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CCRN test Format | CCRN Course Contents | CCRN Course Outline | CCRN test Syllabus | CCRN test Objectives


A criterion-referenced standard setting process, known as the modified Angoff, is used to establish the passing point/cut score for the exam. Each candidates performance on the test is measured against a predetermined standard.
The passing point/cut score for the test is established using a panel of subject matter experts, an test development committee (EDC), who carefully reviews each test question to determine the basic level of knowledge or skill that is expected. The passing point/cut score is based on the panels established difficulty ratings for each test question.
Under the guidance of a psychometrician, the panel develops and recommends the passing point/cut score, which is reviewed and approved by AACN Certification Corporation. The passing point/cut score for the test is established to identify individuals with an acceptable level of knowledge and skill. All individuals who pass the exam, regardless of their score, have demonstrated an acceptable level of knowledge.

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (17%)
1. Acute coronary syndrome:
a. NSTEMI
b. STEMI
c. Unstable angina
2. Acute peripheral vascular insufficiency:
a. Arterial/venous occlusion
b. Carotid artery stenosis
c. Endarterectomy
d. Fem-Pop bypass
3. Acute pulmonary edema
4. Aortic aneurysm
5. Aortic dissection
6. Aortic rupture
7. Cardiac surgery:
a. CABG
b. Valve replacement or repair
8. Cardiac tamponade
9. Cardiac trauma
10. Cardiac/vascular catheterization
11. Cardiogenic shock
12. Cardiomyopathies:
a. Dilated
b. Hypertrophic
c. Idiopathic
d. Restrictive
13. Dysrhythmias
14. Heart failure
15. Hypertensive crisis
16. Myocardial conduction system abnormalities
(e.g., prolonged QT interval, Wolff-ParkinsonWhite)
17. Papillary muscle rupture
18. Structural heart defects (acquired and congenital, including valvular disease)
19. TAVR

B. Respiratory (15%)
1. Acute pulmonary embolus
2. ARDS
3. Acute respiratory failure
4. Acute respiratory infection (e.g., pneumonia)
5. Aspiration
6. Chronic conditions (e.g., COPD, asthma, bronchitis, emphysema)
7. Failure to wean from mechanical ventilation
8. Pleural space abnormalities (e.g., pneumothorax, hemothorax, empyema, pleural effusions)
9. Pulmonary fibrosis
10. Pulmonary hypertension
11. Status asthmaticus
12. Thoracic surgery
13. Thoracic trauma (e.g., fractured rib, lung contusion, tracheal perforation)
14. Transfusion-related acute lung injury (TRALI)

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)
1. Endocrine
a. Adrenal insufficiency
b. Diabetes insipidus (DI)
c. Diabetes mellitus, types 1 and 2
d. Diabetic ketoacidosis (DKA)
e. Hyperglycemia
f. Hyperosmolar hyperglycemic state (HHS)
g. Hyperthyroidism
h. Hypoglycemia (acute)
i. Hypothyroidism
j. SIADH
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC, HIT)
c. Immune deficiencies
d. Leukopenia
e. Oncologic complications (e.g., tumor lysis syndrome, pericardial effusion)
f. Thrombocytopenia
g. Transfusion reactions
3. Gastrointestinal
a. Abdominal compartment syndrome
b. Acute abdominal trauma
c. Acute GI hemorrhage
d. Bowel infarction, obstruction, perforation (e.g., mesenteric ischemia, adhesions)
e. GI surgeries (e.g., Whipple, esophagectomy, resections)
f. Hepatic failure/coma (e.g., portal hypertension, cirrhosis, esophageal varices, fulminant hepatitis, biliary atresia, drug-induced)
g. Malnutrition and malabsorption
h. Pancreatitis
4. Renal and Genitourinary
a. Acute genitourinary trauma
b. Acute kidney injury (AKI)
c. Chronic kidney disease (CKD)
d. Infections (e.g., kidney, urosepsis)
e. Life-threatening electrolyte imbalances
5. Integumentary
a. Cellulitis
b. IV infiltration
c. Necrotizing fasciitis
d. Pressure injury
e. Wounds:
i. infectious
ii. surgical
iii. trauma
D. Musculoskeletal/Neurological/

