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  1. Critical care and progressive care is an ever-changing world. In order to provide the best care for our patients, we need access to the newest knowledge. The American Association of Critical-Care Nurses (AACN) is here to help expand our knowledge. They recently published the Scope and Standards for Progressive and Critical-Care Nursing Practice. This up to date resource contains information based on the AACN Synergy Model of Care: The AACN Synergy Model for Patient Care is a conceptual framework that aligns patient needs with nurse competencies. Originally developed in 1996 as a new framework for AACN’s certification programs, the Synergy Model shifted the assessment of nursing skills from the then-prevalent body systems/medical model — which didn’t consistently match actual practice — to a “nurse competencies” framework. The central idea behind this is that the patient's needs drive the nurses' competencies. This is the basic tenet of AACN's policies and practices - the needs of the patient. What is the Healthy Work Environment Initiative? The Scope and Standards for Progressive and Critical-Care Nursing Practice also incorporate healthy work environments guidelines: Skilled communication True collaboration Effective decision making Appropriate staffing Meaningful recognition Authentic leadership What are some of the latest trends? AACN built on these principles to author the new scope and standards. The latest trends also direct this document which includes: Rising nursing turnover. It is estimated that 28% of the nurses in their first year of practice will change jobs. Overall nursing shortage. It is estimated that "one million RNs will retire by 2030 and that “the departure of such a large cohort of experienced RNs means that patient care settings and other organizations that depend on RNs will face a significant loss of nursing knowledge and expertise that will be felt for years to come"." More opportunities exist for nurses away from the bedside. As nurses develop their professional role through education and experience, they often progress to managerial positions, advanced practice or other leadership positions. Nurses who remain at the bedside face increasing stress due to high patient acuity, low staffing situations and more technology. Governmental regulations... Regulatory changes impact nurses too. We all face the ever-present HCAPHS survey: The HCAHPS survey asks discharged patients 27 questions about their recent hospital stay. The survey contains 18 core questions about critical aspects of patients' hospital experiences (communication with nurses and doctors, the responsiveness of hospital staff, the cleanliness and quietness of the hospital environment, pain management, communication about medicines, discharge information, the overall rating of the hospital, and would they recommend the hospital). The survey also includes four items to direct patients to relevant questions, three items to adjust for the mix of patients across hospitals, and two items that support Congressionally-mandated reports. Value-based healthcare is another government initiative: "The Hospital Value-Based Purchasing (VBP) Program is a Centers for Medicare & Medicaid Services (CMS) initiative that rewards acute-care hospitals with incentive payments for the quality care provided to Medicare beneficiaries." This too impacts nursing care as nurses strive to provide the best patient care while being held accountable for a standardized quality measure. The multigenerational workplace... The multi-generational workplace also offers challenges. allnurses.com recently interviewed Karen Stutzer, PhD, RN, a recognized expert on the topic. She identified the five generations that are currently working: Veterans - (born before 1945) who are mostly retired Baby boomers - (1946 - 1964) want to work in collaboration with co-workers Gen Xers - (1965 - 1980) many grew up in families of divorce and are quite independent Millennials or Gen Y’ers - (1981 - 1995) grew up with technology so the world is much smaller. However, they also grew up with more violence in the world. Gen Zs - (1996 - 2012) just starting to enter the workforce so these are nursing students, nursing assistants. They are less sure of their career path but can multitask and overall they read less. Progressive and critical care nurses will always be needed. As our general population ages and technology advances the stress and strain on nurses will also increase. AACN strives to be proactive in providing guidance to nurses. “AACN Scope and Standards for Progressive and Critical Care Nursing Practice” can be downloaded for free on the AACN website for AACN members after signing in. A print version of the 49-page booklet can be purchased for $10 for AACN members and $25 for nonmembers from AACN’s online store."
  2. The American Association of Critical Care Nurses awards the Pioneering Spirit Award to medical professionals who have “significant contributions that influence acute and critical care nursing. Successful applicants exemplify a pioneering spirit, influencing the direction of acute and critical care nursing. The recipient addresses or resolves a significant issue facing acute and critical care nursing on a regional or national scale.” One of the 2019 award winners is Celine Gelinas, PhD, RN in recognition of “her work developing the Critical-Care Pain Observation Tool (CPOT), one of the most valid and reliable behavioral pain scales for assessing pain in critically ill adult patients unable to communicate pain.” She is an associate professor at Ingram School of Nursing, McGill University, and a researcher at the Centre for Nursing Research and the Lady Davis Institute of the Jewish General Hospital in Montréal, Québec, Canada She was interviewed recently by Mary Watts, BSN, RN, allnurses.com Content and Community Director at NTI 2019 in Orlando, Florida. Vital signs alone can not be used to assess pain in a patient that can’t communicate. Dr. Gelinas commented that as a critical nurse there was no consistent assessment for pain prior to 2000. She was frustrated with her inability to gauge her patient's pain and relay that to the physician in a meaningful and consistent manner. She wanted to develop a tool that could be used by any nurse to adequately and successfully assess their patients’ pain and relay this to the physician in order to obtain pain relief. “We had no evidenced based tool and we had discussions about this need. This is what motivated me to do something about it and even change practice.” Mary also asked about the subjective nature of the tool and Dr. Gelinas stated, “It’s not clear-cut. We try as much as we can to make the parts of the tool to be as subjective as possible but of course, there will always be a difference in perception of the individual observer.” Dr. Gelinas commented that there are several components of this assessment including grimace or facial expression which can consist of “brow lowering, eyes clenching, and cheek contractions.” There is also “muscle tension which the nurse can assess when turning the patient. We also have another item selection which we choose based on a patient’s compliance. If they are on a ventilator; are they fighting it, or trying to over breathe.” Body movements is a fourth part of the CPOT tool. Patients are scored on four components of the assessment and it is expected that the score will decrease after successful pain reduction intervention. Dr. Gelinas added that it's very important to have a tool that all nurses can utilize and that provides consistent clinical information for the physician to determine comprehensive pain management. The CPOT tool can be used for pain reassessment as well with the goal to reduce the CPOT score by at least 2 points. This tool was originally developed in French and then translated into English. Currently, it has been utilized around the world and translated into at least 15 languages. The original CPOT has been revised to include hearing loss in the assessment and they have added additional assessments for patients with brain injuries who are deeply sedated. This new version for use with brain injuries is referred to as CPOT-Neuro. Here is the entire NTI interview with Dr. Gelinas: Education on the use of this tool is easily accomplished by watching a free 15-minute video training video which was funded and developed by Kaiser Permanente Northern California Research.
  3. AACN offers the premier critical care conference, National Teaching Institute (NTI) annually. Recently allnurses.com’s Content and Community Director Mary Watts, BSN, RN, interviewed Anna Dermenchyan, MSN, RN, CCRN-K. In 2010, she founded the first hospital-based chapter of the American Association of Critical-Care Nurses (AACN). As the first chapter president, she began an annual Leadership Symposium for nurses and nursing students within the hospital and the community. Issues Associated with the Job Anna started her nursing career in a CVICU at UCLA. She relates; “they cared for such critically ill patients and provided such an enriching environment for a new nurse. What I was not prepared for was the issues associated with my job.” She progressed in her nursing career and had many roles including resource nurse, preceptor, and charge nurse. Approximately five years down the road, she wanted to take on a quality role. She went back to school and is currently working on a PhD looking at outcomes for HF patients in primary care. Idealism as a New Nurse allnurses.com asked about the issues surrounding nursing care. Anna discussed the idealism that is felt in nursing school, “you don’t know the expectations of the new job.” She went on to discuss the need for teamwork and that sometimes this isn’t always there and “the patients suffer.” One of the stressors at the start of her career was that the CVICU manager left within six months and the unit felt “lost.” Another issue was that she had numerous preceptors which added to her stress. Healthy Work Environment Anna also commented that AACNs healthy work environments (HWE) initiatives are so important for critical care nurses. The six initiatives are: Skilled communication True collaboration Effective decision making Appropriate staffing Meaningful recognition Authentic leadership The Importance of Networking Next, they talked about networking which is a great way to make connections that will lead to success in your nursing career or any career. Mary asked, but how do you network successfully at a large conference like NTI? Anna replied, “It is a place to learn clinical topics and there are 300 sessions, motivating. It’s also a value-added commodity. You can let your guard down and network and it's an amazing experience. It’s not only about practice education but also a great way to connect and make new members. You can find a mentor.” Don’t take learning for granted. Collaborate with others. Here is the complete interview presented in 2 videos:
  4. Come and join your fellow critical care nurses at NTI 2019 in Orlando, Florida from May 20-23rd. With more than 37.5 hours of CEUs offered, this conference is sure to teach, inspire and impress all high acuity and ICU nurses. Reasons to attend NTI It would be easy for us to tell you the reasons. However, here are a few of the of the comments from recent attendees: "It pumps me up." "Chance of a lifetime." "Makes me motivated to be a better nurse." "Gave me back my enthusiasm to be a bedside nurse." There are many reasons to attend and some of the past attendees have stated some of these reasons. The sessions are also a solid reason to attend NTI. They are divided into pre-conference offerings that include Chapter Leadership for those nurses who want to advance to an AACN leadership role. The pre-conference sessions also cover other topics such as a cadaver lab for APRNs, advanced 12-lead EKG interpretation, certification prep courses, in addition to other critical care exploration options. The pre-conference topics are offered on Sunday and run most of the day so that you have the ability to more fully explore the topic. Concurrent sessions are usually 60-75 minutes in length and cover such topics as: 12-lead EKG Interpretation, Candida: The Fungus Among Us and From the Playground to the Nurses Station: Understanding and Eliminating Workplace Bullying. NTI 101 One of the most interesting topics is NTI 101. This is an introduction to the conference, how to navigate it, how to get the most out of the experience. Here's what AACN says about NTI 101: "Perhaps it’s your first time or you need a refresher; attending the National Teaching Institute and Critical Care Exposition (NTI) can be an adventurous and sometimes, an overwhelming experience. The Program Planning Committee Chairs offer strategies to help you navigate your way through NTI. Please be sure to bring your mobile devices so you can participate fully in this dynamic session. Learn how to plot your educational journey through hands-on use of the NTI Program Guide, Program Schedule, Learning Action Journal and ExpoEd Guide which can be found in your NTI bag. Join the API or NTI Chair in this interactive and engaging session to explore how to develop a personalized education schedule, identify available resources and use My NTI. This session is designed to answer questions about the multitude of diverse opportunities available to every attendee and to help make your NTI an enjoyable and rewarding professional experience." This session will lead you on your way to a satisfying and enjoyable NTI 2019 and its offered several days and times so fitting it in shouldn't be difficult. The Advanced Practice Institute (API) offers some great options for the APRNs; whether you are just beginning your APRN journey or have been around the block several times. The ECMO session is always a highlight, as is the cadaver lab. Some other topics include: Vasoactive Pharmacology for Pediatric Shock, Neuromuscular Blockade in the ICU: A Review of Practice, Top Sepsis Studies 2018-2019 and Acute Decompensated Heart Failure, Management and Prevention of Recurrence. And these are only a few of the selections. The Exposition Hall This is where you learn, see, and experience all the new technology that is currently available or soon to be available for your critical care units. Its also where you can learn about educational opportunities to advance your career and also where the jobs are found. There are over 300,000 square feet of experience and you can truly spend the entire day here and not see everything. The opportunities are endless - pick up a brochure about a new piece of equipment, listen to a seminar about a new process to make patient care more efficient, network with other critical care nurses about the challenges and rewards. Registration Register Now Where to Stay AACN has a very comprehensive list of available hotels with pricing included here. There are a wide variety of options with many hotels located near the convention center. There is also a shuttle that runs between many of the hotels and NTI. We have just briefly touched on what NTI 2019 offers you. AACN has a very comprehensive site with all the details. Several allnurses.com staffers will at NTI 2019. We love to meet our members. Please let us know if you are attending. Also, we do have the opportunity to interview some of the speakers - who would YOU like us to interview? Tell us!
