scholarly journals Does an Online Computer Based Critical Care Orientation Program Support the Learning Needs of a Multigenerational Workforce?

2011 ◽  
Author(s):  
Patricia Brady
Keyword(s):  
Critical Care ◽  
The United States ◽  
Critical Care Nurses ◽  
Learning Needs ◽  
Orientation Programs ◽  
Orientation Program ◽  
Multigenerational Workforce ◽  
Nursing Orientation ◽  
Program Support ◽  
Computer Based

<p>The complexities of today's health care system challenge acute care hospitals to provide comprehensive nursing orientation programs while meeting the needs of a multigenerational workforce. To prepare nurses to provide the highest quality of care for patients, nursing orientation must provide updated content, be cost effective, time sensitive and comprehensive, stimulate critical thinking skills, and include relevant evidence-based knowledge. Although a comprehensive nursing orientation is essential to every area of practice, specialties, such as critical care nursing, require specialized knowledge and additional skill sets that necessitate a more comprehensive training program while being sensitive to the needs of a multigenerational workforce. These considerations produce additional challenges for hospital orientation programs when considering the lack of available educators, projected nursing shortage, limited resources to accommodate multiple learning styles, and the current influence of healthcare economics. In an attempt to address orientation challenges, organizations such as the American Association of Critical Care Nurses (AACN) have developed online programs. The purpose of this paper is to evaluate one such program, the AACN Essentials of Critical Care Orientation (ECCO) program. ECCO was evaluated to determine if this online computer based orientation program would support the learning needs of multigenerational critical care nurses. Twenty-one nurses representing four generations of nurses from 11 hospitals in the United States completed an 18 question survey. Although the survey results supported the ECCO program as a useful tool for critical c</p>

A national survey of critical care nurses' practices related to administration of neuromuscular blocking agents

2001 ◽  
Vol 10 (3) ◽  
pp. 139-145 ◽  
Author(s):  
JG Foster ◽  
SK Kish ◽  
CH Keenan
Keyword(s):  
Critical Care ◽  
Peripheral Nerve ◽  
The United States ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Critical Care Nurses ◽  
Blocking Agents ◽  
Care Facilities ◽  
Acute Care Facilities

BACKGROUND: Recommendations on use of neuromuscular blocking agents include using peripheral nerve stimulators to monitor depth of blockade and concomitantly administering sedatives and/or analgesics. OBJECTIVE: To evaluate critical care nurses' practices in administering neuromuscular blocking agents. METHODS: A 16-item survey was mailed to 483 acute care facilities in the United States. Of these, 246 surveys (51%) were returned and analyzed to determine use of neuromuscular blocking agents, peripheral nerve stimulators, sedatives, and analgesics. Logistic regression analysis was used to find independent predictors of use of peripheral nerve stimulators. RESULTS: Seventy-five percent of respondents reported long-term use of neuromuscular blocking agents in critically ill patients. Of those, 63% monitored the level of blockade with peripheral nerve stimulators. Reasons for not using peripheral nerve stimulators included unavailability of equipment (48%), lack of training (36%), and insufficient evidence that peripheral nerve stimulators improve care (23%). Predictors of use of stimulators were facilities with more than 150 beds (P &lt; .001) and administration of neuromuscular blocking agents by continuous infusion (P &lt; .001). Ninety-five percent of respondents reported using concurrent analgesics/sedatives always or most of the time. Facilities with fewer than 10 beds in the intensive care unit used concurrent analgesics/sedatives significantly less often than did facilities with 10 beds or more (90% vs 98%, respectively; P = .03). CONCLUSIONS: Small and large facilities differ in concomitant use of analgesics/sedatives and peripheral nerve stimulators. Education and research are needed to ensure that patients receive adequate monitoring and sedation during administration of neuromuscular blocking agents.

Computerized clinical simulations: a strategy for staff development in critical care

1992 ◽  
Vol 1 (2) ◽  
pp. 99-107 ◽  
Author(s):  
SB Henry ◽  
D Waltmire
Keyword(s):  
Critical Care ◽  
Staff Development ◽  
Assessment Tool ◽  
Critical Care Nurses ◽  
Knowledge Assessment ◽  
Basic Knowledge ◽  
Learning Needs ◽  
Evaluation Tool ◽  
Self Evaluation ◽  
Clinical Simulations