Psychosocial (14%)
1. Musculoskeletal
a. Compartment syndrome
b. Fractures (e.g., femur, pelvic)
c. Functional issues (e.g., immobility, falls, gait disorders)
d. Osteomyelitis
e. Rhabdomyolysis
2. Neurological
a. Acute spinal cord injury
b. Brain death
c. Delirium (e.g., hyperactive, hypoactive, mixed)
d. Dementia
e. Encephalopathy
f. Hemorrhage:
i. intracranial (ICH)
ii. intraventricular (IVH)
iii. subarachnoid (traumatic or aneurysmal)
g. Increased intracranial pressure (e.g., hydrocephalus)
h. Neurologic infectious disease (e.g., viral, bacterial, fungal)
i. Neuromuscular disorders (e.g., muscular dystrophy, CP, Guillain-Barré, myasthenia)
j. Neurosurgery (e.g., craniotomy, Burr holes)
k. Seizure disorders
l. Space-occupying lesions (e.g., brain tumors)
m. Stroke:
i. hemorrhagic
ii. ischemic (embolic)
iii. TIA
n. Traumatic brain injury (TBI): epidural, subdural, concussion
3. Behavioral and Psychosocial
a. Abuse/neglect
b. Aggression
c. Agitation
d. Anxiety
e. Suicidal ideation and/or behaviors
f. Depression
g. Medical non-adherence
h. PTSD
i. Risk-taking behavior
j. Substance use disorders (e.g., withdrawal, chronic alcohol or drug dependence)
E. Multisystem (14%)
1. Acid-base imbalance
2. Bariatric complications
3. Comorbidity in patients with transplant history
4. End-of-life care
5. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
6. Hypotension
7. Infectious diseases:
a. Influenza (e.g., pandemic or epidemic)
b. Multi-drug resistant organisms (e.g., MRSA, VRE, CRE)
8. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, postpartum hemorrhage, amniotic embolism)
9. Multiple organ dysfunction syndrome (MODS)
10. Multisystem trauma
11. Pain: acute, chronic
12. Post-intensive care syndrome (PICS)
13. Sepsis
14. Septic shock
15. Shock states:
a. Distributive (e.g., anaphylactic, neurogenic)
b. Hypovolemic
16. Sleep disruption (including sensory overload)
17. Thermoregulation
18. Toxic ingestion/inhalations (e.g., drug/alcohol overdose)
19. Toxin/drug exposure (including allergies)

