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AACN: THE LARGEST AUDIENCE IN CRITICAL CARE
2018 CRITICAL CARE MEDIA PLANNERPRODUCT | DEVICE | PHARMACEUTICAL
The official publications of the
Print Online Custom Publishing
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Advertise in the American Journal of Critical Care, Critical Care Nurse, AACN Bold Voices and AACN Advanced Critical Care. Delivered to the members of AACN or paid subscribers each month, they are the top publications to reach critical care nurses. AACN journals are carried by more than 800 academic and healthcare institutional libraries in the U.S. and abroad. With multiple publications, websites and an e-newsletter, it’s never been easier to reach critical care nurses and track your success – creating ideal environments for your advertising message.
Nurses rely on AACN for expert knowledge and influence. When you advertise with AACN, your message will be surrounded by high-quality, peer-reviewed content you know will be seen by high-interest readers – both AACN members and non-member subscribers. These influential decision-makers are your best prospects in the field of critical care nursing, and the dynamic power of AACN ensures your message greater reach and continuous sales exposure.
About AACNThe American Association of Critical-Care Nurses (AACN) is the world’s largest specialty nursing organization. AACN joins the interests of more than 500,000 critical care and acute care nurses who care for critically ill patients and their families, and serves more than 210,000 members, certificants and nurse constituents. AACN, established in 1969, has grown along with the significance of critical care and acute care nurses.
MissionPatients and their families rely on nurses at the most vulnerable times of their lives. Acute and critical care nurses turn to AACN for expert knowledge and the influence to fulfill their promise to patients and their families. AACN drives excellence because nothing less is acceptable.
PurposeThe purpose of AACN is to promote the health and welfare of patients experiencing acute and critical illness or injury by advancing the art and science of acute and critical care nursing and promoting environments that facilitate comprehensive professional nursing practice.
Reach the members of the world’s largest specialty nursing organization.114,000 high acuity and critical care nurse members
THE POWER OF AACN• TheAmericanAssociation
of Critical-Care Nurses (AACN) is the world’s largest specialty nursing organization.
• AACNjoinstheinterestsofmore than 500,000 critical care and acute care nurses.
• AACNservesmorethan 210,000 members, certificants and nurse constituents.
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Value of the AACN Audience Education + Experience = Influence
Based on 2017 survey respondents and membership analysis.
About the readers of AACN publications
68%
51%
find the advertisements to be valuable sources of product information
purchase and influence products used in the ICU
53% save for future reference
EXPERIENCE IN CRITICAL CARE
36%
24%
18%
22%
36% 1-5 years
24% 21+ years
22% 11-20 years
18% 6-10 years
MARKET INFORMATION
78%
20% 2%
78% Direct patient care
20% Unit managers, advanced practice nurses
2% Educators
SLACK Incorporated, American Association of Critical-Care Nurses Readership Survey, 2017.
Critical Care Nurse is a peer-reviewed clinical journal for nurses involved in the direct care of acute and critically ill patients. Published six times a year, it is an official publication of the American Association of Critical-Care Nurses. Because of its editorial excellence, Critical Care Nurse is the evidence-based clinical journal trusted by staff nurses, nurse educators and nurse managers. The circulation of Critical Care Nurse is more than 114,000 readers, offering the greatest reach of any critical care nursing publication in the market.
Editorial LeadershipJoAnn Grif Alspach, RN, MSN, EdD
Features and Advantages• Official evidence-based clinical journal of the
American Association of Critical-Care Nurses• Largest paid circulation of critical care
nurses available• The highest readership among all critical
care publications• Interspersed advertising• Practical, clinically relevant peer-reviewed articles• Indexed in MEDLINE®/PubMed, Cumulative
Index to Nursing and Allied Health Literature, Medscape, and Scopus
• Included in ISI Web of Knowledge database
The official evidence-based clinical journal of AACN where practical application at the point-of-care is the focus
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The American Journal of Critical Care (AJCC) is AACN’s preeminent peer-reviewed publication for communicating important advances in clinical science research and evidence-based practices in critical care. With particular emphasis on promoting interprofessional practice and research, the American Journal of Critical Care is the most comprehensive scientific publication in the critical care field. Published bimonthly, the American Journal of Critical Care reaches more than 114,000 acute, critical and progressive care nurses — the largest multidisciplinary audience of any critical care science and evidence-based research publication.
Editorial LeadershipCindy Munro, RN, PhD, ANP, FAAN, Coeditor in Chief Richard H. Savel, MD, FCCM, Coeditor in Chief
Features and Advantages• Official evidence-based science and research
journal of the American Association of Critical-Care Nurses
• Peer-reviewed, high-quality editorial environment• More than 114,000 readers: the largest circulation
of critical care professionals of any clinical science and research journal
• Editorial direction from an interprofessional board of leaders in critical care
• Interspersed advertising• Indexed in MEDLINE®/PubMed, Cumulative
Index to Nursing and Allied Health Literature, Medscape, PsycINFO, and Scopus
• Included in ISI Web of Knowledge database
The official evidence-based scientific journal of AACN where innovation is first communicated
Publication 2018 Issue Ad Closing Material Due Bonus Distribution
AJCC Jan 11/27/17 12/4/17 Society of Critical Care Medicine February 25-28, San Antonio, TX
CCN Feb 12/21/17 1/2/18 Society of Critical Care Medicine February 25-28, San Antonio, TX
AJCC Mar 1/23/18 1/30/18
CCN Apr 2/20/18 2/27/18 National Teaching Institute & Critical Care Exposition - NTI May 21-24, Boston, MA
AJCC May 3/20/18 3/27/18 National Teaching Institute & Critical Care Exposition - NTI May 21-24, Boston, MA
CCN June 4/24/18 5/1/18
AJCC July 5/22/18 5/29/18
CCN Aug 6/26/18 7/2/18 Emergency Nurses Association (ENA) September 26-29, Pittsburgh, PA
AJCC Sept 7/24/18 7/31/18
Emergency Nurses Association (ENA) September 26-29, Pittsburgh, PA Trends in Critical Care Nursing Dates TBD, Valley Forge, PA
CCN Oct 8/22/18 8/28/18
Trends in Critical Care Nursing Dates TBD, Valley Forge, PA **Ad Test Study Issue
AJCC Nov 9/25/18 10/2/18
CCN Dec 10/19/18 10/26/18
Frequency One Page 2/3 Pg* 1/2 Page 1/3 Page* 1/4 Page Color Rates
1x $7,610 $6,310 $4,615 $3,985 $3,675 Per page or fraction Page
Standard Color
Matched Color
Metallic Color
Four Color
Four Color + PMS
Four Color + Metallic
925
1,155
1,230
1,840
2,995
3,065
3x 7,480 6,185 4,535 3,930 3,615
6x 7,440 6,120 4,475 3,880 3,585
12x 7,320 6,055 4,420 3,830 3,525
18x 7,270 5,945 4,365 3,790 3,475
24x 7,200 5,860 4,300 3,750 3,430
36x 7,115 5,795 4,240 3,740 3,385
48x 7,040 5,750 4,200 3,685 3,345
*These sizes are available for CCN only.
