Abstract
Critical care courses for noncritical care nurses are developed to meet staff nurses' needs for additional skills because of increasing patient acuities. To be successful it is imperative that staff development nurses provide input to ensure that course content is directed to meet the needs of nurses in their facilities: hospitals, nursing homes, and home care settings.
Critical care courses are usually developed as a cooperative effort among clinical agency personnel-usually staff development nurses-and nurse educators who have expertise in critical care nursing in concert with an agency representative who can clearly address the needs of nurses working in specific hospital units. Thus, a consortium is formed in a specific geographic area that may be a temporary or ongoing association. The structure of that partnership is determined by those representatives of the institutions involved and can be informal or highly structured. The staff development nurses are able to identify patient acuity trends within their specific agency-or their healthcare system-and interact with staff nurses to identify what competencies those professionals see as essential to meet patients' needs. Agency educators bring the information to consortium meetings to ensure that course development will be relevant to the anticipated attendees, in addition to appropriately applying the general critical care core curriculum guidelines. The service-academic liaisons can become permanent and be used to continue updating staff nurses' skills without major, time-consuming difficulties. In some areas, hospital personnel have negotiated and developed a consortium-a group of agencies working together-to develop critical care courses that are made available to all employees of those agencies.
The consortium approach has been used over the last decade to help nurses upgrade their critical care skills. The process of developing such an approach (Articola, 1998), a method for developing basic critical care curriculum (Sammut, 1994), and the need for advanced education for critical care nurses (Earp et al., 1992) have been documented. All of those authors supported the idea that melding the educational skills of nurses employed in staff development and academic settings has been beneficial to all involved. Other outcomes cited were that care delivery agencies supported consortium endeavors because of the cost-saving benefit and the increased quality of care provided by current staff. Staff nurses from a variety of service settings increased their skills, formed new collegial relationships, and became more satisfied in their work environments. Staff development and academic educators achieved group and individual satisfaction regarding their achievement, and the gap between service and education was narrowed.
During the 1990s, there was an enormous shift to increased acuity levels of patients admitted to general medical and surgical care floors as well as nursing homes and other community-based care settings. That ongoing change is a result of the wide acceptance of managed care, case management, and other healthcare trends focused on hospital cost containment (Cohen & Cesta, 1997). At the same time, the role of staff nurses has become more technically complex, workload has increased, and there has been a continuing evolution of nursing education in hospitals (Shi & Singh, 1998). Congruent with staff nurses' awareness of the increased complexity of care required to meet the needs of that higher acuity patient population is their awareness that their current knowledge may need to be updated and expanded. Thus, it seems that all the critical care concepts have become increasingly vital for inclusion into the repertoire of skills of nurses in a variety of hospital and other healthcare delivery areas.
The consortium model for updating staff nurses' skills appears to be a win-win situation. However, none of the literature located to date has been specifically focused on identifying what critical care content should be included in continuing education programs to help noncritical care nurses expand their skills to efficiently care for the high acuity patients transferred or admitted to general floors. Information available includes global ideas and infers that nurses will be assisted to retool for a role change to become critical care nurses. Documents used for course construction include the critical care practice standards and core curriculum as well as current textbooks (American Association of Critical Care Nurses [AACN], 1977; Bucher & Melander, 1999).
The purpose of this article is to present a format that will assist healthcare organization personnel to develop a critical care course for noncritical care nurses that meets the needs of the specific healthcare organization(s). Because the skills update requirement of nurses varies within and between groups, no attempt is made to present one course detailed enough to be applicable in any setting. However, each group can use the basic format presented here and adapt the content to the needs of the specific audience.
The primary focus of such a course is on providing essential critical care knowledge to general staff nurses who need to upgrade their skills, rather than retool for a critical care career. Given that patients are discharged earlier and sicker than in the past, and that a nursing shortage seems imminent (Peterson, 1999), the knowledge that staff nurses will gain from such a program will be invaluable as they continue striving to meet patients' needs for quality care.