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ACNP Exam Format | ACNP Course Contents | ACNP Course Outline | ACNP Exam Syllabus | ACNP Exam Objectives

The Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) Post-Professional Certificate is designed for graduate prepared Nurse Practitioners (NP) or Clinical Nurse Specialists (CNS) who are seeking to expand their roles via nurse practitioner certification in Adult-Gerontology Acute Care. The curriculum prepares nurse practitioners to function as generalist, principal providers of care for adults and older adults with acute, critical and complex chronic health problems across the continuum of acute care services.

AG-ACNP students may choose a clinical emphasis in cardiopulmonary, critical care, oncology, trauma emergency preparedness or directed study. The directed study allows students to design clinical experiences around a particular area of interest (i.e. internal medicine, general surgery). The curriculum consists of NP and AG-ACNP specialty courses and clinical practice hours.

Graduates of the AG-ACNP Post-Professional Certificate are eligible to sit for the national certification examination in Adult-Gerontology Acute Care offered by the American Nurses Credentialing Center or American Association of Critical Care Nurses. Successful passing of the national certification examination entitles the graduate to apply for certification as a Certified Registered Nurse Practitioner (CRNP) in Adult-Gerontology Acute Care by the State Board of Nurse Examiners of the Commonwealth of Pennsylvania.

Course work may be completed in 3 terms

540 clinical hours

Online or onsite

Students are required to attend 2 onsite laboratory intensives - 2 days in the Summer term and 1 day in the Fall term. Each student will be responsible for the room and board cost during the lab intensives.

Online students will need to arrange for clinical placements and appropriate physician or nurse practitioner preceptors. An Affiliation Agreement between the University and the clinical site is required before clinical hours can begin.

Graduates of the AG-ACNP Post-Professional Certificate are prepared to accomplish the following:

Assume responsibility for promoting, maintaining and restoring health to acutely/critically or complex chronically ill adults and older adults

Identify health risks, promote wellness, and diagnosis and manage acute and chronic illness

Participate in multi-disciplinary research and provide leadership in mobilizing health services

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Medical techniques


innovative Injection Molding techniques for the clinical trade | Resources

medical gadget & Diagnostic industry MagazineMDDI Article Index

An MD&DI April 1998 Column

cover STORY

four molding options open up a number of new tactics to the design of clinical accessories.

Plastics injection molding and purposes development for scientific contraptions are two areas of know-how that endlessly leapfrog one yet another. The accelerated functional necessities of molded clinical components force the molding expertise advances required to satisfy these needs. In turn, the increased capabilities of the injection molding manner facilitate innovations in design, manufacturing, and meeting of new medical instruments.

In most cases, past and latest, widespread injection molding know-how has been adequate to satisfy the needs of the functions developed. When regularly occurring molding has fallen brief, however, novel advancements and modifications to the system had been devised to supply unique solutions to the more and more subtle calls for of medical design engineers. There were many such improvements, however 4 in selected stand out. the first, pulsed cooling and induction coil heating, takes the frequent molding process and provides to it a more desirable degree of process handle. for two others, gas-assisted injection molding and multi—are living feed molding, auxiliary equipment is integrated into the standard desktop design. The last technique, multimaterial molding, requires modified molding machines and tooling for top of the line success.


This imaginative system for controlling mould temperature (determine 1) overcomes a prior to now unavoidable disadvantage in moldcooling methodology. in the prevalent molding process, coolant similar to water or oil is circulated during the mould continuously while mold temperature is regulated by means of a controller corresponding to a thermolator or chiller. This category of temperature control continues a fairly consistent water-inlet temperature to the mould.

figure 1. Pulsed cooling and induction coil heating keeps temperature all the way through the injection stroke with the aid of closing manifold valves and stopping water circulate.When the injection stops, the valves reopen except the steel cools to the desired temperature. Illustration courtesy of Ken A. Kerouac

