AACN News—December 2004—Association News

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Vol. 21, No. 12, DECEMBER 2004

Be a Vision Partner
Share the NTI Experience

Do you plan to attend AACN’s National Teaching Institute and Critical Care Exposition, May 7 through 12 in New Orleans, La.? Consider applying for a Vision Partners scholarship, which will not only provide you financial assistance but also extend the influence of AACN to nonmembers.

But don’t delay. Applications are due Jan. 15.

The AACN Vision Partners program grants $1,000 each to 10 pairs of NTI participants. One partner must be an AACN member, who will share the NTI experience and benefits of AACN membership with the other partner, a nonmember who has not previously attended the NTI. The nonmember also receives a one-year AACN membership.

The nonmember partner should be able to share a different perspective with his or her partner, such as a different cultural or ethnic viewpoint or another discipline or clinical practice along the continuum.

The Vision Partners scholarship application asks the partners to describe how they expect to benefit from the learning experience and networking at NTI. They will also commit to continuing to develop the partnership after they return to their workplaces.

For more information, call (800) 394-5995, ext. 204. Apply online.

Societies Collaborate to Address Prominent Issues
Summit to Identify Best Practices in Critical Care Medicine

AACN is joining with the American College of Chest Physicians-Critical Care Institute and the Society of Hospital Medicine to develop a nationwide critical care collaborative of societies that believe the care critically ill patients should receive must be patient-focused, collaborative and go beyond the ICU.

Utilizing experts from disciplines in and outside of medicine, the collaborative plans to form a task force to develop a critical care summit to identify best practices in critical care medicine for the development and refinement of multiprofessional models of patient care.

Formation of the collaborative arose at the initial meeting of the ACCP-Critical Care Institute, of which AACN is a founding
partner. The ACCP-CCI was established as a center of excellence to house programs and initiatives related to critical care medicine. With the help of AACN and other strategic partnerships, the ACCP-CCI will utilize a multidisciplinary team of experts and resources to address and anticipate challenges in critical care medicine for both healthcare professionals and patients.

In addition to ACCP-CCI, AACN, ACCP and SHM leaders, representatives of the American Society of Health-System Pharmacists, the National Association for Medical Direction of Respiratory Care and the Illinois and Florida state Societies of Respiratory Care attended the meeting.

“The development of the ACCP-CCI not only illustrates the college’s important role as a leader in critical care medicine, but also reinforces our commitment to practicing collaborative, patient-focused care,” ACCP-CCI Chair Curtis N. Sessler, MD, FCCP, said.

The ACCP-CCI will address critical care issues, including the critical care workforce shortage, medical errors and patient safety, and rising costs by building on existing critical care educational programs and products, as well as by developing new critical care programs and products. Through strategic partnerships, the ACCP-CCI will provide leadership in promoting collaborative interprofessional patient-focused care to influence the culture of critical care medicine in the United States.

“Healthcare organizations and government institutions have emphasized the urgency of the critical care workforce shortage and corresponding patient safety issues,” said Richard S. Irwin, MD, FCCP, immediate past ACCP president. “These issues will affect professionals in nearly every healthcare specialty, making it essential for an interdisciplinary model of collaboration in addressing these imminent concerns.

“Through the combined talents of ACCP and AACN members, and other healthcare organizations, the ACCP-CCI will develop and support educational and advocacy initiatives that focus on the specific challenges facing critical care professionals and patients and American medicine as a whole.”

“This Critical Care Institute represents the type of forward thinking needed in the care of the critically ill patients for decades,” said AACN President Kathy McCauley, RN, PhD, BC, FAAN. “AACN applauds ACCP’s vision and looks forward to a continued strong partnership on behalf of the patients and families we serve.”

Tips for Submitting a Successful NTI Speaker Abstract

By Nancy Munro, RN, MN, MS, CCRN, APRN, APRN-BC
NTI Work Group

Have you been the recipient of the dreaded NTI speaker rejection letter? Although I will admit I have received that letter, I will not divulge how many times!

Because I thought I had been diligent and tended to every detail, I was extremely disappointed when I received those letters. What had I done wrong? I now realize that I did not do anything wrong. I just didn’t fully understand the NTI speaker selection process.

Serving as a member of this year’s NTI Work Group has given me greater insight into the process. The group met in August to choose the speakers for NTI 2005 in New Orleans, La. Although the task was not easy, it was worth the hard work. Following is information about the selection process to help you better understand the most important components of a successful NTI speaker abstract.