II. PROFESSIONAL CARING 7 ETHICAL PRACTICE (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
• Recognize normal and abnormal:
o developmental assessment findings and provide developmentally appropriate care
o physical assessment findings
o psychosocial assessment findings
• Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed
• Recognize indications for, and manage patients requiring:
o capnography (EtCO2)
o central venous access
o medication reversal agents
o palliative care
o SvO2 monitoring
• Manage patients receiving:
o complementary/alternative medicine and/or nonpharmacologic interventions
o medications (e.g., safe administration, monitoring, polypharmacy)
• Monitor patients and follow protocols for pre- and postoperative care
• Assess pain
• Evaluate patients response to interventions
• Identify and monitor normal and abnormal diagnostic test results
• Manage fluid and electrolyte balance
• Manage monitor alarms based on protocols and changes in patient condition Cardiovascular
• Apply leads for cardiac monitoring
• Identify, interpret and monitor cardiac rhythms
• Recognize indications for, and manage patients requiring:
o 12-lead ECG
o arterial catheter
o cardiac catheterization
o cardioversion central venous pressure monitoring
o defibrillation
o IABP
o invasive hemodynamic monitoring
o pacing: epicardial, transcutaneous, transvenous
o pericardiocentesis
o QT interval monitoring
o ST segment monitoring
• Manage patients requiring:
o endovascular stenting
o PCI Respiratory
• Interpret blood gas results
• Recognize indications for, and manage patients requiring:
o modes of mechanical ventilation
o noninvasive positive pressure ventilation (e.g., BiPAP, CPAP, high-flow nasal cannula)
o oxygen therapy delivery devices
o prevention of complications related to mechanical ventilation (ventilator bundle)
o prone positioning
o pulmonary therapeutic interventions related to mechanical ventilation: airway clearance, extubation, intubation, weaning
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2 )
o thoracentesis
o tracheostomy Hematology and Immunology
• Manage patients receiving transfusion of blood products
• Monitor patients and follow protocols:
o pre-, intra-, post-intervention (e.g., plasmapheresis, exchange transfusion, leukocyte depletion)
o related to blood conservation Neurological
• Recognize indications for, and manage patients requiring neurologic monitoring devices and drains (e.g., ICP, ventricular or lumbar drain)
• Use a swallow evaluation tool to assess dysphagia
• Manage patients requiring:
o neuroendovascular interventions (e.g., coiling, thrombectomy)
o neurosurgical procedures (e.g., pre-, intra-, post-procedure)
o spinal immobilization Integumentary
• Recognize indications for, and manage patients requiring, therapeutic interventions (e.g. wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment) Gastrointestinal
• Monitor patients and follow protocols for procedures pre-, intra-, post-procedure (e.g., EGD, PEG placement)
• Intervene to address barriers to nutritional/fluid adequacy (e.g., chewing/swallowing difficulties, alterations in hunger and thirst, inability to self-feed)
• Recognize indications for, and manage patients requiring:
o abdominal pressure monitoring
o GI drains
o enteral and parenteral nutrition Renal and Genitourinary
• Identify nephrotoxic agents
• Monitor patients and follow protocols pre-, intra-, and post-procedure (e.g., renal biopsy, ultrasound)
• Recognize indications for, and manage patients requiring, renal therapeutic intervention (e.g., hemodialysis, CRRT, peritoneal dialysis)
Musculoskeletal
• Manage patients requiring progressive mobility
• Recognize indications for, and manage patients requiring, compartment syndrome monitoring
Multisystem
• Manage continuous temperature monitoring
• Provide end-of-life and palliative care
• Recognize risk factors and manage malignant hyperthermia
• Recognize indications for, and manage patients undergoing:
o continuous sedation
o intermittent sedation
o neuromuscular blockade agents
o procedural sedation - minimal
o procedural sedation - moderate
o targeted temperature management (previously known as therapeutic hypothermia)
Behavioral and Psychosocial
• Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)
• Use behavioral assessment tools (e.g., delirium, alcohol withdrawal, cognitive impairment)
• Recognize indications for, and manage patients requiring:
o behavioral therapeutic interventions
o medication management for agitation
o physical restraints

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (14%)
1. Cardiac infection and inflammatory diseases
2. Cardiac malformations
3. Cardiac surgery
4. Cardiogenic shock
5. Cardiomyopathies
6. Cardiovascular catheterization
7. Dysrhythmias
8. Heart failure
9. Hypertensive crisis
10. Myocardial conduction system defects
11. Obstructive shock
12. Vascular occlusion
B. Respiratory (18%)
1. Acute pulmonary edema
2. Acute pulmonary embolus
3. Acute respiratory distress syndrome (ARDS)
4. Acute respiratory failure
5. Acute respiratory infection
6. Air-leak syndromes
7. Apnea of prematurity
8. Aspiration
9. Chronic pulmonary conditions
10. Congenital airway malformations
11. Failure to wean from mechanical ventilation
12. Pulmonary hypertension
13. Status asthmaticus
14. Thoracic and airway trauma
15. Thoracic surgery

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)
1. Endocrine
a. Adrenal insufficiency
b. Diabetes insipidus (DI)
c. Diabetic ketoacidosis (DKA)
d. Diabetes mellitus, types 1 and 2
e. Hyperglycemia
f. Hypoglycemia
g. Inborn errors of metabolism
h. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC)
c. Immune deficiencies
d. Myelosuppression (e.g., thrombocytopenia, neutropenia)
e. Oncologic complications
f. Sickle cell crisis
g. Transfusion reactions
3. Gastrointestinal
a. Abdominal compartment syndrome
b. Abdominal trauma
c. Bowel infarction, obstruction and perforation
d. Gastroesophageal reflux
e. GI hemorrhage
f. GI surgery
g. Liver disease and failure
h. Malnutrition and malabsorption
i. Necrotizing enterocolitis (NEC)
j. Peritonitis
4. Renal and Genitourinary
a. AKI
b. Chronic kidney disease (CKD)
c. Hemolytic uremic syndrome (HUS)
d. Kidney transplant
e. Life-threatening electrolyte imbalances
f. Renal and genitourinary infections
g. Renal and genitourinary surgery
5. Integumentary
a. IV infiltration
b. Pressure injury
c. Skin failure (e.g., hypoperfusion)
d. Wounds

