Bold Voices - July 2016 - (Page 6)
Progressive Care? Stepdown? Intermediate
Care? It's All About the Patient
An experienced progressive
care nurse can intervene
and prevent a patient from
needing intensive care-level
he increasing acuity of hospitalized patients coupled with a
move toward shorter hospital
stays continues to propel the growth
of progressive care nursing in the U.S.
Despite its prevalence, understanding
this nursing specialty remains hazy for
The concept of progressive care
emerged in the 1970s to describe care
provided to patients with post-myocardial infarction. Since then, it
has expanded beyond basic cardiac
telemetry to encompass many of the
same technologies and therapies once
limited to critical care units. It now
refers to a speciﬁc level of patient care
and is considered part of the critical
care spectrum - with intensive care
on one end and progressive care on
"Critical care is a continuum of
care, and we need skilled nurses at
all levels of the continuum to provide
patients with the best care," says
Lynn Orser, clinical nurse educator
at St. Vincent's Medical Center in
Bridgeport, Connecticut, who is certiﬁed in both progressive and critical
"Many patients require complex
assessment and monitoring without
the advanced therapies of intensive
care. Progressive care nurses need to
have highly developed assessment
skills and the knowledge to monitor
and anticipate their patients' course."
It's the who, not the where
The progressive care patient population consists of high-acuity patients
who are moderately stable with an
Pursuit of PCCN specialty certiﬁcation reﬂects your dedication to excellence in
caring for acutely ill adults and their families.
Who is it for?
RNs or APRNs who provide direct care to acutely ill adult patients. These patients
are often found in areas such as intermediate care, direct observation, stepdown, telemetry and transitional care units.
What are the practice eligibility requirements?
* 1,750 hours of direct care in the previous two years, with 875 of those hours
accrued in the most recent year preceding application
* OR, At least ﬁve years of direct care with a minimum of 2,000 hours, with 144
of those hours accrued in the most recent year preceding application
elevated risk of becoming unstable, and
who require a high intensity of care
"Progressive care is determined
by the type of patient cared for and
the nursing care delivered, not by the
unit name," says Jo Ellen Craghead, a
36-year nursing veteran at St. Mary's
Hospital-Audrain in Mexico, Missouri.
"Progressive care patients are not quite
as physiologically unstable as critical
care patients. This doesn't mean they
need any less nursing care; they just
need different care."
"This is a specialized population
with specialized needs," adds Craghead,
who helped develop the ﬁrst progressive care certiﬁcation. "An experienced
progressive care nurse can intervene
and prevent a patient from needing
intensive care-level services."
There's a certiﬁcation for that
In 2004, AACN Certiﬁcation
Corporation launched PCCN specialty
certiﬁcation to enable progressive care
nurses to validate their knowledge
against national standards of nursing
excellence. The PCCN Test Plan, based
on a study of practice, deﬁnes the
progressive care patient population
and related nursing competencies.
Today, more than 15,000 nurses are
"I was so happy when AACN recognized progressive care as a bona ﬁde
specialty and introduced PCCN certiﬁcation in the mid-2000s," Orser says.
"Our hospital has a mixed medical ICU
with progressive care beds and patients
requiring progressive care in various
units throughout the hospital."
For Craghead, "Certiﬁcation
helps increase my conﬁdence in my
nursing skills. The knowledge I obtain
to remain certiﬁed helps keep my
practice current and allows me to
contribute valuable input on patient
care decisions. I believe I can better
advocate for the patient."
Learn more about PCCN certiﬁcation at www.aacn.org/pccncert.
Table of Contents for the Digital Edition of Bold Voices - July 2016
Pres Note Front Teaser
We Welcome New Board Members, Thank Those Who Completed Their Service
Progressive Care? Stepdown? Intermediate Care? It’s All About the Patient
Drug-loaded ‘Backpacks’ Take Aim at Disease Sites
Elimination of Pain Should Not Be the Goal
New Blood Analysis May Detect Sepsis
Hospital Guidelines Can Decrease Opioid Overdoses
Hospitals’ Solutions Ease Opioid Overdose Crisis
Aspirin Linked to Lower Risk for Most Cancers
Wearable Defibrillators Provide Another Option
Positive Emotional Stress Can Trigger Broken Heart Syndrome
AACN Scholarships: Expand your Knowledge and Skills
The Power of Compassion
Are Stethoscopes Ready for Retirement?
Safe Practice Recommendations for Copy and Paste
NTI 2016: It Matters
AACN’s Facebook Community Weighs in About NTI
New Recommendations to Enhance Patient Safety
Building Trust With Patients Through Genuine Connection
In Our Journals
Bold Voices - July 2016