Fast track to critical care

Steady growth, coupled with a nationwide shortage of critical care nurses, threatened to create a serious staffing problem at AtlantiCare Regional Medical Center in Atlantic City, N.J. The solution is the Essentials of Critical Care Orientation (ECCO) course, a comprehensive online curriculum that enables the power to “homeschool” critical care nurses as needed.

The ECCO curriculum was created by the American Association of Critical-Care Nurses (AACN) and released in 2003. “Essentials of Critical Care Orientation was our first attempt at any e-learning program, and it has succeeded beyond our wildest expectations,” says David Ward, e-learning manager for AACN. “We’ve had annual growth ranging from 35 to 50 percent.”

Meeting needs

More than 700 hospitals nationwide have been licensed to support AACN e-learning programs. An estimated 30,000 students have participated within the programs, most of whom have received the ECCO curriculum.

AtlantiCare bought the power’s license when the curriculum became available in 2003. Since then, greater than 30 nurses, including latest graduates and nurses changing specialties, have graduated from this system, says Ann MacMurray, RN, BSN, CCRN, residency program director. The facility has 4 intensive care units and employs about 140 intensive care nurses.

“We decided to develop our own critical care nurses because of retention and turnover in the critical care units. We wanted to make sure we were always fully staffed,” MacMurray says.[Prior to obtaining the ECCO curriculum]nurses who were keen on working in critical care needed to have not less than just a few years of experience in medicine/surgery or one other specialty. We can now accept latest graduates because of ECCO and our RN residency program.”

Comprehensive program

ECCO is a 64-hour curriculum consisting of a brief introduction and eight comprehensive modules divided by body systems. They include:

Circulatory system Pulmonary Neurological Renal Gastroenterological Endocrine Hematological Multi-organ disorders

Accessible and convenient format

AACN created ECCO to handle a national shortage of nurses—especially nurse trainers and educators, Ward says. The curriculum also addresses the growing variety of registered nurses who need to enter critical care settings but need the requisite specialty orientation.

“We wanted to create an online learning program that would be convenient for facilities,” says Ward. “We had a precursor, a traditional instructor-led classroom program in a hospital that was eight thick books of material. It sold well, but the format wasn’t the best for our customers, so we took that content and transformed it into an e-learning mode that offers greater accessibility and convenience at your own pace.”

Putting the ECCO curriculum on an internet platform makes it easy so as to add, update or correct information, Ward says. The AACN is currently engaged in a serious revision of the ECCO, which is able to include an introductory anatomy and physiology test.

“A lot of the students who come through the ECCO program are new nurses who just got out of school,” Ward says. “The anatomy and physiology are still fresh in their minds, so we’ll let them test themselves in that part.

From the virtual classroom to the intensive care unit

At AtlantiCare ECCO is a 12-week program. Two days a week, participants spend four hours on the computer going through the curriculum and four hours in the classroom, which typically includes case study presentations and a lab component, such as a demonstration of how to properly place an arterial line.

In addition, participants work two 12-hour shifts per week with a caregiver in their prospective units. If possible, they are assigned to a patient with the condition they are studying at a given point in the ECCO program, MacMurray says.

After completing the ECCO program, nurses work full-time under a mentor for an additional three months and continue to attend monthly educational sessions where they are encouraged to talk about their clinical experiences.

“It’s a safe environment where they can say whatever they want and know it won’t go any further,” MacMurray says. “It’s really great because they get to share ideas and talk about what it’s like to be a new nurse and a new employee. It helps them get through their first year.”

In the second a part of each session, students receive additional knowledge, which can include case study presentations and discussions of real-life incidents from their teaching units.

New graduates and bridge nurses who complete the ECCO program at AtlantiCare Regional Medical Center usually are not required to fill a selected employment contract, but they’re encouraged to remain within the critical care field they trained in. “For example, if a nurse trained in the ICU, we would like them to stay in that field for at least a year before moving elsewhere,” MacMurray says. “But there is no contract.”

Success Story

Paula Downam, RN, critical care nurse, was a RN for twenty-four years but was frustrated by the constraints imposed on her within the critical care unit at one other hospital. After returning to highschool to turn out to be a RN, the ECCO program at AtlantiCare helped her achieve her profession goal of working within the critical care unit.

“I chose AtlantiCare Regional Medical Center because of the ECCO program,” she says. “I wanted to transition into the intensive care unit as a new nurse.”

Downam was impressed by the ECCO program, which she says has enhanced the education she received in nursing school. “When I started the program, as an experienced practical nurse, I thought six months would be a long time,” she says. “But it went by quickly, and when I finished, I felt very well prepared. I wasn’t overwhelmed or panicked, and the transition was very smooth.”

ECCO has been an enormous boon for AtlantiCare Regional Medical Center, especially with regard to staff retention and satisfaction, MacMurray says. “It really allows us to produce the best critical care nurses possible,” she says. “The nurses who go through the curriculum come out of it feeling prepared and ready when they finish orientation. It gives them a huge advantage and they’re much less likely to want to leave.”