D. Musculoskeletal/Neurological/Psychosocial (15%)
1. Musculoskeletal
a. Compartment syndrome
b. Musculoskeletal surgery
c. Musculoskeletal trauma
d. Rhabdomyolysis
2. Neurological
a. Acute spinal cord injury
b. Agitation
c. Brain death
d. Congenital neurological abnormalities
e. Delirium
f. Encephalopathy
g. Head trauma
h. Hydrocephalus
i. Intracranial hemorrhage
j. Neurogenic shock
k. Neurologic infectious disease
l. Neuromuscular disorders
m. Neurosurgery
n. Pain: acute, chronic
o. Seizure disorders
p. Space-occupying lesions
q. Spinal fusion
r. Stroke
s. Traumatic brain injury (TBI)
3. Behavioral and Psychosocial
a. Abuse and neglect
b. Post-traumatic stress disorder (PTSD)
c. Post-intensive care syndrome (PICS)
d. Self-harm
e. Suicidal ideation and behavior

E. Multisystem (13%)
1. Acid-base imbalance
2. Anaphylactic shock
3. Death and dying
4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
5. Hypovolemic shock
6. Post-transplant complications
7. Sepsis
8. Submersion injuries (i.e. near drowning)
9. Hyperthermia and hypothermia
10. Toxin and drug exposure

II. Professional Caring & Ethical Practice (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
• Manage patients receiving:
o continuous sedation
o extracorporeal membrane oxygenation (ECMO)
o nonpharmacologic interventions
o pharmacologic interventions
o intra-procedural and post-procedural care
o post-operative care
o vascular access
• Conduct physical assessment of critically ill or injured patients
• Conduct psychosocial assessment of critically ill or injured patients
• Evaluate diagnostic test results and laboratory values
• Manage patients during intrahospital transport
• Manage patients undergoing procedural sedation
• Manage patients with temperature monitoring and regulation devices
• Provide family-centered care Cardiovascular
• Manage patients requiring:
o arterial catheterization (e.g., arterial line)
o cardiac catheterization
o cardioversion
o CVP monitoring
o defibrillation
o epicardial pacing
o near-infrared spectroscopy (NIRS)
o umbilical catheterization (e.g., UVC, UAC)
• Manage patients with:
• cardiac dysrhythmias
• hemodynamic instability Respiratory
• Manage patients requiring:
o artificial airways (e.g., endotracheal tubes, tracheotomy)
o assistance with airway clearance chest tubes
o high-frequency oscillatory ventilation (HFOV)
o mechanical ventilation
o noninvasive positive-pressure ventilation (e.g., CPAP, nasal IMV, high-flow nasal cannula)
o prone positioning
o respiratory monitoring devices (e.g., SpO2, SVO2, EtCO2)
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)
o thoracentesis
Hematology and Immunology
• Manage patients receiving:
o plasmapheresis, exchange transfusion or leukocyte depletion
o transfusion
Neurological
• Conduct pain assessment of critically ill or injured patients
• Manage patients with seizure activity
• Provide end-of-life and palliative care
• Manage patients requiring:
o neurologic monitoring devices and drains (e.g., ICP, ventricular drains, grids)
o spinal immobilization Integumentary
• Manage patients requiring wound prevention and/or treatment (e.g., wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment)
Gastrointestinal
• Manage patients with inadequate nutrition and fluid intake (e.g., chewing and swallowing difficulties, alterations in hunger and thirst, inability to self-feed)
• Manage patients receiving:
o enteral and parenteral nutrition
o GI drains
o intra-abdominal pressure monitoring Renal and Genitourinary
• Manage patients requiring:
o electrolyte replacement
o renal replacement therapies (e.g., hemodialysis, CRRT, peritoneal dialysis)
Multisystem
• Manage patients requiring progressive mobility
Behavioral and Psychosocial
• Conduct behavioral assessment of critically ill or injured patients (e.g., delirium, withdrawal)
• Manage patients requiring behavioral and mental health interventions
• Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (5%)
1. Acute pulmonary edema
2. Cardiac surgery (e.g., congenital defects, patent ductus arteriosus)
3. Dysrhythmias
4. Heart failure
5. Hypovolemic shock
6. Structural heart defects (acquired and congenital, including valvular disease)

