Implementing early assessment, prevention and detection protocols can reduce risk factors and improve outcomes for some of the most serious complications facing critically ill patients, according to the American Association of Critical-Care Nurses (AACN).
Delirium, catheter-associated urinary tract infections (CAUTIs) and venous thromboembolism (VTE) are associated with longer lengths of stay and higher mortality rates, among other outcomes. Together, these common conditions affect thousands of patients and contribute to billions of dollars in additional healthcare costs.
In an effort to standardize clinical practice and improve patient outcomes, AACN has issued practice alerts on delirium, CAUTI and VTE, featuring the latest evidence-based resources and research. These updated AACN Practice Alerts are available at no cost electronically on the AACN website, www.aacn.org/practicealerts/.
Each AACN Practice Alert outlines the scope of the problem, summarizes the expected nursing practice and provides supporting evidence and research.
Assessment and Management of Delirium Across the Life Span
Delirium — an acute change in consciousness characterized by confused thinking and disrupted attention — affects up to 80 percent of critically ill patients in the United States, with associated annual costs between $4 billion and $16 billion.
The AACN Practice Alert reviews risk factors for pediatric and adult patients and the use of validated tools to assess for delirium. Resources include the ABCDEF Bundle as a helpful tool to reduce modifiable risk factors and improve quality of life for patients and their families.
Prevention of Catheter-Associated Urinary Tract Infections in Adults
Urinary tract infections are the most common healthcare-associated infection, and prolonged indwelling catheterization is the major risk factor for CAUTIs. The AACN Practice Alert outlines preliminary and ongoing assessment, documentation and adherence to infection control protocols.
Preventing Venous Thromboembolism in Adults
VTE affects approximately 900,000 adult patients in the United States annually and results in an estimated 300,000 deaths, with prevalence predicted to more than double in the next 35 years. The AACN Practice Alert reviews risk factors and VTE prophylaxis, including medications and compression devices.
Supported by authoritative evidence, each AACN Practice Alert seeks to ensure excellence in practice along with promotion of a safe and humane work environment. Topics address both nursing and interprofessional activities of importance for patients in acute and critical care environments. Some alerts include additional resources for staff education and performance-improvement activities.
Previously released alerts address verification of feeding-tube placement, dysrhythmia monitoring, pulmonary artery pressure monitoring, ST segment monitoring, family presence during CPR and invasive procedures, and prevention of aspiration.
Source: American Association of Critical-Care Nurses: