AACN/NTI (American Association of Critical Care Nurses)

NTI 2019

Orange County Convention Center
9800 International Dr.
Orlando, FL 32819
May 21-23, 2019

Event Website

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Exclusive ExpoEd Sessions All Week Long.

Esteemed Speakers:

Jan M. Headley, RN, BS — Principal, Consultants in Acute and Critical Care

An award-winning, nearly forty-year member of AACN, Jan lectures and publishes extensively on cardiovascular, hemodynamic, and oxygenation concepts and applications.

Kathryn T. Von Rueden, RN, MS, ACNS-BC, FCCM — Critical Care Consultant

With multiple awards, including the 2015 AACN Circle of Excellence Award, Kathryn is a distinguished author and lecturer with extensive experience in cardiovascular care and sepsis management.

Barbara “Bobbi” Leeper, MN, RN-BC, CNS M-S, CCRN, FAHA — CNS, Baylor University Medical Center

Bobbi is an award-winning author and lecturer in the critical care space and recipient of the 2011 AACN Flame of Excellence Award.

Presentation Highlights

Jan Headley

Connecting When to Use CO vs. SV vs. PPV vs. SVV: What, Where, Why and Why Not

There has been confusion about the differences between various hemodynamic parameters, especially when to use what variable to assess which condition, in what care area and why or why not it is optimal. This session reviews key physiologic aspects of assessing cardiac output and the component stroke volume, and compares the indications, applications and differences between the dynamic parameters pulse pressure variation and stroke volume variation. Connecting with when and how to use these important variables offers an opportunity to further provide optimal care to the acute or critically ill.

Learning Outcomes:

At the end of the session, the attendee will be able to...

  • Discriminate between the various hemodynamic parameters that assesses flow and dynamic response indices.
  • Delineate conditions when caution is used in data interpretation and what alternatives are available.

What Goes in Must Come Out: Fluid Balance Optimization Strategies

Fluid therapy remains a mainstay for resuscitation of patients in shock. Once initial hypotension is corrected with fluid, additional fluid administration may prove detrimental and more so in specific patient conditions such as sepsis, acute renal injury, and acute lung injury. During the various phases of resuscitation; rescue, optimization, stabilization, and de-escalation, there are evidence-based rationale for specific hemodynamic targets and interventions. This session focuses on the various phases and how best to develop an individualized therapeutic intervention strategy. A rationale for accurate and precise fluid measurement is presented.

Learning Outcomes:

At the end of the session, the attendee will be able to...

  • Describe the 4 conceptual phases in the process of resuscitating a patient in shock.
  • Determine appropriate individualized interventions per specific phase of fluid resuscitation.

Kathryn T. Von Rueden

Connecting AACN's Practice Alert to Optimal Hemodynamic Monitoring

Accuracy of pressure readings from invasive hemodynamic monitoring catheters (central, arterial, pulmonary artery) are dependent upon the integrity of the monitoring system and the techniques used in obtaining the measurements. This session includes an analysis of the mechanical and physiological influences on acquisition of accurate hemodynamic parameters. Evidenced based strategies including AACN's Practice Alert on Pulmonary Artery and Central Venous Pressure Measurement and Procedure Manual to optimize accuracy and reproducibility will be incorporated as best practice for nurses to provide optimal care of patients who require hemodynamic monitoring.

Learning Outcomes:

At the end of the session, the attendee will be able to...

    • Describe evidence-based nursing actions to ensure validity of hemodynamic data acquisition.
    • Evaluate mechanical and physiologic influences on validity of hemodynamic data.

Reassessing Oxygen Balance: ScvO2/SvO2 Connects the Dots

Mixed venous oxygen saturation (SvO2 and ScvO2) is useful to evaluate the status of global tissue oxygenation because it reflects oxygen delivery (cardiac output, hemoglobin and arterial saturation) and oxygen utilization (cell/organ oxygen demand and oxygen extraction). Drilling down and analyzing the determinants of SvO2 and ScvO2 are key to identifying and directing appropriate interventions. This session will review the association of pathophysiologic oxygen imbalance etiology with increasing or decreasing SvO2 and ScvO2, and the implications for nursing practice.

Learning Outcomes:

At the end of the session, the attendee will be able to...

    • Identify pathophysiologic, oxygen imbalance etiology of abnormal, increasing or decreasing SvO2 and ScvO2.
    • Analyze continuous venous oximetry case examples to assess oxygen balance and identify appropriate nursing interventions.

Bobbi Leeper

Patient Safety Connections: Closed Blood Sampling and Conservation

In a changing healthcare landscape, hospitals need to achieve improved quality standards for patient care while balancing an increasing cost burden. Blood sampling is a routine procedure conducted frequently in the hospital setting. It is often associated with a large amount of blood loss, unnecessary blood waste, and risk of contamination. This can have important clinical consequences such as anemias leading to increased transfusions, and central line infections contributing to poor patient outcomes and increased costs. Studies have shown that the use of closed blood sampling devices not only reduce blood loss but also reduces the risk of infections. This session discusses the ABIM “Choosing Wisely” campaign top 5 “don’ts” that frequent blood sampling impacts. Additionally, a review of evidence from meta-analysis showing a significant reduction in transfusion risk connected with the use of a closed sampling system compared to conventional methods.

Learning Outcomes:

At the end of the session, the attendee will be able to...

  • Describe current issues related to the impact of blood loss on patient complications and hospital costs.
  • Cite evidence supporting use of closed blood sampling systems as a means to reduce transfusion risks and achieve improved outcomes.

Hemodynamic Monitoring in Cardiovascular Patients: Case Study Connections

Hemodynamic monitoring plays an important role in the management of today’s critically ill cardiovascular patient. Hemodynamic parameters can assist with identification of the underlying pathophysiological processes and direct the management of the patient. Secondly, monitoring allows preemptive interventions to occur before a significant problem occurs. While there are many hemodynamic monitoring technologies available today, this session will focus on the basics of advanced monitoring including hemodynamic data from pulmonary artery catheters and mixed venous oxygen saturation. The purpose of this interactive session is to demonstrate the usefulness of connecting the hemodynamic data with the clinical presentation within the case examples. A case will be presented and attendees will be invited to interpret the data and use their clinical judgment to identify the potential problem and recommend an appropriate intervention.

Learning Outcomes:

At the end of the session, the attendee will be able to...

  • When given a case scenario, use hemodynamic data to identify a potential problem.
  • Formulate a plan of care based on the identified problem.