Submit an Abstract
The process begins with submitting an abstract. You can now submit your abstracts online via the AACN Web site (www.aacn.org). This mechanism proved popular, because AACN received the largest number of abstracts ever submitted for an NTI (1,038). From them, 200 were to be selected.

Reading every abstract and then grading them according to specific criteria was a daunting task. We received our copy of the abstracts in June, giving us two months to review and choose the 200 best ones. One of the biggest challenges was that some topics were more popular than others, so that only those that we considered outstanding or that offered a different perspective were chosen. As the work group came together to read and discuss the abstracts over two days, identifiable characteristics of a great abstract began to emerge. A “Top Ten Tips for NTI Speaker Success” list evolved and will hopefully serve as a guide for achieving NTI speaker status.

Top 10 Tips
1. When deciding on a topic, choose a less popular one, such as endocrine or renal, where there will be less competition. Don’t wait until the night before the deadline to decide on a topic. Take time to research a topic and focus on unique aspects.
2. Start early. When a large number of abstracts must be reviewed, quality of content is a top criterion.
3. Carefully read the directions for abstract submission and meticulously complete each step. The online process can make proper formatting a challenge. Use your computer to check grammar, spelling and other technical aspects.
4. Use your word processing program’s “cut and paste” function. After writing the abstract and checking that the details are correct, “paste” it into the appropriate area on the submission form.
5. Remember that length is not synonymous with quality. Try to summarize the theme of the abstract immediately and state it clearly.
6. As you finish writing the abstract, begin to consider what the title should be. Although you want the title to be “catchy,” it should reflect the content. A “catchy” title that is misleading may actually detract from your abstract. The title is the introduction to your abstract.
7. Consider using different formats for the topic you are interested in presenting. Panel discussions, pro and con debates and the three-hour comprehensive mastery sessions are examples of different formats that could enhance the presentation.
8. If you are a novice speaker and know an experienced speaker that you respect and admire, ask that person to mentor you through this process. The accomplished speaker can also use this avenue to help develop the hidden potential of a colleague.
9. Don’t limit yourself to one topic and abstract. Submit several on different topics.
10. If at first you don’t succeed, try, try again…with the rest of us! Good luck with your abstract submissions for 2006.

Members of the NTI Work Group are (from left) Carol Goodyear-Bruch,
Kristine Peterson, Marcheta Lynn Rodgers, Alisa Shackelford, Dennis
Cheek, Karen McQuillan, Nancy Munro, Shawn McCabe, Justine Medina,
Lisa Gingerich, Linda Bell and Bonnie Baker.

Submit Abstracts Online for NTI 2006

June 1 is the deadline to submit speaker proposals, including chapter-related proposals, for NTI 2006, May 20 through 25 in Anaheim, Calif. Abstracts can be submitted online.

Circle of Excellence Awards Nominations Open Jan. 15

AACN will begin accepting nominations for its 2006 Circle of Excellence Awards on Jan. 15.

Recipients of these awards will be recognized at AACN’s National Teaching Institute and Critical Care Exposition, May 20 through 25, 2006, in Anaheim, Calif. In addition, all recipients are presented a personalized plaque. Some also receive honorariums, monetary awards or complimentary registration to the NTI.

Following is a list of the awards that will be available:
• 3M Health Care Excellence in Clinical Practice Award, sponsored by 3M Health Care
• AACN Value of Certification Award
• Baxter Excellence in Patient Safety Award
• Dale Medical Products Excellent Clinical Nurse Specialist Award
• Datascope Excellence in Collaboration Awards with awards in four categories:
Nurse-Physician Collaboration, Nurse-Administration Collaboration, Nurse-Family Collaboration and Multidisciplinary Team Collaboration
• Eli Lilly & Company Excellent Preceptor Award
• Excellence in Caring Practices Award
• Excellence in Clinical Practice—Non-Traditional Setting
• Excellence in Education Award
• Excellence in Leadership Award
• Excellence in Research Award
• Excellent Nurse Manager Award
• Excellent Nurse Practitioner Award
• Excellent Nursing Student Award
• Marsh-AACN Community Service Award (cosponsored by Marsh Affinity Group Services, a service of Seabury and Smith)
• Media Award
• Mentoring Award
• Research Abstract Award

Additional information about these recognition awards will be presented in the January 2005 issue of AACN News. The deadline to nominate yourself or a colleague is July 15.

ECCO Survey Reveals Satisfaction, Trends in Usage

A recent Web-based survey of administrators and managers who use AACN’s ECCO (Essentials of Critical Care Orientation) with their nurses provided insight into the effectiveness and benefits of the program.

Responses came from throughout the United States, as well as international sites.

Most respondents (58.3%) listed their facilities as nonprofit community hospitals. Other responses were from military/government hospitals (9.9%), for-profit community hospitals (8.7%), university hospitals (8.3%) and health systems (7.5%).

With respect to size, most facilities listed their number of licensed beds as between 100 and 199 (21%). This was followed by between 200 and 299 (17.1%), 300 and 399 (16.3%) and 400 and 499 (11.7%).

Most facilities (20.6%) hire approximately six to 10 new nurses each year.

Overall, almost 80% of respondents said they were “satisfied” or “very satisfied” with the content included in the program. Approximately 70% said they were “satisified” or “very satisfied” with the presentation. Almost 70% of the respondents said they were “satisfied” or “very satisfied” with the level of interactivity the program affords.

Although the vast majority of respondents said they used ECCO for new-hire orientation, other uses were cited. (See Table) The amount of time students spent with the program each week varied, though most indicated between seven and eight hours to nine or more hours per week (see Figure).

Scene and Heard

AACN continues to seek visibility for our profession and the organization. Following is an update on recent outreach efforts.

Our Voice in the Media
Wall Street Journal (Oct. 12, 2004)—An article titled “Hospitals Let Families Witness Procedures” addressed the issue of family presence. The article stated, “Although the American Medical Association has yet to take a position on the issue, the American Association of Critical-Care Nurses and the Emergency Nurses Association both support family presence.”

Washington Post (Sept. 18, 2004)—An article titled “Alexandria Hospital to Create a Virtual ICU” announced that ICU patients at Inova Alexandria Hospital in Alexandria, Va., will be monitored continuously via electronic equipment such as digital cameras and microphones. Justine Medina, RN, MS, AACN’s director of professional practice and programs, was quoted as saying that “nurses have received the systems well when they have been installed in other hospitals around the country.” The article was picked up by a number of other media outlets, including the Critical Care Forum, Forbes.com and Dallas County News.

Nursing Spectrum (Sept. 20, 2004)—“Their Biggest Fan” was the title of an
in-depth interview with AACN President Kathy McCauley, RN, PhD, BC, FAAN. Responding to a series of questions, McCauley discussed a variety of issues, including AACN’s policies and positions, and her “Live Your Contribution” theme for the year. “We made the decision that AACN was going to be invested in the education of its members—and that’s always what we’re going to be about,” she was quoted as saying. Also included was a section with information on AACN’s history and mission.

Advance Online (Sept. 27, 2004)—An article titled “Leading the Way” highlighted McCauley’s background and how she became interested in nursing. The article noted “in her capacity as president of AACN, Dr. McCauley plans to carry her ‘Live Your Contribution’ message to critical care nurses throughout the country.”

Journal of the Association of Nurses in Aids Care (January/February 2004)—“The Value of Certification in HIV/AIDS Nursing” was the title of an article that included numerous references to AACN and its white paper, “Safeguarding the Patient and the Profession.” The writers noted that AACN’s white paper “highlighted the importance of certification in nursing as a process of validating specialized knowledge, skill, and experience essential in today’s healthcare environment in which ‘consumers have become more informed and involved in their healthcare.’”

Minneapolis-St. Paul Star Tribune (Sept. 10, 2004)—“Playing a Critical Role” was the title of an article tracing the evolution of critical care nursing as a specialty since the 1950s and establishment of the first ICUs. AACN was cited as a source. Laurie Ruff, a critical care nurse at Methodist Hospital, St. Louis Park, Minn., was quoted as saying that CCRN certification is “a mark of professionalism.”

Post and Courier Charleston.net (Oct. 3, 2004)—An article titled “Hospitals Extend Patient Visiting Hours” indicated “there is a growing movement across the country to open up ICU visiting hours, as more healthcare experts realize that family members can help, rather than hinder, the care of patients.” Medina was quoted as saying that “patient outcomes are improved when family visits are more open and relaxed. Families feel better about the care their relatives receive.”

Advance Online (Sept. 27, 2004)—An article titled “Information Anytime, Anywhere: Wireless Technology Has the Potential to Dramatically Impact Nursing” reported that AACN “has established a PDA center on its Web site that allows nurses to purchase downloadable patient-management software with a wide range of topics from clinical reference guides, advanced cardiac life support arrhythmias and assessment reference material.”