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ADDED VALUE
New Advertiser Discount
Take 10% off our regular rates.For advertisers that have not run in the prior year of AJCC or CCN. Minimum half-page ad (cannot be combined with Efficiency Discount).
Efficiency Discount
Buy 4 ad units, receive 10% discount
Buy 6 ad units, receive 13% discount
Buy 10 ad units, receive 16% discount
Buy 12 ad units, receive 20% discount
Combined Frequency Discount Program:
Insertions in the American Journal of Critical Care or Critical Care Nurse can be combined with each other or with insertions in AACN Bold Voices to help you reach the highest possible frequency rate. The result is a direct savings in your advertising expenditures.
Premium Positions (Color Additional)
Cover 2: earned b/w rate plus 25%
Cover 3: earned b/w rate plus 15%
Cover 4: earned b/w rate plus 50%
Opposite Table of Contents: b/w rate plus 15%
Opposite Masthead: b/w rate plus 15%
Contact
Product/Device/ Pharmaceutical Nicole Rutter [email protected] (800) 257-8290, ext. 305
Administrator Joann Campisi [email protected] (800) 257-8290, ext. 585
Product 2018 Advertising Rates and Dates
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Reach more than 2,700 subscribers
composed of high-level experienced critical care nurses.
About the readers of AACN Advanced Critical Care
53% save the issue for future reference
47% share with a colleague
Content attribute ratings
69% of respondents felt the journal’s overall content was of value at work
AACN Advanced Critical Care is a quarterly, peer-reviewed publication of in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. Each issue includes a topic-based symposium, feature articles, and columns of interest to critical care and progressive care clinicians. “Select articles feature opportunities to earn CE contact hours. Select “Drug Update” columns feature pharmacology-based CE contact hours.”
Editorial LeadershipMary Fran Tracy, RN, PhD, CCNS
Features and Advantages• An official publication of the American
Association of Critical-Care Nurses
• Contains concisely written, practical information for immediate use and future reference
• Continuing nursing education units are available for selected articles in each issue
• Indexed in Nursing Abstracts, Cumulative Index to Nursing & Allied Health Literature, International Nursing Index, MEDLINE®/PubMed, Nursing Citation Index, and Scopus
Reach key audiences• Staff Nurse/Clinicians
• Clinical Nurse Specialists
• Nurse Practitioners
• Clinical Educators
• Academic Faculty
• Admin/Nursing Directors
• Nurse Managers
AACN Advanced Critical Care Readership Study, 2017
AACN’s quarterly evidence-based journal for advanced practice caregivers where bedside nurses and clinical educators read the latest critical care information
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Ad Position Rate
Cover 2 $3,570
Cover 3 $3,060
Cover 4 $4,590
Issue Ad Closing Material Due Bonus Distribution
Spring 1/30/18 2/6/18 National Teaching Institute & Critical Care Exposition - NTI May 21-24, Boston, MA
Summer 5/1/18 5/8/18
Fall 7/30/18 8/6/18 Emergency Nursing Association (ENA) September 25-29, Pittsburgh, PA Trends in Critical Care Nursing Dates TBD, Valley Forge, PA
Winter 10/30/18 11/6/18
ADDED VALUE
Efficiency Discount
Buy 4 ad units, receive 10% discount
Buy 6 ad units, receive 13% discount
Buy 10 ad units, receive 16% discount
Buy 12 ad units, receive 20% discount
Combined Frequency Discount Program:
Must advertise in a corresponding issue of American Journal of Critical Care or Critical Care Nurse.
Contact
Product/Device/ Pharmaceutical Nicole Rutter [email protected] (800) 257-8290, ext. 305
Administrator Joann Campisi [email protected] (800) 257-8290, ext. 585
Product 2018 Advertising Rates and Dates
Mechanical Requirements
Ad sizes available for AACN Advanced Critical CareFull Page Non Bleed: 5.5" x 8.75"
Full Page Bleed: 6.875" x 10.125" Hold live matter 1/2" from trim Trim size of Journal is 6.625" x 9.875"
Ad RequirementsAll ads should be submitted as font-embedded PDFs, minimum 300 dpi. Four-color ads must be constructed in CMYK with no use of spot colors and no PMS colors. Black and white ads must be constructed using grayscale, bitmap, or line art accordingly, not using CMYK, spot colors, “rich black” or “Registration” in place of black. Ad files must be converted within the native layout application or flattened in Acrobat using the High Resolution Flattener Presets.
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AACN Bold Voices is AACN’s monthly source of news and current events about critical care, progressive care and high acuity care nursing. Concise and easy-to-read articles present the information readers need at their fingertips. Timely articles ensure high readership and visibility for your recruitment ads. More than 140,000 acute and critical care nurses receive AACN Bold Voices, including members of AACN and nonmembers with CCRN, CCRN-K, CCRN-E, PCCN, and PCCN-K specialty certification; ACNPC, ACNPC-AG, CCNS, ACCNS-AG, ACCNS-P, and ACCNS-N advanced practice certification; and CMC and CSC subspecialty certification.
Product Advertising AACN Bold Voices accepts product advertising. Device and pharmaceutical advertisers can gain a unique market presence and increase ad exposure when they purchase an ad in the official monthly member magazine of AACN. Be seen by a target audience of more than 140,000 critical, acute and progressive care nurses. For more information on how to maximize your visibility by advertising in AACN Bold Voices, please contact Nicole Rutter by phone (800) 257-8290, ext. 305 or email [email protected].
Reach more than 140,000critical care, acute care and progressive care nurses
with the only monthly source of news and current events about critical, progressive and high acuity care nursing.
Only with placement of an ad in American Journal of Critical Care or Critical Care Nurse
50% OFF AACN Bold Voices Published Rates
The official monthly member magazine of AACNwhere clinical information and association news are delivered
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Color Rates
Per page or fraction Page
Standard Color
Matched Color
Four Color
700
1,020
1,690
Issue Ad Closing Material Due Bonus Distribution
Jan 11/29/17 12/6/17
Feb 1/4/18 1/10/18 Society of Critical Care Medicine February 25-28, San Antonio, TX
Mar 2/1/18 2/9/18
Apr 3/1/18 3/8/18
May 4/5/18 4/12/18 National Teaching Institute & Critical Care Exposition - NTI May 21-24, Boston, MA
June 5/3/18 5/8/18
July 5/31/18 6/7/18
Aug 7/5/18 7/12/18
Sept 8/2/18 8/9/18 Emergency Nurses Association (ENA) September 26-29, Pittsburgh, PA
Oct 8/29/18 9/6/18 Trends in Critical Care Nursing Dates TBD, Valley Forge, PA
Nov 10/4/18 10/11/18
Dec 11/1/18 11/8/18
ADDED VALUE
Efficiency Discount
Buy 4 ad units, receive 10% discount
Buy 6 ad units, receive 13% discount
Buy 10 ad units, receive 16% discount
Buy 12 ad units, receive 20% discount
Combined Frequency Discount Program:
Insertions in AACN Bold Voices can be combined with insertions in the American Journal of Critical Care or Critical Care Nurse to help you reach the highest possible frequency rate. The result is a direct savings in your advertising expenditures.
Premium Positions (Color Additional)
Cover 2: earned b/w rate plus 25%
Cover 3: earned b/w rate plus 15%
Cover 4: earned b/w rate plus 50%
Opposite Table of Contents: b/w rate plus 15%
Opposite Masthead: b/w rate plus 15%
Contact
Product/Device/ Pharmaceutical Nicole Rutter [email protected] (800) 257-8290, ext. 305
Administrator Joann Campisi [email protected] (800) 257-8290, ext. 585
Product 2018 Advertising Rates and Dates
The official monthly member magazine of AACNwhere clinical information and association news are delivered Frequency One Page 2/3 Pg 1/2 Page 1/3 Page 1/4 Page 1/8 Page
1x $6,680 $5,890 $5,035 $4,400 $3,775 $2,055
3x 6,540 5,745 4,875 4,255 3,625 1,915
6x 6,380 5,600 4,730 4,095 3,475 1,790
12x 6,225 5,440 4,585 3,955 3,325 1,665
18x 6,080 5,295 4,430 3,795 3,170 1,535
24x 5,920 5,145 4,275 3,645 3,015 1,425
36x 5,780 5,000 4,130 3,495 2,855 1,275
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Mechanical Requirements
Ad RequirementsElectronic submissions only.
Electronic ads must be submitted as high-resolution PDF, EPS or TIFF. Minimum 300 dpi. Quark XPress EPS files are not acceptable.
ALL fonts (both screen and printer versions) and graphics must be included on the disk or embedded in PDFs.
Ads must be submitted in the correct size (full page, half page, etc., allowing for bleed if ad is to bleed; see “Ad sizes”) and orientation (vertical or horizontal per insertion order).
All ad files must be constructed properly. For example: 4-color ads must be constructed in CMYK with no use of spot colors. (If any PMS colors are in the ad the creator of the ad must convert those colors to CMYK.) Any ads intentionally printing with spot colors must be constructed with the proper PMS colors; PMS colors must be indicated and called out on the color proof. Ads to print in black and white must be constructed using grayscale, bitmap, or line art accordingly, rather than CMYK or spot colors, or “rich black” or “Registration” in place of black. Ad files must be converted within the native layout application or flattened in Acrobat using the High Resolution Flattener Presets. Any ads not following these guidelines will be returned to the advertiser for correction if time permits; otherwise, they will be corrected at the printer and printer charges will be billed to the advertiser accordingly. AACN, the printer, and SLACK Incorporated take no responsibility for color shifts or other quality problems that occur when ad files must be corrected at the printer because of poor construction or improper submissions from advertisers or their agencies. Late ads are subject to additional fees.
All ads must include a proof. Color ads must include color copy that can be matched on press (examples: tearsheets; digital proof such as an iris, chromalins, matchprints).Color photocopies or color laser printouts are not acceptable. AACN will not supply a proof for Advertiser-supplied files.
Insert Requirements
Insert requirements for the American Journal of Critical Care and Critical Care Nurse:
Two to 8-page inserts; gatefolds are acceptable.
Paper and copy sample must be submitted for approval before running.a) Size: 8 7/16" x 11 1/8" to trim to 8 1/8" x 10 7/8"; supplied folded.
b) Paper Stock: 2-page (one leaf ), minimum 70# coated, maximum 80# coated. 4–8 page, minimum 60# coated, maximum 70# coated.
c) Trimming: Supply folded. Bleed: outside and foot trim bleed 1/8". Binding edge bleed 1/8". Head bleed 1/8". BRCs need 1/2" margin from edge of grind to vertical perf. Journals jog to the head.
d) Rates:
Two-page inserts: 3x earned black-and-white rate.