BACKGROUND: Identifying the learning needs of employees and evaluating the results of staff development offerings are essential elements of the responsibilities of the staff development educator. High patient acuity, the shortage of critical care nurses, and rapidly changing technology within the critical care environment demand the provision of staff development offerings that are appropriate for the learning needs of critical care nurses and the evaluation of the effect of programs on critical care nursing practice. OBJECTIVE: The purposes of this descriptive, correlational study were to compare the ability of a knowledge test, a self-evaluation tool, and computerized clinical simulations to discriminate between nurses with varied levels of knowledge and experience, and to compare the learning needs identified from the three types of evaluative instruments. METHODS: Each subject (n = 142) completed the Basic Knowledge Assessment Tool for Critical Care, Cardiovascular Self-Evaluation Tool, and four computerized clinical simulations. RESULTS: Both the Basic Knowledge Assessment Tool and the Cardiovascular Self-Evaluation Tool discriminated between experienced/inexperienced and Advanced Cardiac Life Support-certified/noncertified critical care nurses. The computerized clinical simulations discriminated according to Advanced Cardiac Life Support certification, but not between experienced and inexperienced critical care nurses. The computerized clinical simulations identified more specific learning needs than did the Basic Knowledge Assessment Tool or Cardiovascular Self-Evaluation Tool. CONCLUSIONS: The evidence for discriminant validity, adequate internal consistency reliability, and ease of administration supports the continued use of these two tools as methods for critical care staff development needs assessment and evaluation. In addition, the study findings support the use of computerized clinical simulations as an adjunct to other needs assessment and evaluation methods in nursing staff development.

Safeguarding the Patient and the Profession: The Value of Critical Care Nurse Certification

2003 ◽  
Vol 12 (2) ◽  
pp. 154-164 ◽  
Author(s):  
◽  
Keyword(s):  
Critical Care ◽  
American Association ◽  
The United States ◽  
White Paper ◽  
Critical Care Nurses ◽  
Specialized Knowledge ◽  
Care Nurse ◽  
Call To Action ◽  
Knowledge And Skills ◽  
The Public

Today’s critically ill patients require heightened vigilance and extraordinarily intricate care. As skilled and responsible health professionals, the 403 000 critical care nurses in the United States must acquire the specialized knowledge and skills needed to provide this care and demonstrate their competence to the public, their employers, and their profession. Recognizing that nurses can validate specialty competence through certification, this white paper from the American Association of Critical-Care Nurses and the AACN Certification Corporation puts forth a call to action for all who can influence and will benefit from certified nurses’ contribution to patient care.

Exploratory and Confirmatory Factor Analysis of the Maslach Burnout Inventory to Measure Burnout Syndrome in Critical Care Nurses

2020 ◽  
Vol 28 (1) ◽  
pp. E18-E29
Author(s):  
Alexander Schneider ◽  
Jeri E. Forster ◽  
Meredith Mealer
Keyword(s):  
Factor Analysis ◽  
Critical Care ◽  
Confirmatory Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Factor Model ◽  
Maslach Burnout Inventory ◽  
The United States ◽  
Critical Care Nurses ◽  
Burnout Syndrome ◽  
Confirmatory Factor

Background and PurposeBurnout syndrome is common in critical care nursing. The Critical Care Societies Collaborative recently released a joint statement and call to action on burnout in critical care professionals.MethodsWe conducted an exploratory factor analysis and confirmatory factor analysis (CFA) of the 22-item MBI.ResultsThe exploratory factor analysis identified three factors but after questions were removed; we were left with a 2-factor, 10-item abridged version of the MBI-HSS to test with CFA modeling. The CFA indicated conflicting fit indices.Conclusionswe conducted an exploratory and CFA of the abridged MBI-HSS in critical care nurses from the United States and found the two-factor model was the best fit achieved.

scholarly journals The Connor-Davidson Resilience Scale in Critical Care Nurses: A Psychometric Analysis

2016 ◽  
Vol 24 (1) ◽  
pp. 28-39 ◽  
Author(s):  
Meredith Mealer ◽  
Sarah J. Schmiege ◽  
Paula Meek
Keyword(s):  
Factor Analysis ◽  
Critical Care ◽  
Factor Structure ◽  
Model Comparison ◽  
Factor Model ◽  
The United States ◽  
Critical Care Nurses ◽  
Group Differences ◽  
Resilience Scale ◽  
Confirmatory Factor