Nursing Spectrum (Oct. 4, 2004)—“Making Progress in Health and Health Care” was the title of an article that included quotes from Ray Quintero, RN, MSN, CCRN, and Diane Salipante, RN, APRN-BC, MS, CCRN, both members of AACN’s former Progressive Care Task Force, and Karen Harvey, RN, MSN, AACN certification specialist. Louise White, RN, chief nursing officer at Eisenhower Medical Center in Rancho Mirage, Calif., said, “The work the nurses do fits in with AACN’s description of progressive care. They care for patients formerly admitted to an ICU, but who now go to a step-down unit to receive highly trained nursing care according to patients’ needs.”

Our Voice at the Table
AACN board member Denise Buonocore, RN, MSN, CCRN, APRN, BC, and board Treasurer Mary Holtschneider, RN, BSN, MPA, EMT, attended a meeting of the American Nurses Association-Specialty Nursing Association Partners in Geriatrics in New York City. The goal was to obtain feedback regarding the Nurse Competence in Aging program and ways to enhance a commitment to geriatrics within specialty nursing associations, encourage gerontological nursing certification and provide an online resource (www.GeroNurseOnline.org), which will incorporate geriatric issues specific to specialty areas.

AACN board members Denise Buonocore (left)
and Mary Holtschneider represented AACN at
the American Nurses Association-Specialty
Nursing Association Partners in Geriatrics.

McCauley was joined by AACN CEO Wanda Johanson, RN, MN, President-elect Debbie Brinker, RN, CNS, MN, MS, CCRN, and Medina at a planning meeting hosted by the American College of Chest Physicians Critical Care Institute, of which AACN is a founding partner. The purpose of the meeting was to establish a multiprofessional collaborative to advance patient-focused care of acutely and critically ill patients. In addition to leaders from ACCP and AACN, representatives of the Society of Hospital Medicine and health system pharmacists, medical directors and respiratory care practitioners attended the meeting. (See related story, page 1)

Several AACN members attended the eighth annual Magnet Conference in Sacramento, Calif., which was hosted by the American Nurses Credentialing Center and University of California-Davis Medical Center. Representing AACN were AACN board members John Dixon, RN, MSN, Carol Puz, RN, BSN, MS, CCRN, and Nancy Blake, RN, MN, CCRN, CNAA, and Nominating Committee member Natalie Correll-Yoder, RN, CNS, MS, CCRN, CCNS. Approximately 2,000 representatives of facilities that have achieved Magnet status or that are seeking Magnet status attended.

Ramon Lavandero, RN, MA, MSN, FAAN, AACN’s director of Development and Strategic Alliances, attended the 12th annual Indiana University Nursing Gala, in Indianapolis, where AACN member Diane M. Billings, RN, EdD, FAAN, chancellor’s professor of nursing and associate dean for teaching, learning and information resources, received the Emily Holmquist Lifetime Achievement in Nursing Award. Billings was honored for her innovative and pioneering contributions to distance and electronic learning for nurses.

Chris Alvarez, AACN marketing communications manager, attended the Oncology Nursing Society’s Media Cooperative Summit at ONS headquarters in Pittsburgh, Pa. Representatives from other healthcare organizations, including the American Nurses Association, American Association of Nurse Practitioners and Association of Women’s Health Obstetric Neonatal Nurses, also attended. The summit focused on improving media coverage of nurses and nursing issues, creating successful public relations campaigns and cultivating more positive images of the nursing profession.

“Live Your Contribution” was the title of a speech delivered by Brinker at the Southeast Connecticut Chapter’s fall kickoff meeting in New Haven. More than 100 nurses attended the meeting, including pediatric nurses, progressive care nurses, novice nurses, advanced practice nurses and nurse managers. Brinker and Buonocore also provided an AACN update.

Brinker gave the keynote address on “Creating a Positive Culture Through Mentoring” and a clinical speech on “Hematology Oncology Case Studies” at the Peninsula Chapter symposium, in Newport News, Va. She also presented an AACN update, including information on the new cardiac medicine and cardiac surgery subspecialty certification exams, which will be launched in January. Denise Thornby, RN, MS, past president of AACN and a current Ethics Work Group member, spoke on “Coaching Others for a Higher Level of Performance.”

Katie Schatz, RN, MS, MSN, APRN, NP, NP-C, Region 18 chapter adviser, facilitated a Region 18 meeting in Seattle, Wash. Schatz, Brinker and AACN Certification Corporation board member Michael Day, RN, MSN, CCRN, also presented an AACN update, with details on the new cardiac medicine and cardiac surgery subspecialty exams.

Brinker attended the Mount Rainier Chapter symposium in Seattle. Tom Ahrens, RN, DNS, CS, a past AACN Board member, and Gladys Campbell, RN, MSN, past AACN president, were guest speakers. Brinker presented the keynote address titled “Live Your Contribution.” Discussions included creating unit cultures and taking accountability for one’s own practice.