Four-page inserts: 5x earned black-and-white rate, by special request only. Consult advertising office. Perforations are subject to approval and/or additional cost.
Contact advertising department for insert tip-in charge.
e) Ship: printed, folded, untrimmed. Label with publication name, date of issue, and insert quantity. American Journal of Critical Care and Critical Care Nurse: Call for quantities as insert quantities vary by issue.
Ship to: Sheridan NH 69 Lyme Road Hanover, NH 03755 Attn: Tim Gates (issue and month)
Ad sizes available for the American Journal of Critical Care (AJCC), Critical Care Nurse (CCN) and AACN Bold Voices (non-bleed)
Quarter Page: 33/8" x 47/8"Spread: 14" x 10" (151/4" x 10" includes gutter spread)Full Page: 7" x 10"Half Page (Horizontal): 7" x 47/8"Half Page (Vertical): 33/8" x 10"
Ad sizes available for Critical Care Nurse and AACN Bold Voices only (non-bleed)
One-Third Page (Vertical): 21/8" x 10"Two-Third Page (Vertical): 43/8" x 10"
Ad sizes available for AACN Bold Voices only (non-bleed)
One-Eighth Page: 33/8" x 23/8"
Spread
14"
10"
Full Page
7"
10"
1/2 Page (Vertical)
33/8"
10"
1/4 Page
33/8"
47/8"
1/8 Page
33/8"
23/8"
2/3 Page (Vertical)
43/8"
10"
1/3 Page (Vertical)
21/8"
10"
1/2 Page (Horizontal)
47/8"
7"
Bleed sizes (available in AJCC and CCN only)
Spread: 161/2" x 111/8" Full Page: 83/8" x 111/8" Two-thirds: 51/4" x 111/8" Half Vertical: 41/4" x 111/8" Half Horizontal: 83/8" x 51/2" Third Vertical: 215/16" x 111/8" Hold live matter 1/2" from all sides.
Trim size of journals is 81/8" x 107/8"
AACN Advanced Critical Care specs: See page 7.
For digital ad specifications, please contact Joann Campisi at [email protected] or (800) 257-8290 x585
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1. Commission and Cash Discounta) Agency commission: 15% gross billings on space,
color, cover and preferred position charges.b) Cash discounts: 2%, within 10 days of invoice date.
No discount allowed after this period.
2. General Rate Policya) Effective Rates and Discounts: Beginning January 2018 for
all advertisers.b) Earned Rates: Full run: Earned rates are given to advertisers
based on advertising frequency within a 12-month period. The earned rate is determined by the number of insertions. A spread counts as two insertions. Full-page and fractional pages count as single insertions. Each page of an insert counts as one insertion.
c) Combined Earned Frequency: Advertisers may combine advertising space units run in Critical Care Nurse, AACN Advanced Critical Care, the American Journal of Critical Care and AACN Bold Voices to achieve maximum rate frequency.
3. ExtensionsIf an extension date for material is agreed upon and ad material is not received by the Publisher on the agreed upon date, the advertiser will be charged for the space reserved.
4. CancellationsIf, for any reason, an advertisement is cancelled after the closing date, the Publisher reserves the right to repeat a former ad at full rates. If the advertiser has not previously run an ad, the advertiser will be charged for the cost of space reserved. Neither the advertiser nor its agency may cancel advertising after the closing date.
5. Advertising Acceptance PolicyAll advertising is subject to approval by AACN. Publisher reserves the right to refuse any advertising at any time.
6. Disposition of MaterialAd material will be held one year from the date of last insertion and then destroyed.
7. Publisher’s and Representative’s LiabilityThe Publisher and Advertising Sales Representative will not be liable for any failure to print, publish, or circulate all or any portion of any issue in which an advertisement accepted by the Publisher is contained if such failure is due to acts of God, strikes, war, accident or any circumstances beyond the Publisher’s control.
8. Indemnification of PublisherIn consideration of publication of an advertisement, the advertiser and the agency, jointly and separately, will indemnify, defend and hold harmless the magazine, its officers, agents and employees against expenses (including legal fees) and losses resulting from the publication of the contents of the advertisement, including, without limitation, claims or suits for libel, violation of right of privacy, copyright infringements or plagiarism.
9. Billing PolicyBilling to the advertising agency is based on acceptance by the advertiser of “dual responsibility” for payment if the agency does not remit within 90 days. The Publisher will not be bound by any conditions, printed or otherwise, appearing on any insertion order or contract when they conflict with the terms and conditions of this rate card.
10. Contracts, Insertion Orders and Ad Materials:Contracts and Insertion Orders: Nicole Rutter, x305 Association Sales Manager [email protected]
Ad Materials: Joann Campisi, x585 Sales Administrator [email protected]
SLACK Incorporated 6900 Grove Road Thorofare, NJ 08086-9447 (800) 257-8290 or (856) 848-1000 (in New Jersey or outside the U.S.) Fax: (856) 848-6091
Insertion Information
JOURNAL WEBSITE OPPORTUNITIES
Banner Ad Specifications:
• Acceptable file formats: GIF, JPG
• Maximum size on banners: 50K
• All artwork is subject to review/acceptance by publisher prior to placement
• Expandable banners will not be accepted
2018 Rates: $50/CPM Net rates, non-commissionable.
Banner Type Location Size
Leaderboard728 x 90 Top of home page & interior pages 728 x 90
Skyscraper160 x 600 Side of home page & interior pages 160 x 600
Vertical Banner160 x 400 Side of home page & interior pages 160 x 400
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Extend your exposure online
Whether you’re looking to brand or promote your product, banner advertising on the websites of the official evidence-based scientific and clinical journals of AACN will increase your exposure to the largest audience in critical care.
