The American Association of Critical-Care Nurses (AACN) has published an update to its landmark standards for tele-critical care nursing practice, offering specific recommendations for the development and enhancement of tele-critical care programs.
In 2013, AACN issued the first authoritative document to define practice guidelines specifically for the emerging telenursing practice in critical care. The newly released document, "AACN Tele-critical Care Nursing Practice: An Expert Consensus Statement Supporting Acute, Progressive and Critical Care, 2022," addresses the changes and provides up-to-date findings in this fast-growing area of healthcare.
The consensus statement reflects current evidence, best practices and the expert opinions of AACN's nine-person Tele-critical Care Task Force. First convened in 2010 and again in 2017, the task force met throughout 2021 to review and update the previous document. In addition to the task force, a diverse group of tele-critical care clinicians reviewed the document and provided further insights.
The updated document underscores how the contributions of tele-critical care nurses have expanded to embrace additional risk assessments, interventions and patient safety measures.
During the pandemic, tele-critical care nurses have also helped address the loss of experienced nurses from the on-site team, leaving a knowledge gap. Their work may include mentoring on-site nurses, facilitating the ongoing development of newer nurses and supporting excellent nursing care.
The initiative brought together tele-critical care nursing leaders from varied backgrounds to share their expertise and dynamic front-line perspectives, resulting in a comprehensive, patient-centric update.
The task force was led by Theresa Davis, PhD, RN, NE-BC, CHTP, FAAN, and Lisa-Mae Williams, PhD, RN, CCRN-K, two national leaders in tele-critical care nursing. Davis is assistant vice president at High Reliability Center for Inova Health System, Falls Church, Virginia, and serves as president-elect of the AACN national board of directors. Williams is operations director, Telehealth Center, Telecritical Care and Virtual Sepsis Unit at Baptist Health South Florida, Coral Gables.
"Tele-critical care programs have become more pervasive with advances in technologies and expansions in modalities and the number of patients served," Davis said. "We've seen significant growth in the number of tele-critical care services, including expanding beyond traditional critical care areas, including to medical-surgical units and even home-care settings. This document offers a broader definition of the term 'teleICU' to reflect how these nurses contribute to care beyond intensive care units."
"In addition to caring for patients, tele-critical care nurses are helping to address the experience gap by providing an extra layer of support and expertise to the on-site team," Williams said. "Knowledge and expertise are precious commodities, especially when caring for critically ill patients. Mentoring a novice nurse, a float nurse or traveling nurse can instill a greater sense of confidence, while peer-to-peer collaboration can help on-site colleagues feel more supported."
The consensus statement's practice recommendations include essential elements for both tele-critical care nurses and nurse leaders, as well as their healthcare organizations.
The document includes clinical scenarios with real-world examples of how clinicians implemented each key recommendation in various environments, including natural disasters and the COVID-19 pandemic.
An increased focus on the importance of equity, diversity and inclusion has been integrated throughout the document, beginning with its first recommendation and continuing through the practice model and clinical vignettes.
The statement includes the AACN Tele-critical Care Nursing Practice Model, which provides the conceptual framework for implementing and evaluating tele-critical care nursing practice.
The 41-page consensus statement can be downloaded from AACN's website at no charge. A print version of the booklet is also available for purchase from AACN's online store.
AACN offers a CCRN-E specialty certification for nurses who primarily provide acute or critical care for adult patients in a tele-critical care setting.