If you or your chapter has reached out to the media or other groups to promote critical care nursing, we’d like to know. E-mail your information to Judy.Wilkin@aacn.org.

Making Critical Links
Annual Membership Campaign Tops 2,000 Mark

Barbara S. Frey, RN, ADN, AA, of Corpus Christi, Texas, continued to build her lead in October in AACN’s Critical Links Member-Get-A-Member Campaign, adding five new members to boost her total to 46 new members recruited.

Since the drive began May 1, a total of 2,119 new members have been recruited by 669 individuals and chapters. The campaign ends March 31.
An impressive October effort to recruit 31 new members boosted Stacey Bigenho, RN, ADN, of Paducah, Ky., into second place in the campaign. Bingenho’s total now stands at 32 new members recruited. And, Phillip Y. Parcon, RN, BSN, CCRN, of Beaumont, Texas, debuted in the campaign in October with an impressive 15 new members recruited.

Catherine L. Maurer, RN, BSN, CCRN, of Kingsburg, Calif., Elaine D. Mayo, RN, MS, MSN, of Newport News, Va., and L. Jennifer McFarlane, RN, CNS, MS, MSN, CCRN, of Pasadena, Calif., also posted impressive numbers during October. Maurer recruited seven new members and Mayo eight new members, to bring their totals in the campaign to 14. McFarlane recruited six new members to boost her total to 12.

Charlene J. Cink, RN, BSN, BA, CCRN, of Richardson, Texas, Becki L. Fuzi, RN, CNS, MSN, CCRN, PCCN, of Warrenton, Va.; and Dawn Kregel, RN, BSN, of Denton, Texas, were in a three-way tie for third place in the campaign, each with 18 new members recruited.

Other leading campaign totals belong to Leslie A. Swadner-Culpepper, RN, MS, MSN, CCRN, CCNS, of Macon, Ga., Sandra J. Cornish, RN, BSN, CCRN, of Concord, Calif., and Kerin A. Da Cruz, RN, of West Kingstown, R.I., (all at 17); Maria A. Nicasio, RN, BN, BS, CCRN, of Houston, Texas, (16); LaVern Allen, RN, BSN, of Paterson, N.J., Magdalena Ella Monahan, RN, MN, MS, MSN, CCRN, of Columbus, Ohio, and Kathleen M. Richuso, RN, MS, MSN, of Chapel Hill, N.C., (all at 15); Catherine A. Harmer, RN, ADN, BS, MPH, CCRN, of Wayne, Pa., and Cindy D. Kamara, RN, BS, BSN, of Brighton, Minn., (both at 14); Cheryl S. Duran, RN, BSN, CCRN, of Tijeras, N.M., (13); Fredda Kermes, RN, BSN, of Lakeside, Ariz., Ngozi I. Moneke, RN-BC, BSN, CCRN, of Freeport, N.Y.; and Nancy Seskes, RN, ADN, of Nashua, N.H., (all at 12); and Pauline J. McNeece, RN, MS, MSN, CCRN, CCNS, of Pembroke Pines, Fla., and Angela Turner Konrath, RN, of Houston, Texas, (both at 11).

A complete list of Critical Links campaign totals through October is available online at www.aacn.org.

The Rewards
The Critical Links campaign offers valuable rewards to participants, including a $1,000 American Express gift check that will go to the top recruiter. However, anyone who recruits just one new member receives an AACN clinical- or practice-related gift. For every five new members recruited, participants receive a $25 gift certificate toward the purchase of AACN products or services. Recruit a total of 10 new members and receive a $50 gift certificate.

In addition, recruiters are eligible for a monthly drawing to receive a $100 American Express gift check in each month that they recruit a new member.
Lucinda Camacho, RN, BSN, BA, CCRN, of Beaumont, Texas, won the gift certificate for October.

At the end of the campaign, every recruiter who enrolls at least five new members will be entered into three drawings for grand prizes of $500 American Express gift certificates.

Note: To qualify for the prizes and drawings, new members must include the recruiter’s name and chapter, when applicable, on the “referred by” line of the application.

Award Recognizes Collaboration by Nurses

Editor’s note: Part of the AACN Circle of Excellence recognition program, the Excellence in Collaboration Award is sponsored by Datascope Corporation to honor innovative contributions to collaborative practice by nurses who care for acutely and critically ill patients and their families. Following are excerpts from the exemplars submitted in connection with these awards for 2004.