Average monthly impressions: 229,001Average monthly unique visitors: 47,418Average monthly impressions: 221,491Average monthly unique visitors: 63,118
Leaderboard
Skys
crap
erVe
rtic
al
Bann
er
www.ajcconline.org
www.ccnonline.org
Average monthly impressions: 45,614Average monthly unique visitors: 13,591www.aacnacconline.org
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EMAIL OPPORTUNITIES
Increase your exposure online
Banner Ad Specifications:
• Acceptable file formats: GIF, JPG • Maximum size on banners: 40K
• All artwork is subject to review/acceptance by publisher prior to placement
• Expandable banners will not be accepted
• All ads should be static (non-animated); no Flash (SWF) or rich media.
Exclusive ad placementOne ad per email is sent to the full list of AACN opt-in recipients with 100% share of voice.
Personalized content Now your message appears within unique content that aligns with the interests of 4 targeted audiences: Nurse Managers and Educators, New Nurse, Experienced Staff Nurse and Advanced Practice to heighten engagement.
Delivered bi-weekly Now you can connect with more relevant personalized content — every other week!
2018 Rates:
Medium Rectangle300 x 250
1 email $2,850 net per email
4 or more emails $2,350 net per email
Average delivered:
195,000Average open rate:
15%•Atleast2emailsreachthefullmembershipeachmonth
•Buyonebanneradandappearinall4targetaudienceemails
AACN CriticalCare Newsline bi-weekly emailReach more than 195,000 critical care nurses at least twice per month — in an effective and cost efficient way. Advertise in the official bi-weekly electronic newsletter of AACN. AACN CriticalCare Newsline provides AACN members and nurse constituents news and current events about critical, progressive and high acuity care. Articles include the latest news, calls to action, CNE articles, studies, AACN member resources and career opportunities.
Reach 210,000 members, certificants and nurse constituents
Consider the many benefits of a custom editorial supplement bearing the AACN name
Value to nurses• CNE credits• Concise, in-depth,
focused information• Education• Confidence in patient care
• Improved outcome for patients
• Resource for personal and patient education
• Relationship with Industry
More value to advertisers• Image building• Brand recognition• Optimal product utilization• Recognition as a key provider
of valuable education and quality products
• Relationship building with nurses, educators and patients
• Market saturation• Competitive edge• Product success• Measurable reader impact
from CNE returns, web exposure
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When you partner with AACN, you reach our specialized audience of high acuity and critical care nurses while you help educate and advance patient care. Custom opportunities offer you direct access, visibility and the trust that comes with the AACN name. Ask us about the possibilities with or without CNE.
Single-supported activity format ideas:• Enduring materials/monographs/supplements
(print, digital, or both)• Enduring materials from your NTI Sunrise Session
in an NTI Morning Report• Expert panels/roundtables• Satellite sessions at NTI• Cover tips• Bellybands
Your influence• Morethan210,000AACNmembersandsubscribers• Healtheducators,impressionablestudents• Patientsandfamilies
CUSTOM OPPORTUNITIES
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Digital Opportunities
Print Opportunities
CREATE A MULTI-CHANNEL MEDIA STRATEGY
The bi-monthly clinical science research journalThe American Journal of Critical Care reaches the largest interprofessional audience of any critical care science and evidence-based research publication.
The clinical practice journal of AACNCritical Care Nurse is the evidence-based clinical journal trusted by staff nurses, nurse educators, and nurse managers.
Quarterly advanced practice publication AACN Advanced Critical Care contains concisely written, practical information for immediate use and future reference.
AACN’s monthly member news magazine AACN Bold Voices updates members with late-breaking clinical information and association news.
AACN CriticalCare NewslineReach more than 195,000 critical care nurses with this bi-weekly email offering banner advertising.
AACN journal websites Expand your reach online by advertising on the official journal websites of AACN: www.aacnacconline.org, www.ajcconline.org, and www.ccnonline.org.
VER.02
CE ArtiClE
CLASS CODE: ART104
THURSDAY
May 25, 2017
Each year, thousands of critic
al
care nurses in the United States
and worldwide perform cardio-
pulmonary resuscitation.1-4 It is esti-
mated that between 40% and 84% of
all resuscitation attempts within criti-
cal care units result in immediate or
imminent death of the patient within
24 hours.1-3,5,6 Because critica
l care
nurses have frequent and cumulative
exposures to unsuccessful cardiopul-
monary resuscitations, psychological
trauma often ensues.7 The literature
in this area is nascent. Despite a grow-
ing workforce demand for registered
nurses in critical care, turnover and
vacancy rates are high.7,8 Investiga-
tion of the cumulative psychological
injuries associated with unsuccessful
cardiopulmonary resuscitation is war-
ranted and may offer new insights on
strategies to attenuate the psychologi-
cal morbidity associated with provid-
ing life-sustaining care and highlight
a need for psychological support pro-
cesses that may aid in the retention of
critical care nurses in the workforce.
The influence of postcode stress
and coping behaviors on the psycho-
logical health of critical care nurses is
unclear. However, it is hypothesized
that critical care nurses who are
exposed to the psychological trauma
of cardiopulmonary resuscitation ef-
forts that fail to prolong the patient’s
life will perceive heightened states
of postcode stress, coping behaviors,
and lower states of psychological
health. Therefore the aims of this
article are to examine the relation-
ships among postcode stress, coping
behaviors, and the severity of symp-
toms of posttraumatic stress disorder
(PTSD), to evaluate the influential
demographic characteristics associ-
ated with postcode stress and PTSD
symptom severity, and to describe
the association between access to
institutional psychological support
(availability of postcode debriefing)
and magnitude of postcode stress
and PTSD symptom severity in a na-
tional sample of critical care nurses.