  5. The 2018 Marguerite Rodgers Kinney Award for a Distinguished Career was awarded to Beth Tamplet Ulrich, EdD, RN, FACHE, FAAN at the 2018 American Association of Critical Care - National Teaching Institute annual conference. While at the NTI conference, Mary Watts, BSN, RN, allnurses.com Community Director interviewed Dr. Ulrich and discussed her career and some of her accomplishments. Dr. Ulrich received her bachelor’s degree from the Medical University of South Carolina, her master’s degree from the University of Texas Health Science Center at Houston, and her doctorate from the University of Houston in a collaborative program with Baylor College of Medicine. When she moved to El Paso, Texas; due to her husband’s job, she started in dialysis and learned from the ground up as dialysis was in infancy. She worked to set standards of care and is a past president of the American Nephrology Nurses Association (ANNA). While earning her doctorate, she worked in hospital administration developing nursing simulations and nurse residency programs. She became interested in the healthy work environment and began her work with the American Association of Critical Care Nurses (AACN). She assisted with development of the first Healthy Work Standards survey in 2005. Dr. Ulrich stated that AACN brought together “an expert panel to create the standards.” In 2006, it was decided to “obtain opinions from those nurses with boots on the ground; the staff nurses who do the doing every day.” She further explained that AACN is “absolutely committed” to obtaining information to help the bedside nurse work in the safest environment possible. The 2005 survey was a snapshot. By the 2008 survey, AACN began to assemble comparisons of data which expanded when the 2013 survey data was added and AACN was able to took at trends. Now in 2018, AACN has received over 8000 responses to their current survey. Every time the survey is done, there are more and more nurses responding. Mary stated, “nurses see the value in these surveys because they want changes” via the published results. Dr. Ulrich continued, “When we first looked at this, we were looking for a baseline. In 2013, we saw the down turn of the economy: nurses were returning to work, they were changing from part time to full time, or for those who were working full time, they were looking for overtime.” In this scenario where the economy dictated how much you needed to work, there were not a lot of changes in the work environment regarding safety as income was the number one reason to work. Mary asked, “What contributes to an unhealthy work environment?” Dr. Ulrich answered that inappropriate staffing - results showed that 39% of the respondents reported they had appropriate staffing. Another more concerning result was that 32% stated that <50% of the time, they had adequate staffing. “This is pretty scary for the patients and the nurses". Dr. Ulrich pointed out that "staffing isn't just about the patients; it's about the nurses too, because when staffing isn't adequate, nurses don’t practice at the top of their license. They get done what they have to get done. They don't get to do the things only nurses can do - the critical thinking things, the discharge planning, comforting, teaching patients and families. They have to do tasks and then nurses aren’t satisfied with their jobs.” This results in decreased job satisfaction. Staffing is more than just about enough nurses to take care of the patients. It reflects on everything in the work environment. “I was surprised at the high number of incidents of discrimination with the 2018 survey.” This included verbal and physical abuse experiences. “We capped it at 200 incidents in the survey.” Nurses aren’t leaving nursing, they are leaving the hospitals - they have many options. They aren’t limited to work in the hospitals. “Once a nurse, always a nurse,” stated both Mary and Dr. Ulrich in unison. The survey results are published in Critical Care Nurse, AACN's clinical practice journal. Link to study Allnurses.com extends their gratitude to Dr. Ulrich and AACN for continued support in disseminating vital information for nurses.
  6. The American Association of Critical-Care Nurses (AACN) recently announced the recipients of its 3 annual Impact Research Grants, valued up to $50,000 each, and the AACN-Sigma Theta Tau Critical Care Grant with up to $10,000 in funding. AACN has awarded more than $1 million and 20 Impact Research Grants since the grant program was launched in 2011. 2018 Grant Recipients This year's grant recipients and funded projects are: Assessing Reiki's Effects on Pain, Anxiety (Impact Research Grant) Assessing Pain in Non-Verbal PICU Patients (Impact Research Grant) Using BIS Monitoring to Detect Delirium (Impact Research Grant) Nursing Certification's Contribution to Mobility Interventions (AACN-STTI Grant) For more details about the winning projects and the recipients, please go to https://www.aacn.org/newsroom/impact-research-grants-top-$1-million-in-total-funding Who Can Apply Members of the AACN community who drive change in nursing practice through research can apply for research grant to support their projects. AACN's Impact Research Grant funds projects to address gaps in clinical research at the organization or system level and translate the findings for bedside clinicians. AACN's research activities and initiatives are guided by the following 5 areas of priority: Effective and appropriate use of technology to achieve optimal patient assessment, management and/or outcomes Creation of healing, humane environments Processes and systems that foster the optimal contribution of critical care nurses Effective approaches to symptom management Prevention and management of complication When to Apply The application period for next year's funding is open. Clinicians and researchers are invited to submit research grant applications by November 1, 2018, to be eligible for part of the available funding of $160,000. Why Apply Contribute to Knowledge - Contribute to the advancement and use of new nursing knowledge to improve patient care. Drive Innovation - Ensure a pipeline for evidence-based resources that support critical care nurses at the bedside. Develop Your Skills - Advance your career as a researcher while adding insights to a clinical question or challenge. Share Your Findings - Partner with AACN to translate your research and distribute it widely. For more information, including award criteria and supporting documents, visit www.aacn.org/grants, or email research@aacn.org.
  7. AllNurses.com's Content and Community Director, Mary Watts recently interviewed Karen Kesten, DNP, APRN at NTI 2018 on the subject of nursing certification. Dr. Kesten is the past chair of the national board of directors for the AACN Certification Corporation, as well as an associate professor George Washington University School of Nursing. Many nursing certifications are available from AACN Certification Corp. for both RNs and APRNs. Dr. Kesten recommends certification for all nurses as a "mark of excellence and distinction." She went on to state that this proves credibility of knowledge and leads to higher patient and nurse satisfaction. New Certifications Two new certifications; CCRN-K and PCCN-K are now available. These certifications are for nurses who do not currently deliver direct bedside care but who indirectly affect patient care thru management, instruction or staff development. The "K" stands for "knowledge." This is a way for nurses to continue to use their knowledge even though they are no longer bedside. Other new certifications include palliative care, and forensics nursing. These specialties show patients and colleagues that the nurse has attained a level of expertise in their specialty. Dr Kesten foresees possible future certifications for nurse navigators and nurses who are involved in transitions of care. APRNs and the Consensus Model Advanced Practice Registered Nurses (APRNs) also need to consider the Consensus Model when choosing their educational pathway. The APRN roles are: Nurse Practitioner Clinical Nurse Specialist Certified Nurse Midwife Certified Registered Nurse Anesthetist "To help take APRN practice to the next level, AACN collaborated with over 40 nursing organizations to address the inconsistency in APRN regulatory requirements throughout the United States. The result was the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education (LACE)." The Consensus Model sought to improve patient access to APRNs, support nurses to work more easily across different states, and enhance the certification process by preserving the highest standards of nursing excellence. Through consistency and clarity of APRN Consensus Model criteria, APRNs were empowered to work together to improve health care for all." LACE also determines what patient population and focus the APRN certifications cover. This is an effort to delineate out each APRN specialty and to develop more consistency. Dr. Kesten encourages nurses to consider a primary care APRN role as nurse practitioners are in great demand especially in underserved and more rural communities. With the current physician shortage, nurse practitioners are filling many provider roles. More and more nurse practitioners are seeking roles in specialty care, which extends the availability of providers. Why Certification is Needed Dr. Kesten encourages nurses to obtain certifications. She emphasized that nurses are in a life-long learning pattern and with certification, they have more options. There are many faces of nurses so there are many certifications and she expects that nurses will have many more opportunities in the future. Dr. Kesten advocates for nurses having a louder voice in order to advocate for their patients. Overall there are many more opportunities available for certified nurses. Consider certification! References: AACN Certification Corporation APRN Consensus Model
  8. tnbutterfly - Mary

    How to Successfully Navigate NTI

    The 2018 NTI Conference is Sold Out. Join Us Next Year in Orlando. The conference this year has sold out. Registration is closed. NTI will not be accepting any additional registrations online or on-site in Boston Thrive at NTI: Some Tips for the Best Experience This year, more than 8,500 attendees are expected. The size of the conference alone can challenge NTI newcomers and veteran attendees alike. It is important to plan ahead. Use this checklist to start planning your week for a fulfilling and stress-free conference experience. Look for more tips on the FAQ page at www.aacn.org/nti. Explore My NTI and get connected. Sign in on the AACN website and use My NTI to create your schedule, plan your week and participate in discussions with facilitators and other attendees - a great forum for your questions about planning, sessions, and Boston. Organize your schedule and special events. Create your schedule on My NTI, and be sure to add a Sunrise Session to secure your seat. Reservations are required. Check if a session is offered twice or online after the conference to help you decide which sessions to attend on-site. Look for the icons in your Program Schedule or online to easily identify these sessions. Because of the high attendance, it's important to pick a second or third choice in case your first one is full. Also, pay attention to the room locations of your second and third choices so you can get there quickly. Try to pick alternatives close to your first choice. Arrive early to sessions that are a top priority for your education plan, and allow enough travel time. Please note that adding a session to your schedule is for planning purposes only and does not guarantee a seat, except for the API reception and Sunrise Sessions. All other sessions are open seating (first-come, first-seated). Please arrive early for the best opportunity to attend a session. Get NTI tips from the pros. Join NTI Program Planning Committee chairs at "Navigating NTI 101," Sunday, May 20, at 4:15 p.m. or Monday, May 21, at 8 a.m. They'll walk you through how to make NTI an enjoyable and rewarding professional experience. Take a tour of the convention center. If you arrive early, consider joining members of the NTI and API program planning committees for a tour of the convention center on Sunday beginning at 10 a.m. every 30 minutes. Familiarizing yourself with the convention center layout and key locations will make it much easier to get around quickly once the conference begins. Maximize your conference experience with the Learning Action Journal. Tools to assist you plan, learn and act on your conference education and activities are available at www.aacn.org/nti. The Learning Action Journal is included in your attendee bag. Dress for comfort and temperature shifts. Buy a pair or two of comfy shoes and break them in before the trip. Meeting room temperatures often fluctuate, so wear layers. Allow adequate travel time to Convention Center. If you are at a hotel in the downtown or Back Bay area, allow for a 20- to 30-minute shuttle ride due to traffic congestion in the city. Plan meals and snacks, and drink plenty of water. The Participant Map in your attendee bag highlights food options and hours at the convention center, but bring nutritious snacks such as fruit, granola or nuts and bottled water for your midday energy boost. Food lines in the convention center can become quite long. Explore Boston beyond NTI. The diverse neighborhoods of Boston offer endless opportunities for cultural and outdoor activities. Get started at Boston Guide | Hotels, Restaurants, Meetings & Things to Do in Boston or ask the locals at the Host Chapters Booth on-site. Enjoy a fun-filled Nurses' Night Off at Seaport World Trade Center, Wednesday, May 23, 6:30-9:30 p.m. Unwind at this Boston landmark and dance to the city's premier band, Night Shift. The evening out includes complimentary "taste of Boston" hors-d'oeuvres, coffee and tea. We'll also offer a cash bar serving bottled water, sodas, wine, and beer. Shuttle service will be provided throughout the evening. Stay and make it a vacation. With a mix of colonial charm and urban sophistication, Boston features a wealth of historical and cultural attractions. Don't miss this opportunity to experience a city offering great dining and nightlife, extraordinary shopping, exciting sporting events, and a vibrant arts and cultural community. Safe travels. See you in Boston! Source: AACN Bold Voices, the member publication of the American Association of Critical-Care Nurses.
  9. allnurses

    NTI 2018 - See you in Boston!

    With more than 37.5 continuing education (CE) contact hours, the outstanding and diverse learning opportunities and inspirational gatherings promise to reignite your commitment to your practice and our profession. Hundreds of learning activities feature the latest innovations in practice, technology, and healthcare delivery, evidence-based practice and research to meet your clinical and professional practice education needs. Connecting with friends and colleagues at special events throughout the week will round out this inspirational experience. There are more than 275 sessions. There are also 2.5 hour sessions at the mastery level. For advanced practice nurses, the Advanced Practice Institute will allow you to obtain pharmacology contacts and to build on your advanced practice nursing skills. Update your knowledge, refine your skills and learn something new in critical care. This educational conference features the latest innovations in high-acuity and critical care practice, technology, healthcare delivery, evidence-based practices and research. When and Where May 21 through May 24, 2018 Boston Convention and Exhibition Center 415 Summer Street Boston, Massachusetts 02210 (800) 899-AACN (2226) Hotel Westin Boston Waterfront 425 Summer Street Boston, MA 02210 (617) 532-4600 Here are some great memories from 2017: Education and Sessions For attendees that come early, there are pre-conferences that offer opportunities for hands-on experiences with 3- and 6-hour sessions providing deeper coverage on relevant topics. If you are an early morning person, consider the Sunrise Sessions which are funded by unrestricted grants from corporate supporters. Reservations are required. SuperSessions are where you can share the joys and challenges of caring for acutely and critically ill patients and their families with thousands of your colleagues. The keynote presentations from AACN leaders and popular motivational speakers will motivate, inspire and celebrate our profession. At the National Teaching Institute & Critical Care Exposition, there are so many educational opportunities that align with the needs of high-acuity and critical care nurses. Choose from hundreds of sessions covering 30 diverse clinical and professional development topics, and visit over 400 exhibitors at the Critical Care Exposition. Attendees practice in many areas in many diverse roles ranging from staff nurse to manager and APRN. Whether you are a new or experienced nurse, the curriculum offers in-depth content using the most up-to-date evidence-based guidelines and practice standards. The Critical Care Exposition is the largest, most comprehensive trade show for high acuity and critical care nurses. Attendees will experience hands-on interactions with exhibitors. The Critical Care Exposition offers 14 hours of exhibit time over three days, with 10 hours unopposed by clinical sessions. There is more than 300,000 square feet of exhibits including the newest equipment, devices, pharmaceuticals, supplies, and technology. Also, there are hundreds of ExpoEd education sessions where you'll receive continuing education recognition points (CERPs). And don't forget all the product demonstrations. Attendees Come to a conference where there will be over 7,000 critical care nurses. Registration and Pricing Registration is open. Register by April 4, 2018 and save $80.00 Member Pricing Early-bird full conference - $450.00 Regular full conference - $530.00 Pre-Conference - $106.00 - $212.00 Daily registration; Mon/Tue/Wed - $225.00 Daily registration; Thu - $144.00 Non-Member Pricing Early-bird full conference - $580.00 Regular full conference - $660.00 Pre-Conference - $140.00 - $280.00 Daily registration; Mon/Tue/Wed - $280.00 Daily registration; Thu - $196.00 Reservations Book your reservations today at the Boston Convention & Exhibition Center
  10. Military nurses do their jobs under periods of extreme stress - the battlefield! AACN recently published a research study that investigated the care of our service men and women from 2008 to 2014. AN was recently able to interview one of the researchers, Elizabeth Mann-Salinas, COL, USA (Ret), MSN, APRN. 1. The research study indicates that all injured servicemen and women that were transferred from Role 2 to Role 3 facilities utilized either fixed wing or rotary wing aircraft. Is the type of aircraft chosen based on patient injuries or availability of aircraft? Generally almost all transport from a Role 2 forward surgical team is by rotary wing aircraft because these teams tend to be in austere locations without a runway for fixed wind transport. A few R2 facilities were co-located with an air base so that is why we had some transports by the fixed-wing platform. What does change is the composition of the team that transports the patient, based on how critical they might be. The En Route Critical Care Nurse program was created to fill the identified gap in transporting post-operative patients. 2. In the study, 40% of the subjects did not have a defined en route care provider. Is there any thought to electronic medical records in combat? EMR is the Holy Grail of all our battlefield documentation!! So many efforts are underway to tackle this difficult problem. In combat, all communications systems are on the secure side and classified as Secret. This includes medical information, making many of the proposed solutions unworkable. The Joint Trauma System works diligently to capture as much of the data on all patient care and movement but this is such a difficult challenge given our operational constraints. Even taking a photo of the paper records and sending it back to JTS is apparently not even tenable at this time until appropriate encryption and safe transfer can be established. 3. What type of military training do the nurses that transport patients have? The JECC - Joint En Route Care Course - was created to meet the needs of the 3 services (Army, Navy, Air Force) to provide rotary wing experience for patient transport. Nurses and medics attend this course when they are expected to fulfill this mission. Critical Care Air Transport (CCAT) course is managed by the Air Force for fixed wing critical care transport teams (MD, ICU RN, RT). There is an Aeromedical Evacuation Course for nurses who care for the non-critically ill patients transported on fixed-wing aircraft, and they are also trained to serve as the operational flight crew. 4. Many of our posters are nursing students. What would be a good career path if a student wants to become a military nurse? I was recruited in 1994 out of my BSN program directly into the Army as a Nurse Corps Officer. It was the absolute best decision I ever could have made. They offered me my choice of initial duty assignment; the opportunity to specialize in either: critical care, emergency nursing, OB/GYN, behavioral health, OR (I chose critical care and attended the 4 month intensive course); and they allowed me a "sabbatical": to earn my Masters in Science as a Clinical nurse Specialist (at the University of Colorado in Denver) and then my PhD in Nursing at UTHealth - Houston. Full pay and benefits during those total 5 years of school. I attended the CCAT course and was a member of the Army Burn Flight Team for 2 years and was an amazing experience. I only retired last year to avoid another move now that my family is established here in Texas, but continue to serve as a civilian. Cannot recommend this option more to all nurses eager for career advancement, leadership opportunities, and world travel. Please encourage interested students to reach out to a Health Care Recruiter. I believe the Army, Navy and Air Force programs are very similar, just depends on what you prefer. I like being on dry land myself...... ----- Thank you so much for this informative interview Dr Mann-Salinas. AN has a robust Government/Military Nursing forum where you can find out more about nursing in the US military. Permission was granted by the Public Affairs Officer, US Army Institute of Surgical Research to reprint this PDF S315.full.pdf
  11. Nurses in Search of Pens and Other Freebies Once again the annual ritual. the countdown to the opening of the NTI convention and a sight that rivals the running of the bulls happened at yesterday morning promptly at 10:30. The team from allnurses was there to witness the event. The nurses came pouring in scurrying the aisles in an almost rabid fashion. One thing is for sure,..you better not get in the way of a nurse in search of nursey treasures. I didn't see any casualties, and I was sure to stay out of the way of the encroaching tide of nurses. Why do nurses love so many freebies, especially pens? The pens are pretty simple. Pens are essential tools for nurses, almost as important as their stethoscope. Pens get borrowed and oftentimes do not get returned. They seem to have legs of their own. At NTI, their is a virtual rainbow of pens..all types and colors and the best part, they are FREE!!! What's not to love about that. In addition, there are so many other cool giveaways that vendors have to entice you to their booths. Chocolate is always good, but most of the time, that is something that does not last not longer than 5 minutes. Nurses need the extra sugar boost to give them energy to continue the hunt. But nurses need things to take home. They can be viewed as NTI souvenirs. This year with NTI being in New Orleans, Mardi Gras beads can be found if you look hard enough. One vendor gave me the beads from around her neck, maybe in self-defense??? They are pretty cool ..bright red hearts. Perfect!!! At the same booth, another one of the exhibitor team thrust a palm-sized Nemo into my hand, telling me it was like a stress ball. What???? Do I look stressed. That glazed look in my eyes is just from being amid so many enticing booths…...and FREEBIES. I admit, I was like a kid in a candy store. Speaking of candy, the Milton S. Hershey Medical Center booth had a HUGE Hershey candy bar that caught my eye and lured me to the booth. I was disappointed to find out that they only had one... and I could not have it unless my name was selected during their drawing. I had to settle on a small Hershey Kiss instead. Every year there are a few giveaways that are a big hit... and make the gotta have list. You have to get them before they are all gone. My hunt for goodies was hampered by having to stop to actually talk to the vendors. But that is why I am there, after all. I need your help. If you have found those extra-special freebies, please post pictures here along with the booth number to help me and others find them. Be proud of the treasures you found and also help your fellow nurses who are also in the hunt. Have a great time at NTI...and be careful out there.
