JoAnn Grif Alspach

Critical Care Nurse (CCN) exists to provide its readers with timely, relevant, and useful information related to the bedside care of critically and acutely ill patients and to the multifaceted issues that affect their practice. As a professional nursing journal with both print and online presence, CCN is also interested in ensuring that we present information effectively and efficiently, and in a style that readers find appealing, inviting, and easy to use. In order to determine whether we are achieving these complementary purposes and to establish direction for evolving improvements, CCN surveys its readers each year shortly after the National Teaching Institute. Survey responses are collected, compiled, and analyzed as our evidence base to better meet reader needs and preferences. Based on reader input, CCN sets sail for the next year’s issues by remaining on course where feedback indicates we are meeting readers’ needs, adjusting course to avoid approaches less favored by readers, and navigating into previously unchartered waters to add fresh insights and new resources for readers. This editorial will provide an overview of the origins of our 2013 redesign plan and introduce you to some of the changes to improve the value added benefits of CCN.

We invite you to browse the new layout as well as read the papers in this issue to see examples of your requested changes. Please let us know if we are on a true course—send your feedback to [email protected].

In June 2012, more than 3200 respondents completed CCN’s annual reader survey, which was e-mailed to all AACN members. Most (61%) of the respondents identified themselves as bedside/staff nurses and 38% reported that they have been AACN members for longer than 10 years. Readers provided us with feedback on journal content and format, print and online offerings, CNE tests, and suggested changes.

A second group of approximately 60 AACN volunteers were convened about a month later to offer their appraisals of a variety of redesigned elements such as CCN’s cover, table of contents, features, columns, content formats, and tables and figures.

In the annual reader survey, respondents provided comments to a question about what changes they would suggest so CCN could better meet their needs. A majority of these comments indicated readers like/love CCN as it currently exists—no changes are needed, and many respondents shared that their subscription to CCN was a primary benefit of their AACN membership. Readers particularly liked the following:

  • Content that maintains its clinical practice and focus on patient care

  • Wide variety of important clinical content

  • Mixture of long and short articles, ranging from single voices in the Editorial and Letters to the Editor to thorough coverage of specific clinical topics

  • Unique forums such as Ask the Experts, I Am a Critical Care Nurse, and In Our Unit

  • Continuation of CCN in a print version

We also paid attention to what readers did not appreciate, including the following:

  • Long pages of dense, solid text

  • Font sizes that are too small to easily read

  • Tables with color backgrounds that reduce contrast with text color

  • Tables or figures that are visually complex or content heavy

  • Research that presents nothing new to affect practice We were disappointed to learn that we have much work to do to “get out the word” to AACN members and other CCN subscribers regarding availability and access to a number of our online resources:

  • CCN’s OnlineNOW articles—online-only articles available to all readers at our website

  • The mobile-friendly version of the CCN website (

  • RSS feeds (

  • CCN Facebook ( and CCN Twitter (

Readers and volunteers were thoughtful and generous in supplying many practical and practice-based recommendations to enhance the value and usefulness of CCN in their professional life:

  • Covers that project a professional and cuttingedge look, yet are inviting

  • More visual elements to break up long pages of text

  • Helpful and easy-to-read tables and figures

  • Summaries of important information relevant to critical care practice

  • Focus on evidence-based science necessary for critical care nursing practice

  • More articles in specified clinical content areas like pediatric, progressive care, cardiovascular, and trauma

  • More articles that help prepare for CCRN and other AACN certification examinations, afford review questions for experienced staff self-development or ongoing continuing education, and help orient new staff nurses to critical care

Some Special Announcements

In direct response to 2 of these reader requests, CCN is pleased to announce the inauguration of 2 new ongoing departments: a certification review department (Certification Test Prep), which debuts in this issue, and a CCN-Cochrane Nursing Care Collaboration department, currently planned for launch in the August 2013 issue.

Carol Rauen, Contributing Editor for the Certification Test Prep department, is coordinating a select group of writers to prepare combinations of multiple-choice items comparable in style, content, and difficulty to items that appear in the following AACN certification examinations:

  • CCRN, Adult Critical Care Nursing Certification

  • CCRN-E, Tele-ICU Adult Critical Care Nursing Certification

  • CCRN-N, Neonatal Acute Critical Care Nursing Certification

  • CCRN-P, Pediatric Acute Critical Care Nursing Certification

  • PCCN, Adult Progressive Care Nursing Certification

  • CMC, Adult Cardiac Medicine Subspecialty Certification

  • CSC, Adult Cardiac Surgery Subspecialty Certification

Each multiple-choice item will include the question and options, the correct answer, rationale, and supporting references. We plan to publish this department in every issue of CCN to meet the expressed needs of our readers.

CCN is equally delighted to announce that we will soon be publishing summaries of reviews prepared by the globally renowned Cochrane Collaboration (, an independent international, nonprofit organization established in 1993 to ensure that unbiased, up-to-date, accurate information regarding the effects of health care interventions is readily available on a worldwide basis. The Cochrane Collaboration produces, updates, and disseminates systematic reviews of research on the effectiveness of various health care therapies that enable health care professionals to make informed decisions based on the latest accumulated scientific evidence. Cochrane Reviews are published in The Cochrane Library, an online collection of databases (Cochrane Database of Systematic Reviews) that brings together these rigorous analyses of health care research evidence to determine the “bottom line” of clinical implications that health care professionals should take away and act upon.

Although critical care nurses could access complete copies of the hundreds of Cochrane Reviews and updates completed each year, few directly relate to critical care, acute care, or progressive care patient populations. We are indeed fortunate, then, that one of the entities within the Cochrane Collaboration is the Cochrane Nursing Care Field (CNCF, CNCF members prepare summaries of nursing care–relevant Cochrane Reviews for publication in nursing journals to heighten awareness of Cochrane Reviews among nurses and to facilitate the transfer of the valid and reliable research findings into practice. Final preparations should be completed in this endeavor very soon, so we look forward to sharing more details with you as soon as these are determined.

Structural and Artistic Changes

The feedback we received from readers and volunteers laid the groundwork for this redesign. We focused on enhancing the readability of CCN, using colors and white space, and on providing content in different and new formats. We invite you to browse the new layout as well as read the papers in this issue to see examples of your requested changes already implemented, including the following:

  • Clear identification of all CNE articles on the cover and a clean, professional cover look that continues throughout the journal pages (Figure 1)

  • In the table of contents, CCN Fast Facts pages are listed to help readers decide if they would benefit from reading the entire article

  • Throughout the issue, font size and use of color enhance the reading experience

  • Synopses of articles in the form of visually highlighted abstracts, CCN Fast Facts that summarize long feature articles, and visually striking pull-quotes that emphasize key points in articles

  • Tables are designed to improve clarity and visibility of entries (Figure 2)

Figure 1

Redesigned cover.

Figure 1

Redesigned cover.

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Figure 2

Old and new, redesigned tables.

Figure 2

Old and new, redesigned tables.

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Journal development and design are always organic efforts, so we will continue to strive to make refinements to improve CCN, especially when readers are so kind to take time from their busy lives to afford us with direction in doing so. Thank you for your investment in CCN. Please let us know if we are on a true course—send your feedback to [email protected].