When plastic is injected into the mold cavity, the mildew temperature rises as warmth is transferred from the molten plastic to the mold itself. because the molded part cools and solidifies, warmth is conveyed out of the system by means of switch to the circulating cooling medium and, to a lesser extent, during the mold base to the ambient ambiance. Cooling continues via mildew opening, part ejection, and mildew closing, right up unless polymer injection on the subsequent shot. This process has unlucky implications for the polymer. The melt is now being injected into the mildew at what is, from a thermal standpoint, the worst possible moment within the cycle—the point at which the mildew is at its coldest temperature. Ideally, coolant should still be flowing during the mildew only when it is required: from the end of polymer injection to the element where the half is cool sufficient to be ejected.

The pulsed cooling procedure is designed to address this problem. A manifold outfitted with solenoid-managed water valves is positioned within the provide line between the incoming water source and the mould. The manifold is linked to a controller, which is in turn linked to probes which are inserted into every half of the mould just under the parting line surface. The favored metal temperature (monitored with the aid of the probes) is determined on the controller. throughout the injection stroke, the manifold valves are closed, allowing no water movement (and therefore no cooling) to the mold. on the end of injection, a sign is sent to the manifold to open all the valves and pulse cold water throughout the gadget. as soon as the probes sense that the desired steel temperature is reached, water circulate during the mildew is again terminated except the next shot.

a distinct function of this device is that with higher, complicated molds during which warmth transfer from the half will now not ensue uniformly, extra probes may well be used at the side of manifolds that have a enhanced variety of ports. this may permit for independent zones of handle within the mould, so that water circulate to areas which are sufficiently cooled might be closed off and diverted to hotter areas of the mould. This diploma of manage affords the possibility for more desirable part uniformity and reduced cycle time.

A coinjection molding computing device varieties constituents using two substances (one dermis and one core), taking capabilities of the benefits of each (Ferromatik Milacron, Cincinnati).

With excessive-temperature polymers, primarily folks that run with sizzling oil instead of water, the issue is frequently now not losing heat too slowly however too abruptly. A excessive thermal gradient exists between the sizzling mold and the ambient air, and the resulting warmth transfer may overcool the mould even with the merits of the pulsed water flow. In such circumstances, the pulsed cooling can be supplemented by way of, and even replaced by way of, induction coils inserted into each and every half of the mould. These coils are additionally managed through the unit that regulates the water manifold. Their function is to provide history heating to the mold around its perimeter, as a consequence fighting extreme heat loss and preserving a stronger thermal equilibrium in the mildew. The drawback to induction coils is that they'll simplest work with ferrous mildew materials and for this reason are not perfect for prototyping efforts with molds created from aluminum or nonferrous alloys.

Pulsed cooling may also be retrofitted to existing molds pretty inexpensively. since the polymer will fill the cavity below warmer situations, elements with reduce, extra uniform molded-in stress may also be executed. this may promote more advantageous dimensional stability, including warmth-distortion resistance, reduced birefringence in transparent ingredients, greater uniform floor finish, greater uniform crystallinity building, and for this reason greater uniform shrinkage. stories have also proven cycle time improvements with some purposes of between 10 and 20%.


although the earliest patents on gas-assisted molding had been issued within the mid- to late Nineteen Seventies, the manner has best come into its own over the last 5 years, after a quiet gestation period within the Eighties. Its recent explosive increase has proven it to be a really enabling technology—issues will also be executed with gas-assist which are effectively now not possible with another category of molding technique.

gas-assisted molding evolved from a change of the structural foam technique called fuel counterpressure, wherein a sealed mold cavity is pressurized with nitrogen before the introduction of the polymer/blowing agent mix. The force within the cavity prevents the foaming action of the blowing agent from taking area at the soften front, permitting a smooth epidermis to be fashioned on the surface while the cellular structure is created within the core. This procedure minimizes the surface swirls, splay, and imperfections that regularly made foamed components complicated to conclude or paint.

fuel-aid, like its dad or mum technology, employs prepressurized nitrogen, however during this case no blowing agent is used in the polymer, and the gas is injected into the indoors of the polymer shot, developing a component with a polymer skin it's either absolutely hole or strong with hole sections, reckoning on the design (determine 2). not like structural foam, gas-support produces no mobile structure; the polymer and gas form separate, discrete layers.

figure 2. Injection, cling, and unlock sequence for gasoline-assisted molding of hollow or in part hole constituents. Illustration courtesy of Cinpres, Ltd. (Tamworth, UK).

Suppliers of gasoline-help machine present a wide choice of hardware and controls, however in all instances the fundamentals of the system are identical. A stand-alone gasoline-support unit wired to get hold of indicators from the molding machine attracts from a nitrogen supply (in most cases either a bottle or a nitrogen generator) and prepares a pressurized charge of nitrogen to be dropped at the mildew. because the injection stage of the cycle starts, a sign in line with time, power, or screw place is sent to the fuel unit to set off gas injection at the appropriate time. gasoline can be injected both into the polymer melt via a notably designed molding machine nozzle, which sends the gasoline throughout the sprue, runners, and gates earlier than getting into the half cavity, or without delay into the mildew itself through gas nozzles outfitted into the mold base.

once injected into the polymer, the gasoline bubble finds the direction of least resistance, favoring the top of the line mixture of high temperature and low pressure. In a competently designed device run under the suitable technique situations, the nitrogen, which is an awful lot decrease in viscosity than the polymer, remains remoted in the gasoline channels of the half devoid of bleeding out into any thin-walled areas. The fuel channels are these areas that have been thickened to achieve functional utility within the part or to advertise more advantageous flow of the polymer during filling. as a result of the decrease viscosity of the fuel, the power drop across the gasoline bubble is a whole lot decrease than throughout a normal polymer shot. This phenomenon money owed for the capability of fuel-help to supply a stronger degree of packing than is viable with the usual method and to permit the melt to trip longer circulation lengths in the mildew with fewer gates.

once the fuel has aided the polymer in filling out the cavity, it is held below pressure until the cloth solidifies, with the gasoline-cling stage changing the dangle stage in a standard cycle. The fuel is then allowed to vent from the half to be able to relieve the interior power prior to mildew opening. via coring out thick sections with fuel, huge cycle time discount rates can be carried out on account that there aren't any thick sections of plastic that require a very long time to cool. right through the length between the conclusion of gas cling and part ejection, the gas unit is recharged with nitrogen for the subsequent shot.

gasoline-support applications regularly fall into one of three classes:

  • brief-shot molding. A process through which definite facets equivalent to ribs or thick partitions are cored out with gasoline in an in any other case strong molded part. This process receives its name from the formula of best partially filling the cavity during the polymer injection phase of the cycle after which counting on the gas injection phase to fill out the remainder of the cavity with the material the gasoline bubble is displacing from the core.
  • Full-shot molding. A technique by which the mildew is absolutely crammed all through the plastic injection phase. gas is brought into the cavity during this case only to supply local packing and to atone for the results of polymer volumetric shrinkage because the half cools.
  • hollow molding. A manner through which all or virtually the entire half is cored out by the fuel, in impact making the part itself the fuel channel. here is the formula most often used to make constituents with big move sections reminiscent of rods, tubes, and handles.
  • With the gas-help procedure, thick constituents can be molded devoid of cycle time sacrifices and linked issues comparable to sink marks and voids. parts cored out with gasoline can be lighter, with a much better stiffness-to-weight ratio, resulting in material rate reductions and reduced costs. gigantic materials may also be stuffed extra without difficulty, creating parts with less molded-in stress and superior dimensional balance. The floor look of gas-aid elements is an awful lot enhanced over that of structural foam. Many objects produced through fuel-support do not require paint or another type of secondary finishing step.

    MULTI—are living FEED MOLDING

    The ordinary injection molding method imposes severe barriers on how the polymer melt may be manipulated once it has crammed the cavity. Between the end of first-stage injection and ultimate half ejection most effective two exterior effects can act on the soften. the primary is heat elimination via a mix of conduction and convection. The second is the particularly static pack-and-cling pressures utilized via the screw. Used to make amends for volumetric shrinkage and to evade sinks from forming as the half solidifies, these pressures can best be applied until the gate freezes off. The multi—are living feed (MLF) method (figure 3) employs auxiliary injection molding equipment to obtain dynamic oscillation of the polymer soften in the mould cavity. This oscillation creates a shearing impact on the polymer that prolongs the time the fabric continues to be in the molten state and promotes improved orientation and weld line characteristics.

    figure three. The varied are living feed process, showing (A) out-of-phase oscillation (fill), (B) in-part oscillation (pack), and (C) holding phase. Illustration courtesy of Eliot M. Grossman (Cinpres-Scorim, Ltd., Tamworth, UK).

    Weld traces are molding defects created when numerous polymer movement paths converge in a cavity, reminiscent of when melt fronts from diverse gates meet each and every other or when movement from a single gate is pressured to cut up and recombine around a pin or different projection within the tool. Weld traces can create look complications, because their visibility on the surface can also require a costly portray step, or they can be structurally objectionable, due to the fact that weld traces are inherently vulnerable areas of the constituents that can act as stress concentrators and feasible failure aspects in influence or flex situations.

    The coronary heart of the MLF procedure is the pinnacle, which mounts to the front of the injection barrel. within this head, the polymer shot is divided into two independent movement paths and brought to the mold via two nozzles rather than one, as is accomplished conventionally. A modified sprue bushing with two sprues is required, as is a runner layout that keeps separation of the movement paths.

    the pinnacle includes hydraulically actuated pistons that act on the melt and supply the oscillation and subsequent pack-and- grasp phases employed via the procedure. Piston movement is managed by a stand-alone unit synchronized with the injection molding computer by using a signal reminiscent of first-to-second-stage transfer time or position on each shot.

    The MLF manner employs three modes of operation:

  • The A mode makes use of an out-of-part motion of both pistons; when one piston is moving ahead, using the melt ahead of it, the other piston is retracting, developing quantity for the melt to circulate into. This mode most frequently begins immediately after first-stage injection, even though it can also be brought on to begin throughout injection as well.
  • in the B mode, both pistons circulation in the equal course simultaneously, packing out the cavity. reckoning on the potential of the molding desktop, the stage of packing drive the MLF unit can provide could be larger than what the computer can deliver.
  • in the remaining C mode, each pistons movement forward once and remain within the forward preserving place except gate freeze-off. The B and C modes within the process take the location of the pack-and-dangle degrees within the regular molding cycle.
  • The MLF unit controls 5 selected parameters:

  • Temperature of the head. Thermocouples within the head regulate the operation of cartridge heaters to hold a preferred temperature.
  • Sequence of operation. In most cases, the sequence of the modes may be within the order described within the outdated section. besides the fact that children, it's viable to alternate the order of operating modes or to eliminate one or two of them fully.
  • force. The forward and return pressure of the pistons may also be controlled. The property that almost all regularly dictates power settings should be the viscosity of the fabric.
  • Frequency. The variety of piston oscillations per 2nd will also be set. The shear sensitivity and thermal diffusivity of the fabric can also dictate this parameter, on the grounds that it's the shearing impact of the oscillations that extend the molten state of the polymer.
  • duration. The length of time each mode is employed within a given cycle controls orientation. If high orientation is desired (with fiber-reinforced constituents, for example), constituents with thicker partitions may also require longer length, since a larger percentage of the cross area is comparatively unoriented polymer, compared to the particularly oriented layers closer to the part floor.
  • The MLF system may also dispose of the should paint parts through reducing the floor weld-line severity to the aspect where the weld lines are almost invisible. even if the surface weld strains are eliminated or now not, the internal ones could be altered to a degree so that it will make the part improved than it would be with weld lines formed through normal techniques. In fiber-strengthened constituents, orientation of the fibers is enhanced, reaching enhanced power within the fiber path. Filling of skinny-wall parts can be facilitated if the oscillation is initiated all the way through polymer fill, creating the shearing effect that may delay the onset of swift cooling and solidification that may limit the success of thin-wall molding.


    unlike the other three strategies reviewed above, which superimpose auxiliary machine and some mould changes onto otherwise normal molding machines, multimaterial molding requires really good molding gadget in and of itself. a few different strategies fall beneath the large umbrella of multimaterial molding: coinjection, overmolding, two-shot molding, and sandwich molding. In all cases, the simple premise of multimaterial molding is to take reasonably-priced expertise of two or extra substances with uniquely distinctive houses with the aid of incorporating them into one molded element.

    The simple equipment requirement for multimaterial molding is to have as many plasticating units (computer barrels) as there are substances to incorporate into the molded half. With some desktop designs, varied barrels are set up onto the computer base itself; with other systems, the design is extra modular, permitting barrels to be delivered or removed as necessary and aligned in diverse configurations (even vertically) to accommodate more or fewer materials or to adapt for flooring house or ceiling top obstacles.

    Coinjection and Sandwich Molding. These two similar approaches (coinjection is every so often categorized as a subset of sandwich molding) form materials with a dermis of 1 material and a core of a different, taking expertise of the advantages of both. The critical fabric requirement during this form of molding is compatibility. If the two polymers aren't compatible, they will not adhere to each and every different, resulting in delamination on the interface between both polymer layers and failure of the part.

    determine four. The coinjection procedure works by means of first injecting the epidermis material (A) then switching to the core material (B). A small volume of dermis material can seal the gate to conclude the method. Illustration courtesy of Battenfeld of the usa (West Warwick, RI).

    In coinjection molding, two barrels are joined collectively via a common manifold and nozzle, by which both materials flow before getting into the cavity (determine 4). The nozzle is designed with a shutoff characteristic that permits only one of the substances to circulation through at any given time. To installation the manner, the relative percent of epidermis to core cloth is determined, most regularly through trial and error, and both barrels are each and every programmed with the applicable shot measurement. On injection, the injection unit with the epidermis cloth (commonly referred to as the A barrel or A aspect) injects the set quantity of polymer. here is adopted with the aid of the core fabric in the B barrel which, in a manner akin to fuel-help, penetrates the epidermis polymer and completes filling of the cavity with out breaking through to the skin surface. since plastics stream in injection molding is laminar, both materials may also be molded in this dermis-core configuration without mixing with each and every other.

    Coinjection molding frequently has a third stage, through which a small volume of dermis material completes the injection stage. this is called an A-B-A injection sequence and accomplishes the assignment of absolutely encapsulating the core fabric, as a result conserving it from any weathering, chemical substances, or different exposures to which it could be inclined.

    figure 5. Sandwich molding's numerous plasticating gadgets serve as extruders that enable fixed quantities of fabric into a single injection unit. Illustration courtesy of Ferromatik Milacron (Cincinnati).

    Sandwich molding also effects in a skin-core constitution, but the mechanics are a bit diverse (figure 5). during this procedure, dissimilar plasticating contraptions are used handiest as extruders to feed their percentage of the entire shot to a single injection unit. The injection unit itself additionally bills for one of the vital polymer layers. earlier than injection, then, the injection unit has built up a shot such as as many layers as there are materials. once more, as a result of the laminar nature of polymer move in the injection molding method, these layers don't mix with every different.