B. Respiratory (21%)
1. Acute respiratory distress syndrome (ARDS)
2. Acute respiratory failure
3. Acute respiratory infection (e.g., pneumonia)
4. Air-leak syndromes
5. Apnea of prematurity
6. Aspiration
7. Chronic conditions (e.g., chronic lung disease/bronchopulmonary dysplasia)
8. Congenital anomalies (e.g., diaphragmatic hernia, tracheoesophageal fistula, choanal atresia, tracheomalacia, tracheal stenosis)
9. Failure to wean from mechanical ventilation
10. Meconium aspiration syndrome
11. Persistent pulmonary hypertension of the newborn (PPHN)
12. Pulmonary hemorrhage
13. Pulmonary hypertension
14. Respiratory distress (RDS)
15. Thoracic surgery
16. Transient tachypnea of the newborn

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (27%)
1. Endocrine
a. Adrenal insufficiency
b. Hyperbilirubinemia
c. Hyperglycemia
d. Hypoglycemia
e. Inborn errors of metabolism
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC)
c. Immune deficiencies
d. Leukopenia
e. Polycythemia
f. Rh incompatibilities, ABO incompatibilities, hydrops fetalis
g. Thrombocytopenia
3. Gastrointestinal
a. Bowel infarction/obstruction/perforation (e.g., mesenteric ischemia, adhesions)
b. Feeding intolerance
c. Gastroesophageal reflux
d. GI abnormalities (e.g., omphalocele, gastroschisis, volvulus, imperforate anus, Hirshsprung disease, malrotation, intussusception, hernias)
e. GI surgeries
f. Hepatic failure (e.g., biliary atresia, portal hypertension, esophageal varices)
g. Malnutrition and malabsorption
h. Necrotizing enterocolitis (NEC)
i. Pyloric stenosis
4. Renal and Genitourinary
a. Acute kidney injury (AKI)
b. Chronic kidney disease
c. Congenital genitourinary conditions (e.g., hypospadias, polycystic kidney disease, hydronephrosis, bladder exstrophy)
d. Genitourinary surgery
e. Infections
f. Life-threatening electrolyte imbalances
5. Integumentary
a. Congenital abnormalities (e.g., epidermolysis bullosa, skin tags)
b. IV infiltration
c. Pressure injury/ulcer (e.g., device, incontinence, immobility)
d. Wounds:
i. non-surgical
ii. surgical

D. Musculoskeletal/Neurological/Psychosocial (13%)
1. Musculoskeletal
a. Congenital or acquired musculoskeletal conditions
b. Osteopenia
2. Neurological
a. Agitation
b. Congenital neurological abnormalities (e.g., AV malformation, myelomeningocele, encephalocele)
c. Encephalopathy
d. Head trauma (e.g., forceps and/or vacuum injury)
e. Hemorrhage:
i. intracranial (ICH)
ii. intraventricular (IVH)
f. Hydrocephalus
g. Ischemic insult (e.g., stroke, periventricular leukomalacia)
h. Neurologic infectious disease (e.g., viral, bacterial, fungal)
i. Neuromuscular disorders (e.g., spinal muscular atrophy)
j. Neurosurgery
k. Pain (acute, chronic)
l. Seizure disorders
m. Sensory impairment (e.g., retinopathy of prematurity, hearing impairment, visual impairment)
n. Stress (e.g., noise, overstimulation, sleep disturbances)
o. Traumatic brain injury (e.g., epidural, subdural, concussion, physical abuse)
3. Behavioral and Psychosocial
a. Abuse and neglect
b. Families in crisis (e.g., stress, grief, lack of coping)

