Preface

This text provides the reader with evidence-informed content about the care of acutely ill patients and their families. Written by nursing experts, this book sets a standard for progressive care nursing education, supports preparation for national certifications, and can be a resource to address uncertainty in patient care delivery. The organization of the text recognizes the learner’s need to assimilate foundational knowledge before attempting to master more complex progressive care nursing concepts. In addition, the American Association of Critical-Care Nurses affirms this book’s value to the AACN community and especially to clinicians at the point of care. As the editor, I am grateful for the time and effort that AACN’s team put forth in providing this validation. The title continues to carry AACN’s name, as it has since the first edition.

AACN Essentials of Progressive Care Nursing is divided into four parts:

• Part I: The Essentials presents core information that clinicians must understand to provide safe, competent nursing care to acutely ill patients who require progressive care. This part includes content on assessment, diagnosis, planning, and interventions common to patients and their families in progressive care units, including interpretation and management of cardiac rhythms; hemodynamic monitoring; airway and ventilatory management; pain, sedation, and neuromuscular blockade management; pharmacology; and ethical and legal considerations. Chapters in Part I provide the progressive care clinician with information to develop foundational competence.

• Part II: Pathologic Conditions covers pathologic conditions and management strategies commonly encountered in progressive care units, closely paralleling the blueprint for the PCCN certification examination. Chapters in this part are organized by body systems and selected conditions, such as cardiovascular, respiratory, multisystem, neurologic, hematologic and immune, gastrointestinal, renal, endocrine, and trauma.

• Part III: Advanced Concepts presents advanced progressive care concepts or pathologic conditions that are more complex and represent expert level information. Specific advanced chapter content includes ECG concepts, cardiovascular concepts, and neurologic concepts.

• Part IV: Key Reference Information contains selected reference information including laboratory and diagnostic values that apply to the content cases in the text; and cardiac rhythms, ECG characteristics and treatment guide. New in this edition is a table that demonstrates how conventional, contingency and crisis standards of care are implemented. Content in part IV is presented primarily in table format for quick reference.

Each chapter in Parts I, II, and III, begins with “Knowledge Competencies” that can be used to guide informal or formal teaching and to gauge the learner’s progress. In addition, each of the chapters provide “Essential Content cases” that focus on key information presented in the chapters in order to assist clinicians in understanding the chapter content and how to best assess and manage conditions and problems encountered in critical care. The case studies are also designed to enhance the learners understanding of the magnitude of the pathologic problems/conditions and their impact on patients and families. Questions and answers are provided for each case so that learners may test their knowledge of the essential content.

The design of this text demonstrates the expertise of the first edition editors, Marianne Chuley and Suzanne M. Burns. Both are outstanding leaders with boundless nursing expertise, and I am honored and humbled to contribute to their tradition. The world of progressive care nursing has shifted dramatically since they published the first edition. The prevalence of e-learning programs, including AACN’s Essentials of Critical Care Orientation, as well as webinars, podcasts and other platforms offers nurses many ways to advance or confirm the knowledge that informs patient care. Technology has also changed our interventions and the way we document them. New evidence has altered old practices and changed our interpretation of clinical data. The COVID-19 pandemic has profoundly altered the delivery of progressive care, and the lives of those who provide it. While the complexity of progressive care requires collaboration among team members who each bring unique expertise, it is nurses who provide a continual and compassionate presence for patients.

As progressive care continues to evolve, the skills and knowledge that nurses leverage will also change. The constant element will be nurses’ profound commitment to learning and translating that learning to optimal patient outcomes. This 5th edition, like its predecessors, meets nurses in their journey to learn, supports their pursuit of validation through certification, and offers a resource for direct patient care. As the book’s editor, I hope it also serves to honor the profound contributions that nurses make every moment of every day and every night in the lives of patients, families, and their communities.

In gratitude for the profession of nursing,