  12. tnbutterfly - Mary

    So You Want to Be Published: Just Do It!

    Last year at the AACN National Teaching Institute and Critical Care Exposition (NTI), I had the opportunity to interview Mary Fran Tracy, Editor of the AACN Advanced Critical Care Journal and a Critical Care Clinical Nurse Specialist at the University of Minnesota Medical Center, Fairview. Mary Fran's association with AACN spans several years beginning as a critical care staff nurse. She benefitted greatly from the resources offered by AACN. She is a former president of AACN and a board member. When her term as president ended, she became a journal editor. AACN has 3 journals. Two are members journals: The American Journal of Critical Care (AJCC) and Critical Care Nurse (CCN). Mary Fran is Editor of AACN Advanced Critical Care which is a subscription journal for the more advanced critical care nurse, critical care educators, and staff nurses who are really experienced in critical care. It is published quarterly. According to Mary Fran, "We are always looking for articles for the journal and ways for people to publish." How do nurses feel about publishing articles for AACN and how do you convince them of the importance of being published? "Each year the 4 editors have a panel discussion at NTI for people who are interested in publishing. They can come to this panel session, hear a little more about the journals, and how to get published in them. The facilitators then ask the questions... Why are you hesitant? What do you want to know about publishing? "What we frequently hear is that people think 'I'm not doing anything innovative. No one wants to hear this. It's just what everyone else is doing. I don't need to do a poster.' Then they come to NTI and 'see people presenting on what I had done, the same topic. I see a publication come out and think well really I could've written that.' So I think people tend to underestimate their knowledge, their skill, they think writing is hard. It is hard but you have to try. If you don't try, then you'll never get published. So I try to convince people they can get a start...get mentors and really they can publish. Their ideas are worthwhile to get out there because we are all struggling with the same problems. Presenting is great, but when you present you do it to a room of 50 or 100 people for one time. When you publish it's in the literature for many years for people to access." After you get them to do the initial article, how many come back and do another one? "After they publish once or twice, people sort of get a feel for it... Then they do come back, maybe not to my journal, but to other journals. People feel if they could just get mentored once or twice, then I feel like they could go mentor the next person to write an article so more people would feel more comfortable. It's the guidance... the how-to... that is overwhelming." "There is research that says the more you write, if you write every day, the more likely you are going to be prolific, and it doesn't matter whether you are a novice or an academic. You have to write, you have to do it and just keep doing it and practice and get in the mode of writing to be successful." What are you waiting for? There are always people who dream about doing things, but they wait too long and then somebody else does it. Then they think "I could've done that." Don't be the one who waits too long. Just Do It! If you are one of those nurses who has been hesitant to follow your dream of being published and would like some help, NTI will be having 2 sessions on publishing. Publishing In AACN Critical Care Journals - Monday, May 22, 12:15 pm - 1:15 pm Writing for Publication: Demystifying the Publishing Process - Tuesday, May 23, 11:45 am - 2:15 pm If you cannot attend NTI this year, feel free to post your questions in our Innovators Hub here on allnurses. Some of our published writers will be glad to assist you.