    Upon injection, the closing fabric fed to the injection unit, which is at the front of the barrel, turns into the dermis of the part, and the entire subsequent layers form under it, working towards the center, unless the last cloth in, which turned into that material plasticized by using the injection unit itself, becomes the very core. as a result of all of the injection is accomplished via only one injection unit, there isn't any probability for an A-B-a series, as in coinjection; therefore, finished encapsulation of the core isn't feasible. The core could be exposed at the gate main into the cavity, which is commonly no longer an issue if the gate is on a neighborhood of the part that will be hidden or if the material within the core is resistant to the hazardous results of environmental or chemical exposure.

    Coinjection and sandwich molding can deliver each least expensive and purposeful merits to a molder. Economically, material prices will also be decreased by using having the top rate or more expensive fabric best on the backyard of the half where it's seen, whereas the inside can be crammed with a much less costly resin. The core of a coinjected half may also be a superb outlet for regrind generated in creation operations. Functionally, parts can mix both constitution and utility. a component requiring floor aspects similar to a delicate contact, or a a hundred% color healthy to dispose of paint, could be molded with a more inflexible core fabric, or perhaps a stuffed one, to provide a superb mixture of a soft, pliable floor and excessive pressure.

    Overmolding. With sandwich or coinjection molding, it might probably no longer all the time be obvious that two substances are getting used. Overmolding, or two-shot molding, outcomes in components in which it's obviously evident that a couple of fabric is being used. In these processes, best a part of a product is molded in a single fabric, and that molded piece is manipulated so the 2d cloth may also be molded around, over, beneath, or via it to complete the remaining part. This formulation is from time to time referred to as in-mold meeting, because the ensuing part with no trouble acts as an meeting of two substances in place of as a layered constitution.

    device design is a vital point for a hit overmolding. In some designs, the primary component is molded within the first cloth; then sliding action in the device creates an additional cavity space that can also be stuffed with the aid of the 2d fabric to comprehensive the in-mould assembly of the half. The mold cavity also needs to be transported, both via mildew rotation or mold shuttling, to a place of alignment with the 2d barrel so it could actually complete filling of the mildew. In different cases, the primary molded part must be physically faraway from its cavity and positioned in an extra cavity for molding with the 2nd cloth. The 2d molding stage may be one other barrel on the same desktop, by which the identical kind of rotating or shuttling tooling can be employed, or it could be an entirely diverse mold on a wholly distinctive desktop, which saves tooling fees however ties up two machines as an alternative of 1.

    In most situations, decent compatibility of the diverse materials is required to advertise first rate adhesion and to steer clear of delamination and half failure. In some situations, although, incompatible materials may be intentionally molded with each other for applications by which relative movement between both subcomponents is desired. it is feasible, as an instance, to create a jointed part with a ball molded in one material and a socket molded in a 2nd, incompatible fabric. The constituents can be assembled correct in the mould, and because the materials are incompatible, the ball and socket will no longer adhere, allowing free circulation between the components.

    The basic benefit of overmolding is mark downs on assembly charges. Downstream assembly operations can be eradicated, and time and cost are decreased if mechanical fasteners or adhesives do not need to be purchased, installed, or utilized. one of the crucial more commercially seen overmolding functions is toothbrushes that have a tender area developed into the tackle to obtain a far better grip. This software would not be practical if it required any type of mechanical fastener, and human oral contact may limit the types of adhesives that could be regarded.


    an article comparable to this may best touch upon the numerous improvements in molding know-how that make contributions to the success of clinical device manufacturing. As unmet wants continue to be identified, new materials in new designs for brand spanking new purposes will proceed to be developed. Injection molding expertise will continue to preserve tempo with these traits and provide the manufacturing capabilities critical to carry these products to life.

    Ken A. Kerouac is a professional with the applied fabrication technology crew within the technical service and construction (TS&D) branch and Peter F. Grelle is a building chief within the automobile technical provider and building group at Dow Plastics (Midland, MI).

    Copyright ©1998 scientific equipment & Diagnostic industry


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