Nurse-Family Collaboration

Sherry Denton, RN, BSN, CCRN
Dallas, Ga.
Wellstar Health Systems
In my position as critical care liaison nurse, I assess patients who are possibly facing the end of life. I vividly recall working with a 42-year-old male patient with metastic lung cancer. He was doing poorly on bipap, struggling to breathe.

The staff nurse told me that the physician had stated the patient wanted “everything done.” In my experience, physicians often say that when the patient hasn’t been given all the options or information. I arranged a family conference, attended by the physician, the patient’s four brothers, the staff nurse, the social worker, the chaplain and me. After the physician explained the situation to the patient’s brothers, we all went into the room to talk to the patient. The physician explained to the patient that mechanical ventilation would do nothing to cure his illness. We also explained to the patient that he would be sedated with a tube in his throat, and he would not be able to communicate with his family.

We were honest with him, explaining that he would die from his illness regardless of whether he chose life support measures. We also made it clear that, if he chose no life support measures, we would not let him suffer or struggle to breathe. As the patient started to cry, his brothers gathered around and held his hand. We left them alone in the room.

The patient and his family decided to discontinue the bipap. He was started on a morphine drip, and he died that night peacefully with his family at his bedside. I feel extremely blessed to be able to help patients achieve a peaceful death.

Nurse-Administration Collaboration

Kay Clevenger, RN, MSN
Indianapolis, Ind.
Clarian Health Partners
Indiana University Hospital
Champion of nurse Satisfaction and unit success is how I view my dream position as retention specialist for nursing. Newly created with no existing blueprint, I saw a blank canvas with the opportunity to create a culture that supports nurses and improve their workplace.

A popular strategy that combines an interpersonal day with activities designed for fun and professional development is conducting team-building retreats. Purposely scheduled away from the “pressure cooker” environment, the retreats lead to bonding experiences that contribute to unit cohesiveness. Some key outcomes include conflict resolution skill building, setting annual goals, developing a mission statement, applauding accomplishments and creating a Celebration Committee to plan morale-boosting activities.

Successful retention requires an understanding of the past, as well as the present. Conducting exit interviews has been a great tool in working closely with all units to improve their culture. I trend the data and share it with the clinical manager and clinical director and help them to develop an action plan for improvement. When retention options are discussed with RNs, the goal is to keep the employee somewhere at Clarian Health.

My role has contributed to organizational success, as evidenced by a decreased turnover rate of 7%, down from 14% two years ago. Nurse retention has become the significant vitamin nurturing today’s healthcare market. My success as a retention specialist is especially satisfying professionally, knowing that I have helped the Clarian nurses light the torch of innovation for the 21st century.

Avera McKennan Critical Care Education Program
Sioux Falls, S.D.
Avera McKennan Hospital & University Health Center
Recruiting and retaining nurses is challenging in today’s healthcare market. With changes incurred at our facility, we needed to develop an evidence-based strategy to enhance nursing practice and satisfaction while improving patient outcomes.

In 2001, the Avera McKennan ICU was fortunate to be fully staffed, with 56% having tenure of five years or more and 40% being certified. In 2002, our organization’s cardiac program transitioned to the Heart Hospital of South Dakota, decreasing our tenure to 15%. We then had 16% travelers, 56% with less than one year of experience, and only 8% CCRNs.

We identified the need for increasing new graduate nurses in the ICU, along with developing our current RNs. We hired 51 RNs during 2001-02. We used AACN’s orientation modules as a guideline for structuring our basic core curriculum, and an advanced curriculum for RNs with one year of experience. In collaboration with the management team from HHSD, our nurses attend their specialized classes and utilize our curriculum. With administration’s support to increase certified staff, we jointly conducted CCRN review classes and a two-day workshop with the HHSD. Our CCRN rate increased from 8% to 28% in 2003.

Our classes have been offered interdepartmentally and incorporated into our general graduate nurse internship program. We provide various lectures to EMS personnel and nursing schools throughout the state. Because of our commitment to the rural hospitals within the Avera Health system, we developed a modified version of the critical care curriculum classes and videoconferenced them to 11 regional facilities. We developed a plan to mentor their staff, allowing them to possess the skills to teach in the future.

By October 2002, the ICU eliminated traveling nurses, saving approximately $425,000 per year in salary and benefits. We have received leadership support with education dollars and full-time employees, allowing us to provide the education our nurses need to achieve excellent patient outcomes. We continue to redesign and improve our programs, soliciting feedback from our mentors, tenured staff and new orientees.

Nurse-Physician Collaboration

Denise Bousman, RN, BSN, CCRN
Muncie, Ind.
Ball Memorial Hospital
After 19 years as a critical care nurse and seven years as a critical care educator, I have seen the profound difference that expertise and collaboration among all members of the healthcare team can make in the management of patients.