  13. The American Association of Critical Care Nurses (AACN) has recently published a new guideline regarding the importance of obtaining accurate non-invasive blood pressure (NIBP) readings and problems that can ensue. How to obtain accurate NIBP readings: 1. Measure BP in the upper arm (between the shoulder and the elbow) using the oscillatory or auscultatory method. 2. Use appropriate-size BP cuff and follow instructions for fit and placement per manufacturer's guidelines. a. If upper arms cannot be used for BP measurement or if the maximum size BP cuff does not fit the upper arm, BP may be measured in the forearm. b. Consider use of thigh and calf for BP measurement if the upper arms and forearms cannot be used. 3. Measure baseline BP in both upper arms. For clinically significant differences in BP (>10 mm Hg), use the arm with the higher pressure. 4. Positioning of patient: The appropriate reference level for NIBP measurement is the heart. a. Patient should be seated with back and arms supported, feet on floor, and legs uncrossed with upper arm at heart level (phlebostatic axis: 4th intercostal space, halfway between the anterior and posterior diameter of the chest. b. If patient cannot be seated, position patient supine or with head of bed at a comfortable level and with upper arm supported at heart level. 5. The patient and the caregiver should not speak while BP is being measured. 6. Minimize complications by using the maximum (least frequent) NIBP cycle time for the shortest time period and by ensuring proper cuff placement. Patient conditions that affect NIBP readings: Stiffness of the arteries, particularly in older patients can nfluence amplitude of the oscillations and may cause underestimation of mean arterial pressure. Accuracy of the automated device may also be limited if patients are hypertensive, hypotensive, and/or have cardiac dysrhythmia. Some precautions: Do not place BP cuff over a bony prominence Do not allow BP cuff to over-inflate - set the parameters of the BP cuff machine no higher than 200mm hg unless patient with known BP higher than this. Set the BP machine interval to what is required by patient condition. If patient is stable, do they need a BP reading every 15 minutes or is every 30 minutes adequate. Remove the BP cuff when not needed for serial readings. Do not take BPs in the arm of a patient with a dialysis access or in the affected arm of a mastectomy patient. Correlate the BP to the patient... If you get a measurement of 60/30 and the patient is awake, alert and talking to you and the last BP was 130/80, consider repositioning the BP cuff and obtaining another reading. For patients with known high BP, a reading of 220/110 is still cause for concern - again always assess your patient. Complications of NIBP... Skin irritation and possible skin breakdown due to frequent NIBP cuff inflation Artificially inflated BP readings if cuff inflates, deflates and reinflates repeatedly Patient discomfort if cuff inflates too high Importance of accurate readings... Hypertension is one of the leading causes of heart disease in the US. The American Heart Association recommends home blood pressure monitoring for patients with known hypertension. It is equally important that the nurse know how to teach patients to do home BP monitoring. Remind patients to take their BP at approximately the same time each day and take all their meds as prescribed. Also, keep a log of BPs and bring it with them to their next appointment. Maintaining accurate BP readings allows providers to have knowledge that will guide them to prescribe the correct medications in order to control your patient's blood pressure. Maintaining good BP control decreases the risk of end-organ damage caused by hypertension and increases the likelihood of excellent BP control. References: AACN Practice Alert, 2016 American Heart Association, Home Blood Pressure Monitoring, 2015
  14. Marian Altman RN, MS, CCRN-K, CNS-BC, ANP is a Clinical Practice Specialist at AACN (American Association of Critical-Care Nurses) who works with the AACN Clinical Scene Investigator (CSI) Academy, a 16-month nursing leadership and innovation training program to empower hospital-based staff nurses as clinician leaders and change agents whose initiatives measurably improve patient outcomes and hospital bottom lines. CSI projects have dealt with Behavioral/Psychosocial, Cardiovascular, Infectious Disease, Pulmonary, and Patient Safety Issues. Marian facilitated a series of sessions at NTI focused on how to impact change on your unit, particularly as it relates to implementing evidence-based knowledge or best-practices. Some of the topics covered were Key concepts of a change project. Team roles and their impact on project outcomes. Social entrepreneurship and how to apply the concepts to a nursing change project. How to apply the steps of Kotter's Change Theory to a nursing change project. Components of an Influence Map and how to apply to a project. The difference between process and outcome measures and how they relate to clinical outcomes and change initiative. How to quantify the fiscal impact of a practice change. How to apply components of a logic model and drill down plan. Redosing strategies that lead to sustaining a change project. How to scale a project to another unit, hospital-wide or system-wide. Methods to disseminate project outcomes. Components of innovative project management. How to develop, plan and implement an innovative project that targets a patient/family or clinical outcome on the unit. Using tools from the CSI Academy to create measurable improvements in patient/family, clinical or organizational outcomes. In a recent NTI allnurses interview, Marian Altman answers the following questions: What is a change agent? How can nurses be effective change agents? What are some challenges or obstacles to accepting change? What are some important skills nurses learn in the CSI Academy? How can nurses use innovation to create business opportunities that benefit patients? Define social entrepreneurship and describe how to apply the concepts to a nursing change project.
  15. traumaRUs

    National Teaching Institute - NTI 2017

    Join AACN as they sponsor the 2017 National Teaching Institute and Critical Care Exposition (NTI) May 22-25th (preconferences May 21st) in Houston, Texas. Why should I attend? This conference will provide you with evidence-based knowledge, networking opportunities, a view of the latest in critical care developments and a chance to hone your skills. With up to 37.5 hours of continuing education (CE) available, you will have many diverse topics and discussions to experience. There are additional CE hours available via online self-study sessions both during and after the conference. Educational sessions There are more than 300 educational sessions offered this year that span a wide range of topics including the following. For the medical/cardiac critical nurse, there are offerings for hemodynamic monitoring, ECMO, sepsis guidelines review, cardiac surgery, and arrhythmias. Pain management, end-title CO2 monitoring sessions are also available. Trauma nurses aren't left out either. There are sessions about multi-organ system failure in the trauma patient, fevers, and pharmacology among others. We all worry about documentation, too much, too little, what to chart? There will be sessions about the legal scope of practice, drug diversion, critical thinking and how to avoid cognitive errors as well as information about medical marijuana. Networking is a big part of NTI but how to do it successfully? Sign up for the Art of Professional Networking session. For the pediatric critical care nurse, there are sessions about child abuse, street drug use, pediatric shock states, poisoning, and early mobilization of the pediatric surgical patient as well as ECMO use for pediatric patients. Career enhancement is important - where to go, what certification to obtain, what educational opportunity to sign up for? If these are your concern, then the session Creating a Unit Culture of Professional Advancement is for you. Here's the important information you will need to take advantage of this prestigious critical care conference. Register by April 5th to take advantage of the early-registration discount. Networking While the CE offerings are a tangible reward for attending a conference, the networking and fun that you will enjoy are sometimes of even higher worth. Being a critical care nurse is a tough job - take this time to de-stress, relax, meet new friends, and renew old friendships. Networking is one of the best reasons to attend NTI 2017. With over 8000 participants, you will surely find other nurses in similar circumstances. The informal atmosphere of NTI easily lends itself to forming bonds with other critical care nurses. Innovative exhibits NTI is easily one of the best conferences in the US. With a wide variety of educational offerings and an exhibition hall that rivals a huge nursing mall, NTI is THE conference to attend. This year there will be over 400 exhibitors in the Exhibition Hall ranging from educational institutions, hospitals and facilities looking to fill vacancies, to product demonstrations, and other critical care related items. Some of the new and different exhibits for 2017 that are sure to draw a crowd: LTACH area Therapy dogs Body Intact from the University of Texas- a digital body that nurses can interact with to play out real situations. Certification Certification shows you have mastered a level of competence in critical care. The Certification Oasis offers a place to rest between sessions and there are informed AACN personnel who can answer your certification questions. There are also sessions devoted to mastering certification exams. FUN And when you have down time? Well, Houston has a lot to offer. It is a financial hub as well as home to the aerospace industry there is much to do and explore while you visit this beautiful city. Celebrate and enjoy a spectacular Nurses' Night Off at the Houston Museum of Natural Science. NTI Frequently Asked Questions If you've never attended NTI, you might have questions like the following: How do I register for NTI? How do I register for Sunrise Sessions? How do I make changes to my registration after I have registered? Can I register on-site? Can I bring my kids or a guest to NTI? How do I plan my schedule? For the answers to these and other questions about the conference, go here. For answers about how to get to Houston or where to stay - Click here. The convention center is huge so knowing where to go and how to get there is also important - you don't want to be late for that much-anticipated conference session. This link will help you to navigate the convention center. Take advantage of this opportunity; come to NTI 2017 where you will learn, laugh and enjoy several days of learning and fun! Register today.