E. Multisystem (14%)
1. Birth injuries (e.g., hypoxic-ischemic encephalopathy, brachial plexus injury, lacerations)
2. Developmental delays
3. Failure to thrive
4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
5. Hypotension
6. Infectious diseases (e.g., influenza, respiratory syncytial virus, multidrugresistant organisms)
7. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, maternal-fetal transfusion, placental
abruption, placenta previa) 8. Low birth weight/prematurity
9. Sepsis
10. Terminal conditions (e.g., end-of-life, palliative care)
11. Thermoregulation
12. Toxin/drug exposure (e.g., neonatal abstinence syndrome, fetal alcohol syndrome, maternal or iatrogenic).

II. Professional Caring & Ethical Practice (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
• Assess pain considering patients gestational age
• Follow protocol for newborn car seat testing, hearing and congenital heart disease screening
• Follow protocol for feeding and supplementation
• Identify and monitor normal and abnormal diagnostic test results
• Implement interventions to keep neonates safe (e.g., transponder use, safe sleep)
• Manage monitor alarms based on protocol and change in patient condition
• Manage patients receiving complementary alternative medicine and/or nonpharmacologic interventions
• Manage patients receiving medications (e.g., safe administration, monitoring, polypharmacy)
• Monitor patients and follow protocols for pre- and postoperative care
• Recognize indications for, and manage patients requiring, central venous access
• Recognize normal and abnormal:
o developmental assessment findings and provide developmentally appropriate care
o family psychosocial assessment findings
o physical assessment findings
• Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed
Cardiovascular
• Apply leads for cardiac monitoring
• Identify, interpret and monitor cardiac rhythms
• Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability
• Recognize early signs of decreased cardiac output
• Recognize normal fetal circulation and transition to extra-uterine life
Recognize indications for, and manage patients requiring:
o 12-lead ECG
o arterial catheter
o cardioversion
o invasive hemodynamic monitoring Respiratory
• Interpret blood gas results
• Manage medications and monitor patients requiring rapid sequence intubation (RSI)
• Recognize indications for, and manage patients with, tracheostomy
• Recognize indications for, and manage patients requiring:
o assisted ventilation
o bronchoscopy
o chest tubes
o endotracheal tubes
o non-invasive positive pressure ventilation (e.g., bilevel positive airway pressure, CPAP, high-flow nasal cannula)
o oxygen therapy delivery device
o prone positioning (lateral rotation therapy)
o rescue airways (e.g., laryngeal mask airway [LMA])
o respiratory monitoring devices (e.g., SpO2, EtCO2) and report values
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)
o thoracentesis
Hematology and Immunology
• Manage patients receiving transfusion of blood products
• Monitor and manage patients with bleeding disorders
• Monitor patients and follow protocols:
o pre-, intra-, post-intervention (e.g., exchange transfusion)
o related to blood conservation
Neurological
• Manage patients with congenital neurological abnormalities



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Epic solutions (smartly, answers some) questions | CCRN PDF download and test dumps

When Marc Eisen set out to write a cover story about Epic methods Corp., he knew working with the famously insular tech company would be a problem. but he did get just a few questions answered.

September 17, 2020 6:31 PM

Marc Eisen

Posted: September 17, 2020 6:31 PM

up-to-date: September 23, 2020 eight:33 AM

Epic9Illustration via Tommy Washbush

As mentioned in my October concern cowl story, “The future of Madison’s Epiconomy,” Epic systems Corp. is famously insular and used to environment the terms of its engagement with newshounds. I’ve periodically written about Epic on the grounds that 2002 and during the past interviewed exact executives. however no longer this time.

I requested an interview in mid-may and became informed in early June it will be “least difficult” for me to post written questions. You’ll locate these questions and verbatim answers beneath. After the furor erupted over Epic’s plans to re-open the campus amidst the pandemic, I submitted additional questions. You’ll locate them on the end of this story. Epic selected to answer only 1.

After the cover story turned into written and in galley kind watching for printing, Epic did present to arrange an interview. This changed into appreciated but their cut-off date had passed.

(A edition of right here questions had been submitted June four, 2020 and answered on July 2, 2020.)