Prior to an NTI, I had the opportunity to participate in a Fundamental Critical Care Support Course, created by the Society of Critical Care Medicine to address the needs of critically ill and injured patients. When I returned home, I was able to interest a physician colleague in this course. Together, we effectively implemented the first FCCS course in the state.

In 2001, my physician colleague and I were invited to coordinate a course for nurses and hospitalists in Atlanta prior to the Society of Hospital Medicine annual meeting. After a successful first course, we were invited to return in subsequent years. In response to my feedback to the course sponsors, both the FCCS course and the SHM conference will be open to nurses and physicians who will learn side by side, enhancing collegial and collaborative relationships.

Because of the shared vision and cooperation among various physician groups, FCCS courses are being provided to many critical care nurses, interns, hospitalists and advanced practice nurses. Through the coordination of these courses, I hope to raise the standard of care for patients and increase respect among diverse care-providers for the knowledge and skills we provide as a team.

AACN to Open New Scholarship Application Process on Jan. 1

The application process for AACN Educational Advancement Scholarships for the 2005-06 school year will open Jan. 1. To be considered, all applications must be postmarked by April 1.

The scholarships help advance the art and science of critical care nursing and promote nursing professionalism. AACN members who are registered nurses
completing a baccalaureate or graduate degree program in nursing are eligible to apply. Each recipient receives $1500 per academic year.

Additional information will be available after Jan. 1.

What's New

Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior
Discover skills to resolve touchy, controversial and complex issues at work and at home—now available in this follow-up to the internationally popular Crucial Conversations. Everyone knows how to run for cover or, if adequately provoked, step up to these confrontations in a way that causes a ruckus. That we have down pat. Crucial Confrontations teaches you how to deal with violated expectations in a way that solves the problem at hand and doesn't harm the relationship—and, in fact, strengthens it.

Crucial Confrontations borrows from 20 years of research involving two groups. More than 25,000 people helped the authors identify those who were most influential during crucial confrontations. They spent 10,000 hours watching these people and documenting what they saw before training and testing with more than 300,000 people. They also measured the impact of crucial confrontations improvements on organizational and team performance. The results were immediate and sustainable: 20% to 50% improvements in measurable performance.
Item #120628
Member: $15.95 (nonmember, $16.95)

EKG Windows: MI Classroom Resource on CD-Rom
No other teaching tool like it! Original teaching method helps you learn to systematically review 12-lead ECGs, looking for ischemia, injury and infarction. Includes video clip for precordial lead placement, more than 140 slides, 3-D pictures, animations, practice ECGs, completely scripted teacher's notes and a high quality participant outline master ready for copying. Content progresses from novice to expert. Navigate through common MI presentations; learn to identify posterior, right ventricular and less obvious infarct patterns; predict the culprit artery, anticipate conduction defects; and learn how to select an appropriate lead to monitor.
Item #100155
Member: $253 (nonmember: $270)

MI Windows with Overlay
Color-coded template for screening 12-lead ECGs for STEMI and NSTEMI. Color-coding ties in lead groups, culprit artery, conduction defects and lead to monitor! Bedside or classroom tool moves you from novice to expert. Generic design accommodates most ECG tracings, even those obtained in the ambulance. Cost effective, practical, and easy to use! A must have for all clinicians.
Item #100154
Member: $18.00 (nonmember: $20)

To order or for more information, visit the  AACN Website or call (800) 899-2226.

PDA Center

Just released! Power-Packed Tungsten T5 PDA Bundle
The newest PDA device from PalmOne, the Tungsten T5, is a major breakthrough in PDA technology. This lightweight device comes with 256mb of memory capacity, allowing you to store dozens of nursing software applications and much more! AACN is offering a special introductory bundle on this new device. For only $399, here is what you will get:
Tungsten T5 PDA device
ER/ICU Toolbox
Davis’ Drug Guide with Integrated Calculators (Ultimate Drug Guide)
AACN Lab Values e-reference
Latest Evidence on InfoPoems
The device alone retails for $399, so all the software in this bundle is FREE! Act now, this introductory offer expires Dec. 31, 2004. Visit the AACN PDA Center to learn about the abundant features of the T5. Click on the “Specials and What’s New” link.

Free Ultimate Drug Guide With Tungsten E PDA Device Purchase
For a limited time, you will receive a free copy of the Davis Drug Guide with Integrated Calculators, also known as the Ultimate Drug Guide, when you purchase the 32mb Palm OS Tungsten E device. Just $199. For more information, visit theAACN PDA Center and click on the “Specials and What’s New” link.