  16. Critical care nursing changes fast! Keeping up with the ever increasing changes challenges all of us. Who has time on a busy shift to read a journal or listen to a podcast? So, why not get away from your unit, come to a conference where there will be over 8,000 critical care nurses? And...that conference is AACN's National Teaching Institute - NTI 2017. Of course, its not as easy as getting on a plane and jetting off to Houston, Texas. Lets get the steps in order. How to pay for the conference? Conferences are expensive. Do you receive educational money from your organization? Are there scholarships available? Some ways I've come up with the money in the past for conferences: 1. When the organization offered educational money for school, I've pitched the idea of using some of that money for a conference. 2. I offer to conduct bite-sized educational pieces to the unit in exchange for conference cost. These have included bathroom/locker room poster presentations, short spiels at shift report, and a presentation at a monthly unit meeting. I've also worked on updating policy and procedure books to reflect current practice. NTI offers an "Action Pack" which is a take-home toolkit to easily share with your unit co-workers. 3. Shared costs with a co-worker. I've driven to conferences (when reasonable) to cut costs and shared a hotel room. 4. Combined a conference with a family vacation. My husband and I are actually doing this soon. 5. NTI offers a ready-made packet to justify the expense and emphasize the benefit that the conference will have for the entire unit. I've used these in the past also. 6. Look at the costs of a one or two day attendance. Now...you are ready to go...or are you? 1. The earlier you register, the best chance you will have to pick the sessions you want to attend and get the best hotel rate. If possible, I try to register in the "early-bird" period in order to have the best picks. I peruse the topics to see what interests me or which speaker I would most like to hear. NTI offers pre-conference sessions as well. These can be great opportunities to network and further hone skills or delve in-depth to a subject. 2. A word about hotels: try to get a room at the conference hotel. NTI has convention housing management which will help to guide you to a hotel. 3. Transportation: start scouting flights as soon as you decide where/when you are going. On most travel sites you can set alarms so that you are notified when a price drops. NTI also offers an airline discount code. 4. Cancellations: Invest in travel insurance. This will cover (depending on the policy of course) your flight and hotel if you have an emergency and can not attend. You've arrived Save your receipts. If you are not reimbursed by your organization, these expenses can be tax deductible. Check into your hotel and obtain a map of the hotel and surrounding area. Where are the restaurants? The sites of interest locally? If you are not in the conference hotel, plan now on how to get to the conference sites. Ask the hotel concierge how much time should you allow to get to the conference? If you are taking a cab, find out approximately the cost BEFORE you engage their services. Is mass-transit available and convenient? If other attendees are in the same hotel, is there a conference shuttle, can you share rides and split the cost? NTI has a shuttle service to and from many local hotels. Expect to do a lot of walking so wear comfortable shoes. This might be the most important tip of all! Eat a protein-filled breakfast to power you thru the morning sessions. Bring snacks that can be eaten on the run. For lunch, the conference food stands and restaurants can often be over-run. They may not be open all day either. Perhaps grab lunch on one of your earlier breaks instead of the traditional lunch time. Use your lunch time wait to network and talk with others in line - maybe arrange to get together for dinner to discuss the conference, their work environment. Ask if they have attended the conference before and if yes, what are their tips? And don't forget to explore Houston! Most of all...enjoy yourself, learn something new, get refreshed and take back some knowledge to your unit. Have a great conference experience! We'll see you there!
  17. Why do we do what we do? For many reasons: we are professionals with a job to do and we've gone to school to learn what we do. Most of all...we do what we do because we care! And..in an effort to improve ourselves, we come to NTI to learn more, to network, and to immerse ourselves in the latest technology and research. So...to that end...we are going to talk about sudden cardiac death. Not the most fashionable topic at hand, but one most of us have experienced. But first.... What kind of car do you drive? A sturdy 4-door sedan that has 243,000 miles on it but still runs? A pick-up truck with full bed? A convertible? A mini-van? What brand do you drive? Ford, Chevy, Toyota, Kia, Subaru, BMW or a Cadillac? Some cars are synonymous with certain images: a mini-van with a family, a convertible with a free spirit and a Cadillac with someone who likes the finer things in life. Aw...but in this article, being a Caddy is not what you should aspire to be and I'll tell you why. What is sudden cardiac death? From the National Institutes of Health, "sudden cardiac death is a condition in which the heart suddenly and unexpectedly stops beating. If this happens, blood stops flowing to the brain and other vital organs". That sounds simple enough, right? However, the "why" behind it is not always so simple. Sudden cardiac death (SCD) is thought to arise from an arrhythmia. However, it has been documented to happen in previously healthy individuals as well. SCD strikes more than 500,000 people per year. It is the third leading cause of death in the US. In-hospital cardiac arrest accounts for 209,000 pts per year. Survivability of these in-hospital cardiac arrests is 24%. Overall, a shockable rhythm was only present in 17% of these cases! You can't shock what you don't have... It's important that we have a scorecard to risk stratify patients who might have an SCD while on our watch. The Cadillac Risk Score The components of the Cadillac Risk Assessment Score Some risk factors are modifiable: Smoking Weight Hypercholesterolemia High blood pressure Diabetes And some...unfortunately are not: Age Family history Ethnicity As nurses, we like to use scorecards and the Cadillac Risk Score is one we should be familiar with as it can alert us to impending danger! References Cadillac Risk Score Killip Class Calculator National Institutes of Health

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