BACkgROUnD
Critical care nurses are prone to
observe or take part in life-sustaining
procedures (eg, cardiopulmonary
resuscitation) that can alter their
ability to manage negative emotion
effectively and can precipitate signifi-
cant decrements in their psychologi-
cal health. Repeated participation in
unsuccessful resuscitation attempts
creates a unique form of psychologi-
cal stress known as postcode stress,
which has significant effects on the
psychological health of registered
nurses across practice settings.9-11
Lazarus and Folkman’s Transac-
tional Model of Stress and Coping12
provides the theoretical framework
for this study. When presented with
a stressor, it is the appraisal of the
potential psychological harm and the
coping behaviors used that become
the integral components influencing
psychological well-being. Postcode
stress is posited to initiate processes
for regulating emotions, such as cop-
ing behaviors, that aim to maintain
an individual’s psychological health
and prevent manifestation of stress-
associated symptoms.10,12-14 The
difference in coping behaviors used
may offer an explanation of why
individuals have different psycho-
logical outcomes (PTSD symptom
severity) after similar events.15-17
Distinct from moral distress,
which occurs when critical care
nurses are unable to act on moral
decisions or judgments in practice,
postcode stress is the acute psycho-
logical response to unsuccessful
At the end of this learning activity, the participant will be able to:
1. Examine the relationship among postcode stress, coping behaviors, and post-
traumatic stress disorder (PTSD) symptom severity after unsuccessful cardio-
pulmonary resuscitation (CPR).
2. Identify ineffective coping behaviors that may put critical care nurses at risk for
PTSD symptom severity following unsuccessful CPR.
3. Discuss the implications of the study findings to the American Association of
Critical-Care Nurses’ Healthy Work Environments initiative.
Stress and Coping of Critical
Care Nurses After Unsuccessful
Cardiopulmonary Resuscitation
Dawn E. McMeekin, RN, DNP, CNE, Ronald L. Hickman, Jr, RN, PhD, ACNP-BC, Sara L. Douglas, RN, PhD, and Carol G. Kelley, RN, PhD, AGNP-BC
Reprinted from American Journal of Critical Care, March 2017, pp 128-135
1.0 CE, 1.0 CERP, Cat. C
CE/CERP Evaluations
Due June 16
Follow the online prompts at www.
aacn.org/myntisessions to enter your
program and session evaluations
and print your certificate. Copies
of CE/CERP certificates issued are
maintained at AACN in a secure,
password-protected file for a 6-year
period. You may enter evaluation
information online during NTI or at
home until midnight PT, June 16,
2017. After this date, you may only
print your certificate.
Background Participation by a critical care nurse in an unsuccessful resuscitation can
create a unique heightened level of psychological stress referred to as postcode stress,
activation of coping behaviors, and symptoms of posttraumatic stress disorder (PTSD).
Objectives To explore the relationships among postcode stress, coping behaviors, and
PTSD symptom severity in critical care nurses after experiencing unsuccessful cardio-
pulmonary resuscitations and to see whether institutional support attenuates these
repeated psychological traumas.
Methods A national sample of 490 critical care nurses was recruited from the American
Association of Critical-Care Nurses’ eNewsline and social media. Participants completed
the Post-Code Stress Scale, the Brief COPE (abbreviated), and the Impact of Event Scale–
Revised, which were administered through an online survey.
Results Postcode stress and PTSD symptom severity were weakly associated (r = 0.20, P
= .01). No significant associations between coping behaviors and postcode stress were
found. Four coping behaviors (denial, self-distraction, self-blame, and behavioral disen-
gagement) were significant predictors of PTSD symptom severity. Severity of postcode
stress and PTSD symptoms varied with the availability of institutional support.
Conclusions Critical care nurses show moderate levels of postcode stress and PTSD symp-
toms when asked to recall an unsuccessful resuscitation and the coping behaviors used.
Identifying the critical care nurses most at risk for PTSD will inform the development of in-
terventional research to promote critical care nurses’ psychological well-being and reduce
their attrition from the profession. (American Journal of Critical Care. 2017; 26:128-135)
CE ArtiClE
CLASS CODE: ART103
WEDNESDAY
May 24, 2017
New technologies have al-
lowed patients with heart
failure to live longer after
diagnosis. These life-prolonging
technologies may eventually become
incongruent with a patient’s goals
and preferences at the end of life.1,2
An implantable cardioverter defibril-
lator (ICD) is one technology that
may conflict with these goals and
preferences. At the end of life, ICD
therapy can become burdensome
for both the patient and the patient’s
family by causing pain and anxiety
and preventing a sudden death.3-6
Patients have the right to be
informed of all options that might
decrease pain and suffering at the
end of life, including the option to
deactivate ICD therapy. Critical care
nurses often provide care for patients
with heart failure at the end of life
and play an important role in assess-
ing patients’ goals and preferences.
Deactivation of an ICD is ethically
acceptable and should be discussed
with all patients when goals and
preferences are likely to change. This
literature review explores the issues
surrounding ICD therapy at the end
of life; based on this author’s find-
ings, recommendations for discussing
and implementing device deactiva-
tion are provided.
ICD ThERApY IN END-STAgE
hEART FAILuRE
An ICD reduces the risk of death
from potentially lethal arrhythmias.
In patients with heart failure, ICD
implantation is often recommended
for individuals with a reduced ejec-
tion fraction and a life expectancy
greater than 1 year.7 Unfortunately,
providing an accurate prognosis in
heart failure is difficult. Prognosti-
cation tools predict life expectancy
in populations of patients, but can-
not accurately predict how long an
individual patient will live.3 Heart
failure has a changeable course,
characterized by acute exacerba-
tions followed by periods of rela-
tive stability.1,3,6,8-13 It has been
estimated that between 300,000 to
600,000 individuals in the United
States have end-stage refractory
heart failure.6
The first ICDs became available
in the 1980s,14 and the prevalence
of these devices continues to in-
crease,15 with most implanted in pa-
tients more than 65 years of age.16
These devices may prolong life in
some stages of heart failure, but giv-
en the increased prevalence of these
devices at the end of life, it is crucial
that health care professionals discuss
device management when the goals
of care change. Patients may not
desire prolongation of life as heart
failure advances and are not always
aware of their progression into
end-stage disease. The difficulty in
prognostication and the changeable
course of heart failure contribute
to uncertainty about how close the
patient is to death for both health
care professionals and patients.11
This uncertainty may delay end-of-
life discussions and place patients at
risk for increased pain and anxiety
in the final hours of life because of
ICD shocks. Published reports sug-
gest that 21% to 27% of patients
receive a shock in the last 30 days of
their life14,17 and that these shocks
were distressing when witnessed by
the patient’s family.17 In a Swedish
study18 of 130 ICD devices explant-
ed postmortem, 31% of patients
with active ICDs experienced a
shock in the last 24 hours of life.
