title: Evolving trends in critical care nursing practice: results of a certification role delineation study.
abstract: BACKGROUND
  In 1997, the AACN Certification Corporation, in conjunction with Professional Examination Service, undertook a role delineation study as 1 component of a large-scale, comprehensive, and systematic study of practice to update previous data. Focus groups made up of practicing critical care nurses were used to determine trends and changes in adult, pediatric, and neonatal critical care nursing practice.
  
  
  METHODS
  Sixteen focus groups (6 adult, 5 pediatric, and 5 neonatal) used specially prepared protocols to guide discussions. Questions were designed to elicit descriptions of changes in critical care nursing practice in the preceding 5 years. Qualitative comments of the participants were analyzed across all the focus groups, rather than separately for the adult, pediatric, and neonatal focus groups. Then data for the focus groups for each patient-age range were aggregated and reviewed to abstract themes.
  
  
  RESULTS
  Trends and changes in practice for adult, pediatric, and neonatal critical care nurses were determined. Common themes include ethical and legal issues, changes in the population of patients, psychosocial factors, and the impact of managed care.
  
  
  CONCLUSIONS
  The results of these focus groups can be used to update the test blueprints that underlie the CCRN certification examination programs for adult, pediatric, and neonatal critical care nurses. Critical care nursing practice is changing. Specific knowledge of the changes is important for educators, managers, and clinicians. The results of this role delineation study can be used to teach, adapt systems, and validate practice.
authors.affiliation: AACN Certification Corporation, Aliso Viejo, Calif. 92656, USA.
authors.forename: M
authors.initials: M
authors.lastname: Biel
authors.forename: J A
authors.initials: JA
authors.lastname: Eastwood
authors.forename: P
authors.initials: P
authors.lastname: Muenzen
authors.forename: S
authors.initials: S
authors.lastname: Greenberg
mesh_terms: D000328:Adult; D000367:Age Factors; D001291:Attitude of Health Personnel; D002568:Certification / Q000458:organization & administration*; D002648:Child; D003422:Critical Care / Q000639:trends*; D004521:Educational Measurement; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007231:Infant, Newborn; D007587:Job Description; D017283:Neonatal Nursing / Q000193:education / Q000639:trends; D015402:Nursing Education Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology; D009936:Organizational Innovation; D010371:Pediatric Nursing / Q000193:education / Q000639:trends; D013041:Specialties, Nursing / Q000193:education* / Q000639:trends*; D014481:United States