AACN News—June 2008—Practice

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Vol. 25, No. 6, JUNE 2008

ECCO 2.0 Has Arrived

AACN e-learning administrators and their students can now take advantage of the exciting upgrade to Essentials of Critical Care Orientation (ECCO), AACN’s e-learning program that has become the gold standard in Web-based critical care education.

ECCO is a comprehensive introduction to critical care nursing. The course focuses on the fundamentals of critical care nursing, providing the theoretical foundation necessary to care for critically ill patients. ECCO has been used in more than 700 hospitals across the United States and Canada.

Since the program’s inception in 2002, administrators and learners have provided valuable feedback about the content of ECCO and what improvements they would like to see. For this highly anticipated upgrade, the AACN E-Learning team listened to this feedback and worked to include more interactivity, more case studies and more critical thinking exercises. ECCO 2.0 contains all the content people have come to count on, as well as some new content that makes it a more complete orientation program for nurses.

Included in the updated version are revisions to outdated clinical content, more interactivities designed to help keep the learner engaged and to help students retain the information presented, more focused use of audio as a tool for orienting users as to where they are in the course and what they can expect, and a more comprehensive module notebook that contains full summaries of each of the lessons as well as space for users to take notes. Critical thinking exercises have been added throughout to help the user apply the concepts they have just learned. The new user interface in ECCO 2.0 has been designed for even greater ease of use and manageability, and there is a brand-new module titled Basic Hemodynamic Monitoring. An expanded Introductory Module now includes lessons on how to organize the care of the critically ill patient, evidence-based practices associated with critical care and special critical care procedures. There are 63.5 CNE credits available.

For more information about ECCO 2.0 as well as other AACN E-Learning courses, visit www.aacn.org/e-learning.

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July 1 Is the Deadline to Apply for AACN Nursing Research Grants

Clinical Inquiry Grant
This grant funds an award of up to $500 to qualified individuals carrying out clinical research projects that directly benefit patients and/or families. Interdisciplinary projects are especially invited. Ten awards are available each year.

End-of-Life/Palliative Care
Small Projects Grant
This grant funds an award of up to $500 to qualified individuals carrying out a project focusing on end-of-life and/or palliative care outcomes in critical care. Examples of topics are bereavement, communication issues, caregiver needs, symptom management, advance directives and life support withdrawal. Two awards are available each year.


Small Projects Grant
Co-sponsored by Physio-Control, this grant funds an award for up to $1,500 to a qualified individual carrying out a project focusing on aspects of acute myocardial infarction, resuscitation or sudden cardiac death, such as the use of defibrillation, synchronized cardioversion, noninvasive pacing or interpretive 12-lead electrocardiogram. Examples of eligible projects are patient education programs, staff development programs, competency-based educational programs, CQI projects, outcomes evaluation projects or small clinical research studies. One award is available each year.
To learn more about AACN’s research priorities and grant opportunities, visit the Research area of the AACN Web site or e-mail research@aacn.org.

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Practice Resource Network

Q I am looking for educational information on the administration of Diprivan, Morphine, Ativan, Levophed, Dopamine and Epinephrine, specifically the indications for titration of these medications; i.e., vital signs, perfusion and level of consciousness, to effect a favorable outcome.

A Several things need to be taken into consideration when administering vasoactive drips:
• the stability and condition of the patient
• hospital and unit policy
• the competency level of the nurse
• titration
• the half-life of the medication

Titrating vasoactive drips is definitely an art and a science. Working with one of your pharmacists, look at the medications and concentrations most frequently used on your unit and develop a table based on medication half-life and your patient population. As a nurse you are practicing within the parameters set by the physician for the titration of these medications. You maintain the monitoring parameters that were set as a goal for the use of the medication.

Monitoring of vital sign frequency should be determined by the needs of the patient; that is, vital signs should be documented when there are any changes rather than at a set frequency. The frequency of vital sign monitoring should be determined by the specific medication being infused, the half-life of the medication and the titration. If you read the manufacturer’s instructions for each medication it will give you information on monitoring. A medication with a very short half-life, such as nitroglycerin/nitroprusside, should be monitored more frequently than every 15 minutes when titrating because the effect should occur very quickly.

AACN offers many resources that will guide you in medication administration and titration. Every year there are sessions at NTI that address the administration of these drugs.

“AACN Essentials of Critical Care Nursing” includes a table with information on vasoactive agents and their pharmacological effects:

“AACN Essentials of Critical Care Nursing”
M. Chulay, S. Burns
Product #128750
Member price: $59.50
Nonmember price: $62.65

The AACN Medication Calculation Pocket Card also contains valuable information on administering these medications:

AACN Medication Calculation Pocket Reference
Product #400851
Member price: $2
Nonmember price: $4
In “AACN Protocols for Practice: Care of Mechanically Ventilated Patients” (2nd ed.) read the chapter titled “Sedation and Neuromuscular Blockade in Mechanically Ventilated Patients.”
There are many resources in Critical Care Nurse and American Journal of Critical Care. Listed below are two articles that are available online from Critical Care Nurse. You can download them at http://ccn.aacnjournals.org/.

October 2000
Sedation and Pain Management in Critically Ill Adults
Richard Arbour, RN, BSN, CCRN, CNRN
August 1998
Use of Propofol for Sedation in the ICU
Holly Covington

Some states restrict the use of Diprivan to CRNAs/anesthesiologists, because it is listed as an anesthetic induction agent. Check with your state board of nursing and refer to the Nursing Practice Act to determine the practice in your state.

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