Approximately half of the patients
with a do-not-resuscitate (DNR)
order still had active shock therapy
at 1 hour before death, and 24% of
these patients received shocks in the
last hour of life.18 In cases where
the device was discharged, 55% of
patients received at least 3 shocks,
and 32% received more than 10
shocks.18 Two-thirds of these shocks
were not documented in the medi-
cal records and may not have been
noticed by family or nursing staff;
however, 19% did have a nota-
tion of pain or stress accompanying
the shocks.18 These statistics are in
stark contrast to the estimated 14%
of patients who receive a shock in
the first year after implantation.19
Patients are more likely to receive
shocks at the end of life if their ICD
has fired previously, but predicting
which patients will receive a shock
at the end of life is impossible.2
Learning Objectives
At the end of this learning activity, the participant will be able to:
1. Discuss strategies for reducing unwanted implantable cardioverter.
2. Identify key triggers for when the discussion of device deactivation should
be addressed.
3. Describe barriers to the discussion of device deactivation with patients
with heart failure.
Planning for Deactivation of Implantable
Cardioverter Defibrillators at the End of Life in
Patients With Heart Failure
Destiny R. Brady, RN, MSN, CCRN
Reprinted from Critical Care Nurse, December 2016, pp 24-31
1.0 CE, 1.0 CERP, Cat. B
CE/CERP Evaluations
Due June 16
Follow the online prompts at www.
aacn.org/myntisessions to enter your
program and session evaluations
and print your certificate. Copies
of CE/CERP certificates issued are
maintained at AACN in a secure,
password-protected file for a 6-year
period. You may enter evaluation
information online during NTI or at
home until midnight PT, June 16,
2017. After this date, you may only
print your certificate.Implantable cardioverter defibrillators (ICDs) may be burdensome in end-stage heart
failure. At the end of life, as many as one-fifth to one-third of patients experience an ICD
shock. Critical care nurses should be aware of the potential burden of these shocks at
the end of life as well as the ethics and organizational policies surrounding ICD deacti-
vation. This literature review examines the issues surrounding ICD therapy at the end of
life. Based on this author’s findings, recommendations for discussing and implementing
ICD deactivation are offered. Health care organizations should have clear policies ad-
dressing ICD deactivation to provide for seamless integration of palliative care services
throughout the course of heart failure. These policies should empower nurses to acti-
vate resources in a timely manner and should clearly outline processes for ICD deactiva-
tion. (Critical Care Nurse. 2016;36[6]:24-32)
CE ArtiClECLASS CODE: ART102
TUESDAY
May 23, 2017
Children are at increased risk
for inadequate pain manage-
ment, with age-related fac-
tors typically determining pain man-
agement regimens.1 The challenge
in pain management can include,
but is not limited to, insufficient
knowledge of pediatric pain and
pain pathway development, uncer-
tainty about appropriate dosages of
analgesics in children, and difficulty
assessing both pain and adequacy
of analgesia in children, as well as
adults.2,3 Currently, few published
reports describe investigation of pain
management strategies to improve
pain-related outcomes in children
and adults following cardiothoracic
surgery. The purpose of this study
was to further clarify these existing
knowledge gaps by discussing the
use of patient-controlled analgesia
(PCA) for the management of pain
in poststernotomy cardiac patients
10 years of age through adulthood
in an intensive care unit (ICU) at
a medical university and teaching
hospital in a southeastern city of the
United States.
According to data collected by
Naguib and colleagues,4 PCA is
more effective than traditional
intravenous as-needed dosing
regimens in both older children
and adults. Researchers deter-
mined that if acute postopera-
tive pain is not well managed, a
patient is at risk of forming a “pain
memory” along with experienc-
ing chronic pain, both of which
have long-term physical, psycho-
logical, social, and developmental
consequences.2 The smaller, more
frequent dosing regimen of PCA
leads to fewer adverse effects and
greater consistency in pain con-
trol.4 Staff education is integral to
the implementation of such a pro-
tocol for minimizing patient safety
concerns and optimizing patient
outcomes. Therefore, with appro-
priate preoperative teaching and
encouragement as well as postop-
erative application, PCA can be an
effective means of postoperative
pain relief in the pediatric cardiac
ICU (PCICU) for patients 10 years
of age through adulthood.
A general assessment of cur-
rent practice shows many options
Learning Objectives
At the end of this learning activity, the participant will be able to:
1. Identify potential barriers to postoperative pain management in patients 10
years of age through adulthood.
2. Compare the use of as-needed pain medication for postoperative pain to the
use of patient-controlled analgesia.
3. Evaluate the importance of accurate reporting and documenting of pain
scores.
Postoperative Patient-Controlled Analgesia
in the Pediatric Cardiac Intensive Care Unit
Hanna M. Epstein, RN, DNP, CPNP-PC, CHPPN
Reprinted from Critical Care Nurse, February 2017, pp 55-61
1.0 CE, 1.0 CERP, Cat. A
CE/CERP Evaluations
Due June 16Follow the online prompts at www.
aacn.org/myntisessions to enter your
program and session evaluations
and print your certificate. Copies
of CE/CERP certificates issued are
maintained at AACN in a secure,
password-protected file for a 6-year
period. You may enter evaluation
information online during NTI or at
home until midnight PT, June 16,
2017. After this date, you may only
print your certificate.
Background High rates of uncontrolled pain in critically ill patients remain
common. Patient-controlled analgesia is more effective than traditional
intravenous as-needed dosing regimens for managing postoperative pain
in older children and adults.