What are one of the vital greatest challenges and opportunities facing Epic?Our most efficient challenge and possibility will continue to be assisting health care organizations worldwide be triumphant with their affected person care missions, aid their personnel and operate sustainably. during the pandemic, we’ve helped their consumers handle many challenges like opening box hospitals, including beds to present amenities, expanding testing and monitoring COVID-19 information.

Please clarify the place Epic sees itself getting into the next five to twenty years in regards to market innovation.a number of things we’ll be working to expand sooner or later include:

  • Epic fitness analysis community, a journal designed for quick sharing of skills to aid solve scientific issues. reports posted on EHRN are in keeping with electronic fitness listing records — spanning tens of millions of patients — to speed up analysis. contemporary experiences have examined delays in movements cancer screenings all the way through the pandemic and associations between pre-latest conditions and COVID-19 severity.
  • “hiya Epic,” a voice assistant that lets clinicians ask the gadget questions like, “What became the patient’s last ldl cholesterol outcomes?” and coach it to order medicinal drugs and perform other tasks. sooner or later, clinicians will be capable of finished their notes and other documentation for some visits only by talking – with out using the mouse or keyboard.
  • artificial Intelligence helps clinicians make sense of thousands of pieces of affected person statistics generated every minute coming from machines that video display coronary heart cost, blood pressure, temperature and extra. There’s too plenty records for the human brain to system, but algorithms can take all of that complexity and turn it into understandable, actionable tips.
  • Payer Platform automates records sharing and collaboration between payers and health care companies. as an instance, when a physician orders a method, the affected person’s insurance business might be capable of approve it electronically, reducing administrative work and helping patients get the care they need sooner. They see opportunities to proceed to enrich sharing throughout all events to pressure better consequences at a lessen can charge.
  • What does Epic trust its most enjoyable successes?We’re proud to aid health care suppliers store lives and preserve their patients fit. As their valued clientele share their consequences, they move alongside what they’ve discovered to other shoppers so that greater sufferers can improvement.

    what's Epic’s response to the may also four, 2020, article within the New Yorker that criticizes digital fitness information? health practitioner “burnout” is a huge concern in health care. a variety of reports blame the added hours that medical doctors put into EHR listing-retaining as a huge reason for their burnout.The article highlights the elements that add to doctors’ work. health care agencies use EHRs to compile tips they're required to post to companies like regulators and insurers, and this frequently results in physicians being requested to doc tips no longer directly involving affected person care. Their developers work perpetually to automate these tasks and make the system handy to make use of.

    reviews from KLAS, an unbiased research company that interviews lots of clinicians, have shown that the three most essential issues for physicians to be a hit with Epic are 1) personalizing the gadget by the use of its many configuration settings so that it works as the physician would like it to, 2) decent practicing, and three) an agile health gadget that at all times improves workflows, activates new facets and makes selections immediately.

    what is the repute of the have faith and scientific groundwork that [Epic founder Judith] Faulkner announced in 2015 as the inheritor of her stock? Has the Epic Heritage foundation been created?A believe has been centered to help Epic’s lengthy-time period aim to stay deepest and worker-owned. A foundation has been established for charitable giving.

    What’s the total dimension of the campus?The campus is greater than 1,000 acres complete, with about 225 acres developed to date.

    what number of constructing phases have there been? how many rectangular feet built and acres developed?There have been seven building phases. This includes 5 office campuses, the getting to know center for consumer practising, and the Deep space auditorium. collectively, they cowl more than 8 million square ft. Geothermal heating and cooling, underground parking and sustainable building substances support us reduce environmental impact.

    Which architect(s) do you're employed with?The architect is Cunningham community from Minneapolis.

    Are Epic staffers eligible to purchase stock at a definite point? If sure, have they got to promote the shares once they go away?Our stock software acknowledges the dedication and dedication of their workforce through giving people that have been at Epic for as a minimum two years the opportunity to turn into owners. When personnel go away, Epic can purchase back inventory.

