Q Our unit is going to start caring for patients receiving extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). How can I develop and maintain competence in managing these patients?

A Marci Ebberts, MSN, RN, CCRN-K, replies:

Expanding a critical care unit’s capability to provide advanced therapies for the most critical patients is a challenging decision that requires institutional commitment. Developing a high-acuity program is a multifactorial process and can result in critically ill patients being kept on the unit instead of being transferred to another setting. Intensive care unit nurses caring for these patients must develop and maintain competency in applying these therapies, which require planning and administrative support to ultimately ensure patient safety. True collaboration among different disciplines and nurses in various roles—manager, professional development, advanced practice, and clinical staff—is required for successful implementation of high-acuity programs.

Critically ill...

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