on a multiprofessional pronation team and the prevention of pressure injuries in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients with acute respiratory distress syndrome. The analysis included 130 patients (40 percent treated by a team that included a certified wound and skin care nurse) hospitalized with COVID-19 between Feb. 1 and Aug. 30, 2020.
Employment of Nurses Decreased Early in COVID-19 Pandemic
Health Affairs
Peter I. Buerhaus, Ph.D., R.N., from Montana State University in Bozeman, and colleagues used national data from federal government surveys to demonstrate the pandemic's impact on employment and earnings across categories of the nurse workforce. Monthly data were obtained from the Current Population Survey between January 2011 to June 2021 to identify employment trends.
Guidelines & Recommendations
ACG Issues Guidelines for Managing Acute-on-Chronic Liver Failure
American Journal of Gastroenterology
The authors note that prognostic markers that predict ACLF outcome should be differentiated from diagnostic markers that confirm the presence of ACLF. With further validation, microbial composition and microbial-origin metabolites can be used as biomarkers for development and prognosis of ACLF. The diagnosis of ACLF is supported by the presence of kidney, lung, circulatory, or brain failure. Albumin is recommended in addition to antibiotics to prevent AKI and subsequent organ failure in patients with cirrhosis and spontaneous bacterial peritonitis. Assessment for infection is recommended in hospitalized decompensated cirrhotic patients because infection is associated with development of ACLF and increased mortality. Management strategies include a recommendation against daily albumin infusion to maintain serum albumin levels in hospitalized patients with cirrhosis as a means to improve mortality or to prevent renal dysfunction or infection.
Recommendations Updated for Recombinant Zoster Vaccine
CDC Morbidity and Mortality Weekly Report.
For adults aged 19 years and older who are or will be immunodeficient or immunosuppressed due to disease or therapy, the ACIP recommended two doses of RZV for prevention of herpes zoster and related complications.
ACP Issues Two Guidelines for Acute Left-Sided Colonic Diverticulitis
Annals of Internal Medicine
American College of Physicians (ACP) suggests the use of abdominal computed tomography imaging in the case of diagnostic uncertainty in a patient with suspected acute left-sided colonic diverticulitis. It is suggested that clinicians manage most patients with acute uncomplicated left-sided colonic diverticulitis in an outpatient setting. Furthermore, the guideline suggests select patients can be managed initially without antibiotics.
ACP suggests that patients who have not undergone recent colonoscopy should be referred for a colonoscopy after an initial episode of complicated left-sided colonic diverticulitis. The guideline recommends against use of mesalamine to prevent recurrent diverticulitis. In addition, ACP suggests clinicians discuss elective surgery for the prevention of recurrent diverticulitis after initial treatment in patients with uncomplicated diverticulitis that is persistent or recurs frequently; this suggestion also applies to patients with complicated diverticulitis.
WHO Living Guideline Updated for Drug Treatment of COVID-19
The BMJ
The Janus kinase (JAK) inhibitor baricitinib is strongly recommended for patients with severe or critical COVID-19, and sotrovimab is conditionally recommended for nonsevere COVID-19, according to the updated World Health Organization living guideline on drugs for COVID-19.
ADA Updates Standards of Medical Care in Diabetes for 2022
Diabetes Care
Updates and additions to the 2022 report include guidance on first-line therapy determined by comorbidities and a recommendation for initiation of screening for prediabetes and diabetes for all people at age 35 years. Changes were made to gestational diabetes mellitus recommendations, including when and who to test. In addition, recommendations were updated on technology selection, based on individual and caregiver considerations, ongoing education relating to device use, continued access to devices across payers, support of student use of devices in schools, use of telehealth, and early initiation of technology.
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