    Does the business in shape staff donations, fund their donations, or simply serve as a conduit for employee gifting?We provide returned to the community via volunteering, business-broad drives and annual donations to lots of of nonprofits. They focal point on helping education programs for underserved populations and programs that deliver clinical suggestions for low profits, underinsured or at-chance populations. For their annual giving application, they present a protracted record of charities starting from food pantries right here in Dane County to international catastrophe relief organizations. every staff member gets to vote on how Epic allocates donations.

    Epic is frequently accused of no longer sharing data with different methods. Critics argue that patients may still be in can charge of their personal facts in the same method that people can direct their economic data to be shared with third events. They additionally say that opening the EHR information movement will drastically facilitate new apps for you to parse the records and free up new lifestyles-saving cures. That Epic selfishly appears to suppose that the information is Epic’s. What say you?Epic’s application makes it possible for comfy statistics sharing with other systems the use of country wide interoperability specifications. Their purchasers alternate over 5 million patient charts every day and pretty much 2 billion per year. greater than forty% of those exchanges are with businesses using different methods.

    We help connections with apps via requisites referred to as sensible on FHIR, and they publish the necessities that they use on-line.

    sufferers can decide to share suggestions from their Epic medical statistics through MyChart with any care provider on the earth that has internet access.

    App Orchard is disliked through some app builders who say Epic’s expenses and income-sharing reduce are each too excessive and undeserved. they say Epic provides no real support to them in making revenue to health systems, so why may still Epic be taking a reduce of profits?App Orchard offers a lot of supplies and assist for app builders. Epic team of workers help them design their purposes to integrate with their application. They provide documentation, tutorials and classroom practicing as well as test records, simulators and other tools to aid them construct and test their items.

    To help app builders study extra about connecting with Epic, they deliver webinars and discussion boards, and they host an annual developers’ conference.

    consumers are free to choose apps that top-quality meet their needs. When a consumer chooses an app from the App Orchard library, Epic supports each the client and the developer during the installation technique.

    Does Epic suppose that its EHRs have produced the financial discounts that were firstly estimated when the feds began subsidizing the conversion from paper facts?Our software supports their valued clientele’ fiscal health in lots of techniques. as an instance, Bellin fitness in eco-friendly Bay makes use of Epic to control its price-based mostly care model, which specializes in health and managing chronic conditions. This helps their patients live in shape and saved $1.four million in 365 days.

    Duke college fitness system in North Carolina decreased the time sufferers spend within the clinic to treat complicated conditions, saving $20 million over five years.

    Moody’s financial data shows that groups that change to Epic enhance their working margins after installation their utility.

    for example, businesses that switched from one enormous EHR vendor had a regular boost of 18% three years after installing Epic which greater to 41% 5 years after installing Epic. companies that switched from one other enormous EHR vendor had a typical increase of 38% three years after setting up Epic which greater to 100% 5 years after installation Epic.

    (The questions below were submitted on Aug. 28, 2020.)

    Epic caught flack for its preliminary return-to-campus plan. What did the general public and body of workers no longer be aware about the urgency?We had been assembly normally with Public fitness Madison and Dane County right through the summer, sharing in detail their reopening plan. They many times observed that they had on no account been in violation of any part of the health order. really, they advised us they supposed to come visit their campus in adult as the plan stepped forward. The letter they obtained from PHMDC on Aug. 7, one enterprise day before their phased plan turned into scheduled to begin, became abrupt, sudden and not consultant of what they regarded to be an open and collaborative technique. (Answered Sept. eight, 2020.)

    beneath power from its group of workers and public health officers, Epic has considering that revamped and slowed (and/or adjusted) its return to campus. to quote a truism from veteran jazz artist Ben Sidran: “existence’s a lesson.” What instructions has Epic discovered from this episode?(no longer answered.)

    other fundamental IT agencies with superb campuses like Epic’s have embraced far flung working as a safer yet productive technique to carry out company. Why did Epic suppose this alternative approach changed into below fascinating for its work?(no longer answered.)

    as a result of the COVID-19 emergency, many hospitals and health facilities are reporting large-time salary declines and are chopping expenses by way of delaying digital health checklist projects. Has this trend affected Epic’s salary circulate? could Epic should inn to layoffs because of this?(not answered.)

    Epic announced an incredible interior consolidation these days. Are different fundamental changes at Epic in the works?(no longer answered.)


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