AACN Practice Alert includes most recent evidence-based practice for monitoring pulmonary artery and central venous pressure in critically ill patients
ALISO VIEJO, Calif. — Oct. 18, 2016 — Because of new research and its impact on clinical practice and assessment methods, the American Association of Critical-Care Nurses (AACN) has issued an updated AACN Practice Alert about functional hemodynamic monitoring.
The alert, Pulmonary Artery/Central Venous Pressure Monitoring in Adults, outlines expected nursing practice related to pulmonary artery pressure, pulmonary artery occlusion pressure and central venous pressure, as well as pulmonary artery catheter-guided therapy. The recommended protocols reflect the most current evidence related to invasive hemodynamic monitoring.
Elizabeth Bridges, RN, PhD, CCNS, FCCM, FAAN, is a professor, Biobehavioral Nursing and Health Systems at University of Washington (UW) School of Nursing, Seattle, and clinical nurse researcher at UW Medical Center. She initially developed the practice alert for AACN and is one of the co-authors for the updated alert. Other contributing authors are Lia Barros, RN, BSN, CCRN; Marie Cockerham, RN, BSN, CCRN; Sheryl Greco, RN, MN, CCRN; Farah Herrera, RN, BSN, CCRN; and Nicole Solvang, RN, BSN, CCRN – all of whom practice at the UW Medical Center.
“Critical care providers rely on invasive hemodynamic monitoring for its precise and continual results, and the use of functional hemodynamics as a tool to evaluate fluid responsiveness in critical care patients has evolved over the last several years,” Bridges said. “It’s imperative for optimal patient outcomes that nurses integrate these new parameters into practice at the bedside.”
Referencing 100 citations, the practice alert includes supporting evidence for various aspects of hemodynamic monitoring:
- Monitoring for complications during catheter insertion and use
- System assessment to ensure accurate measurement
- Positioning of patients
- Waveform assessment and interpretation
- Alternative sites for monitoring
- Effect of ventilation on measurement
In addition to the alert, two webinars in the monthly AACN Critical Care Webinar Series have focused on hemodynamic monitoring – Integrating Functional Hemodynamics at the Point of Care and Q&A: Functional Hemodynamic Monitoring. Now available on-demand, the webinars are available at no cost and are accompanied with ready-to-use implementation tools and resources.
This alert is the latest in a series issued by AACN to standardize practice and update nurses and other healthcare providers on new clinical advances and trends. All practice alerts are available on the AACN website, www.aacn.org/practicealerts.
Supported by authoritative evidence, each AACN Practice Alert seeks to ensure excellence in practice along with promotion of a safe and humane work environment. Topics address both nursing and interprofessional activities of importance for patients in acute and critical care environments. Some alerts include additional resources for staff education and performance-improvement activities.
Previously released alerts address verification of feeding-tube placement, dysrhythmia monitoring, noninvasive blood pressure monitoring, ST segment monitoring, family presence during CPR and invasive procedures, and prevention of catheter-associated urinary tract infections and aspiration.
About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than half a million acute and critical care nurses and includes more than 225 chapters worldwide. The organization's vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.