Objective: (a) To investigate the factor structure of the Connor-Davidson Resilience Scale (CD-RISC) in critical care nurses, using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and (b) to assess reliability and known group differences of the CD-RISC on critical care nurses. Methods: CD-RISC surveys were collected on 744 critical care nurses across the United States. An abridged version of the CD-RISC was used for the EFA and CFA. Further reliability and known group differences were also tested. Results: EFA identified 3 factors with eigenvalues >1.0 and an explained variance of 59%. The factors were labeled personal competence, perseverance, and leadership, and each factor had salient loadings. The 3-factor CFA provided good fit to the data, χ2 = 243.1, p < .001; RMSEA = .062; CFI = .935, although correlations among the 3 factors were high (.78–.86). A 1-factor model was subsequently tested but did not produce a better fit, and model comparison analyses supported retention of the 3-factor model. Known group differences was supported as intensive care unit (ICU) nurses with a diagnosis of posttraumatic stress disorder (PTSD) had significantly lower total resilience scores (M = 75.43) compared to those without a diagnosis of PTSD (M = 83.21; t = 5.01; p < .001). Discussion: The current investigation found that the 3-factor structure provided the best fit for the data on the abridged version of the CD-RISC in a population of ICU nurses. Analyses also supported the reliability and known group differences of the 16-item measure. Further research is needed to examine trait and capacity features of resilience as it relates to this population.

USING SIMULATION TO IMPROVE PROFESSIONAL PERFORMANCE OF CRITICAL CARE NURSES AT KING ABDUL-AZIZ MEDICAL CITY, RIYADH

2015 ◽  
Vol 1 (1) ◽  
pp. 41.1-41 ◽  
Author(s):  
Maha Aljuaid
Keyword(s):  
Critical Care ◽  
Clinical Education ◽  
Technical Skills ◽  
Critical Care Nurses ◽  
Nursing Knowledge ◽  
Nursing Orientation ◽  
New Nurses ◽  
Simulation Education ◽  
Simulation Based ◽  
Medical City

IntroductionHealth care institutions strive to develop orientation programs that are effective and efficient to prepare nurses entering to critical care. Clinical education must have combined knowledge of physical, behavioural and technical clinical education (American Association of Critical Care Nurses, 2004).Objectives:1. To identify the effect of simulation based education in standardizing nursing orientation2. To share the experience of KAMC-R in utilizing simulation education to improve patient safety and the quality of careBackgroundSimulation provides safe learning environment, allows debriefing, and stimulates critical thinking skills (Critical Care Nursing, 2007). Neuro Critical Care unit (NCCU) at King Abdul-Aziz Medical City (KAMC-R) faces influx of new nurses; therefore continuous education is imperative to those nurses. Simulation education strategy is utilized to improve technical and non-technical skills for new nurses. The critical care collaborative leadership adopted simulation based education to replace the old nursing orientation. The new‖orientation program piloted in Trauma ICU and Surgical ICU for two months, it was then implemented into all adult critical care units.MethodologyClinical resource nurses (CRNs) are the educators who run the program to the new staff. Clinical skills are validated by using Mosby skills checklist in which nurses demonstrate the skills on high fidelity simulation manikins.ResultsDecember 2010, nurses' anecdotal reports used to evaluate the experience of NCCU in utilizing simulation education. 32 nurses reported increase nursing knowledge, and improve technical skills. April 2014, survey was conducted to evaluate the effectiveness of the new orientation participated by CRNs, practice facilitators, and new nurses. The result showed that using of simulation enhances nursing knowledge and skills, simulation activities are engaging, and staffs build more confidence.ConclusionA healthy learning environment is essential for optimal nursing training. Nursing orientation requires abundant resources to ensure patient safety and competency of critical care nurses.

Strategies for Acute and Critical Care Nurses Implementing Complementary Therapies Requested by Patients and Their Families

2016 ◽  
Vol 36 (6) ◽  
pp. 52-58 ◽  
Author(s):  
Debra Kramlich
Keyword(s):  
Critical Care ◽  
Complementary Therapies ◽  
Care Setting ◽  
The United States ◽  
Critical Care Nurses ◽  
Critical Care Setting ◽  
Complementary And Alternative Therapies ◽  
Centered Care ◽  
Family Centered ◽  
Complementary And Alternative

As consumer use of complementary and alternative medicine or modalities continues to increase in the United States, requests for these therapies in the acute and critical care setting will probably continue to expand in scope and frequency. Incorporation of complementary therapies in the plan of care is consistent with principles of patient- and family-centered care and collaborative decision-making and may provide a measure of relief for the distress of admission to an acute or critical care setting. An earlier article provided an overview of complementary and alternative therapies that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses. This article provides key information on the legal, ethical, safety, quality, and financial challenges that acute and critical care nurses should consider when implementing patient and family requests for complementary therapies.