AHA/AACN PALS e-Reference for Palm OS: Now Available
The PALS e-Reference provides a summary of ABCD maneuvers; tables for newborn initial assessment, modified Glasgow Coma Scale for infants and children, pediatric trauma assessment, drugs used in PALS, and pediatric resuscitation supplies; and lgorithms for postarrest treatment of shock and maintenance fluid requirements, pediatric bradycardia, pediatric tachycardia with poor perfusion, pediatric tachycardia with adequate perfusion, and pediatric pulseless arrest. A joint project of AACN and the American Heart Association, this reference provides an alternative for healthcare providers to quickly access information for management of pediatric emergencies. Only $12.50. Pocket PC version coming soon. To purchase, visit the AACN PDA Center.

Monthly Super Savers from AACN’s Catalog Products!

These Super Saver prices are valid through Jan. 31, 2005. To be eligible for the Super Saver price, orders must be received or postmarked by Jan. 31.

Developing an Educational Consortium: The Portland Experience
This monograph is a reproduction of the original article titled “Developing an Educational Consortium: The Portland Experience,” which was published in the October 2002 issue of Critical Care Nurse. Includes additional backup information from the consortium of hospitals contributing to the Greater Portland Chapter compilation of essential elements for core review.
Regular Price
Member: $18
Nonmember: $22
Super Saver Price
Member: $12
Nonmember: $13.50

Multisystem Audio Series 2004
(#NCE9042504A or #NCE9042504C)
Includes 5 audio programs on either cassette or CD:
• You Make the Call: Interactive Case Studies in Severe Sepsis
• Rhabdomyolysis: The Silent Syndrome
• Two for the Price of One: Critical Care Obstetrics
• Immunobiology of Transplantation
• Blasts, Cytes & Phils: Critical Care Immunology
Regular Price
Member: $60
Nonmember: $60
Super Saver Price
Member: $52
Nonmember: $52

Synergy for Clinical Excellence: The AACN Synergy Model for Patient Care
The Synergy Model is the most widely applicable framework for nursing practice. As such, Synergy for Clinical Excellence: The AACN Synergy Model for Patient Care is an essential reference for nurses in developing and implementing the competencies necessary in caring for critically ill patients.
Regular Price
Member: $33.20
Nonmember: $34.95
Super Saver Price
Member: $28
Nonmember: $30.50


AACN Journals Now Searchable Online
Check Out the New Critical Care Nurse and American Journal of Critical Care Web Sites

All issues from 2002 forward are available. Users will be able to print PDFs of articles.

These enhanced Web sites are accessible to anyone until mid-January, after which time they will be available only to AACN members and journal subscribers. Subscriptions to both journals are included in AACN membership dues.

The Web sites are hosted by Stanford University’s HighWire Press, the largest medical journals site host in North America. In addition to AACN journals, visitors will be able to search the more than 300 medical journals hosted by HighWire.

What’s Coming in the American Journal of Critical Care?

• New-Generation Pulse Oximetry in the Care of Critically Ill Patients

• Effect of a Multidisciplinary Intervention on Communication and Collaboration Among Physicians and Nurses

• Attitudes of Critically Ill Filipino Patients and Their Families Toward Advance Directives

• Management of Patients With Preformed Reactive Antibodies Who Are Awaiting Cardiac Transplantation

Subscriptions to Critical Care Nurse and the American Journal of Critical Care are included in AACN membership dues.

Looking Ahead

January 2005

January 1 Applications for AACN Educational Advancement Scholarships open.

January 7 Deadline to apply for Chapter Advisory Team positions in nine of AACN’s 19 regions. To apply, register online.

January 15 Deadline to submit applications for AACN Vision Partners NTI continuing education scholarships. Apply online or call (800)
894-5995, ext. 204, for more information.

January 15 Deadline to submit applications for Clinical Inquiry Grants and End-of-Life/Palliative Care Small Projects Grant. Additional information is
available online e-mail research@aacn.org.

January 18 New CMC (cardiac medicine certification) and CSC (cardiac surgery medication) exams available. Information about eligibility and the exam
application handbooks are available online.

February 2005

February 1 Deadline to submit applications for Mentorship Grant and Critical Care Grant. Additional information is available online or e-mail

February 22 Deadline to apply to take paper-and-pencil versions of CCRN, PCCN and new CMC and CSC certification exams on April 6 during Trends
conference in Philadelphia. For more information or to register for the exams, call (800) 899-2226.
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