Objective To determine whether pain-related clinical outcomes in patients
from age 10 years to adult following cardiac surgery are improved by using
patient-controlled analgesia as a pain management strategy.
Methods Using the plan-do-study-act method of quality improvement, a
process was instituted to have both staff and patients’ families support the
use of patient-controlled analgesia postoperatively as opposed to tradi-
tional pain control with as-needed analgesics. Use of as-needed medica-
tions and pain scores were retrospectively compared from before to after
initiation of patient-controlled analgesia.
Results The cumulative mean pain score from the time of extubation
through the following 24 hours decreased from 4.14 (on a scale from 0 to
10) when strictly as-needed medications were used to 2.8 with patient-
controlled analgesia. Further, the mean amount of opioid consumed
decreased from 14.98 mg of morphine and 22.27 mg of oxycodone to
13.58 mg of morphine and 3.33 mg of oxycodone after implementation of
patient-controlled analgesia.
Conclusions Standardized use of patient-controlled analgesia for postop-
erative pain management in patients 10 years of age through adulthood is
efficient and effective, as evidenced by less medication being consumed by
patients and lower mean pain scores. (Critical Care Nurse. 2017; 37[1]: 55-61)
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It Matters that AACN is a com-
munity of exceptional nurses.
And there is no better way of
showing just how much It Mat-
ters than by connecting with our
AACN community at our 2017 Na-
tional Teaching Institute & Critical
Care Exposition.
I’m so happy to be in Houston,
a Texas-sized city with Southern
charm. In addition to being a hub
for healthcare innovation, Houston
is home to a vital food scene, dy-
namic music and arts, vibrant street
culture and colorful attractions.
With 12 acres of parks adjacent to
the convention center and
18 world-class museums
within walking distance of
each other, I think you’ll
agree that Houston is the
perfect backdrop for NTI
2017.
And with education,
excellence and inspiration
aligned with your needs,
I guarantee there will be plenty
to love about this NTI. As always,
you’ll find the best educational
opportunities for you,
your co-workers and
colleagues. But you’ll
also find something
more: a chance to take
part in a week of con-
nection with the AACN
community that will
renew, recharge and
restore you.
So enjoy yourself this week and
show the world that NTI Matters,
because YOU Matter!
NTI attendees love the rich
combination of inspiration,
entertainment and motiva-
tion at SuperSessions. And this year,
a new element has been added to the
mix — magic!
On Monday, AACN President
Clareen Wiencek will inform and
inspire us as she kicks off the week’s
festivities with a look at what she
has learned related to the theme,
“It Matters,” during her presidential
year. As associate professor of nurs-
ing at University of Virginia School
of Nursing and coordinator of the
ACNP program, Wiencek has almost
40 years of experience as a bedside
nurse in critical care, nurse man-
ager, educator and researcher.
Businessman and entrepreneur
Vinh Giang will then take the stage
for a magical keynote about opening
our minds. Giang will lead us on an
unforgettable voyage of new pos-
sibilities through the use of dynamic
storytelling, reflections on the world
of business, remarkable insights into
human psychology, and the wonder-
ful and wondrous art of magic.
The magic will continue when
Jennifer Arnold joins us for Tues-
day’s keynote to share how she
gained a new appreciation for life
after some difficult times, discovering
the importance of being quality-of-
life driven. Board-certified in pediat-
ric and neonatal medicine, Arnold is
medical director of a state-of-the-art
simulation center at Texas Children’s
Hospital. She is featured on TLC’s
docudrama “The Little Couple” and
has appeared on numerous televi-
sion programs, including “Oprah,”
“The Today Show,” “Good Morning
America” and “Dr. Oz.”
The unveiling of the new theme
for the coming year is a
magical moment, and
AACN President-elect
Christine Schulman
will share that magic
with us during her
speech Wednesday
morning. Schulman
is a critical care and
trauma clinical nurse specialist at
Legacy Health in Portland, Oregon.
She will be followed onstage by
graffiti artist, best-selling author,
entrepreneur and philanthropist Erik
Wahl, who will explore innovative
thinking and superior performance
during his keynote. Wahl certainly
knows what he’s talking about: Forbes
magazine calls his book “UNTHINK” a
blueprint for “actionable creativity.”
So plan to attend each magical
moment and all the actionable cre-
ativity at this year’s SuperSessions!
A decade of research and the experience of thousands of nurses all add up to one thing—Healthy Work Environments matter. Have the conversation at your workplace, and share the no-cost AACN Healthy Work Environment Assessment Tool. It matters.
www.aacn.org/sharehwe
InsIdeCE Article 4
Start Your Week With These Monday Sessions 8
Three Ways to Learn, More Ways to Earn CE 9
Sunday7 a.m.-6 p.m.Registration
Sunday/Monday8 a.m.-6 p.m.Resource CenterBookstore Certification Oasis
Monday10-11:30 a.m.Opening supersession
sunday/mOndayat a glanCe
NTI Matters!
The Magic of NTI Unfolds at This Week’s SuperSessions
Clareen WiencekaaCn President
Program and Exhibit UpdatesOr visit www.aacn.org/nti
Canceled, C60M299 Physiology of Wound Repair and Wound Management Choices May 24, 7:30-8:30 a.m.
Time change, EXED274B Bloodstream Infections: Preventing CLABSIs, Tales From the Frontline May 24, 3:15 p.m. Booth 4300
Vinh giang
sunday/mOnday May 21/22, 2017
#NTI2017
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• NTI Exhibit Floorplan & Locators
• Morning Report from NTI
NEWSWIRE
Reducing Hospital-Acquired Pressure Injuries in the OR and ICU
Morning report
from NTI 2016
This Morning Report from NTI 2016 is produced by SLACK Incorporated and is sponsored by Smith & Nephew.
CNE/CERP credits NOT included.
Page 5 a look at pressure injury research
Page 7 Implementing a protocol
Page 9 a five-layered dressing
Page 12 Discussion
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