scholarly journals Critical Care Nurses’ Experiences During the COVID-19 Pandemic: A US National Survey

2021 ◽  
pp. e1-e7
Author(s):  
Jill L. Guttormson ◽  
Kelly Calkins ◽  
Natalie McAndrew ◽  
Jacklynn Fitzgerald ◽  
Holly Losurdo ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Moral Distress ◽  
Community Support ◽  
Well Being ◽  
The United States ◽  
Critical Care Nurses ◽  
Emotional Symptoms

Background Given critical care nurses’ high prepandemic levels of moral distress and burnout, the COVID-19 pandemic will most likely have a tremendous influence on intensive care unit (ICU) nurses’ mental health and continuation in the ICU workforce. Objective To describe the experiences of ICU nurses during the COVID-19 pandemic in the United States. Methods Nurses who worked in ICUs in the United States during the COVID-19 pandemic were recruited to complete a survey from October 2020 through early January 2021 through social media and the American Association of Critical-Care Nurses. Three open-ended questions focused on the experiences of ICU nurses during the pandemic. Results Of 498 nurses who completed the survey, 285 answered the open-ended questions. Nurses reported stress related to a lack of evidence-based treatment, poor patient prognosis, and lack of family presence in the ICU. Nurses perceived inadequate leadership support and inequity within the health care team. Lack of consistent community support to slow the spread of COVID-19 or recognition that COVID-19 was real increased nurses’ feelings of isolation. Nurses reported physical and emotional symptoms including exhaustion, anxiety, sleeplessness, and moral distress. Fear of contracting COVID-19 or of infecting family and friends was also prevalent. Conclusions Intensive care unit nurses in the United States experienced unprecedented and immense burden during the COVID-19 pandemic. Understanding these experiences provides insights into areas that must be addressed to build and sustain an ICU nurse workforce. Studies are needed to further describe nurses’ experiences during the COVID-19 pandemic and identify effective resources that support ICU nurse well-being.

Nurse/physician collaboration: solving the nursing shortage crisis

1992 ◽  
Vol 1 (1) ◽  
pp. 25-32 ◽  
Author(s):  
SA Evans ◽  
R Carlson
Keyword(s):  
United States ◽  
Critical Care ◽  
Nursing Shortage ◽  
American Association ◽  
The United States ◽  
Critical Care Nurses ◽  
Critical Care Medicine ◽  
The Status

This summary article discusses the status of the nursing shortage in the United States, with emphasis on successful strategies to address it. Liaisons between the American Association of Critical-Care Nurses (AACN) and the Society for Critical Care Medicine, as well as with the American College of Cardiology, are highlighted, with primary emphasis on the strategy of nurse-physician collaboration.

Assisted suicide, recent judicial decisions, and implications for critical care nurses

1997 ◽  
Vol 17 (5) ◽  
pp. 71-79 ◽  
Author(s):  
GS Wlody
Keyword(s):  
Critical Care ◽  
Assisted Suicide ◽  
Healthcare Providers ◽  
Supreme Court Decision ◽  
The United States ◽  
Critical Care Nurses ◽  
Value Systems ◽  
Physician Assisted Suicide ◽  
Death With Dignity Act ◽  
The Individual

The passage of the Oregon Death With Dignity Act on November 8, 1994, heralded a wake-up call for healthcare professionals. Oregon, the first state to systematically "ration care" was thought to be a fertile ground for testing new and, some say, radical concepts in healthcare and government. Although the act was not implemented because it was tied up in legal action until February 1997, the fact that more than 50% of the voters in Oregon voted for it mandates that healthcare providers listen to their patients. Patients want more control of their pain, the way they die, and the resources spent on their care in the final days of their lives. Thoughts of future suffering engender great fear on the part of healthcare consumers. Concern exists that physician-assisted suicide in the ICU will affect not only physicians but also nurses, pharmacists, respiratory therapists, and other clinicians as terminally ill patients make requests for assisted suicide while in the acute and critical care setting of the hospital. Critical care nurses must examine their value systems, review the Code for Nurses, and make their own decisions about participation in deliberately ending lives of patients. With the impending Supreme Court decision due in July 1997, the court may leave these issues to the individual states, opening the door for assisted suicide to occur throughout the United States. Therefore, the possibility will remain that critical care nurses may be put in positions in which physicians are providing assistance to patients who wish to commit suicide and are requesting nurses' assistance to do so.

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