Clinical nurse specialist CNS最新文献

{"title":"NACNS Newsletter.","authors":"Vince Holly","doi":"10.1097/NUR.0000000000000298","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000298","url":null,"abstract":"","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":" ","pages":"127-130"},"PeriodicalIF":1.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NUR.0000000000000298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34890855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of Heart Rhythm Management Devices After Cardiac Rehabilitation Program.","authors":"Mahnaz Rakhshan,&nbsp;Leyla Ansari,&nbsp;Zahra Molazem,&nbsp;Najaf Zare","doi":"10.1097/NUR.0000000000000293","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000293","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine physical and heart rhythm management device malfunction complications after participating in a cardiac rehabilitation program intervention compared with usual care.</p><p><strong>Method: </strong>This study was a clinical trial of 100 patients. After randomization, intervention group patients received 8 cardiac rehabilitation program sessions for 8 weeks and follow-up phone calls. Each session consisted of exercise training, education, and psychological interventions. Data were collected at 3 points in both groups-baseline and 8 and 12 weeks after the first day of the intervention-using a researcher-designed case report form. Data were analyzed using descriptive and nonparametric tests.</p><p><strong>Results: </strong>Of the participants, 59% were men, and the sample was aged 40 to 60 years. At the 8- to 12-week follow-up, there were less physical complications among the cardiac rehabilitation group (P < .001) and no between-group differences in complications related to device malfunction. By heart rhythm device type, cardiac rehabilitation had the greatest efficacy in reducing physical complications in patients with cardioverter/defibrillators.</p><p><strong>Conclusions: </strong>Cardiac rehabilitation reduced physical complications in patients with cardiac rhythm management devices, especially in patients with cardioverter/defibrillators. Cardiac clinical nurse specialists should recommend rehabilitation programs as part of postimplantation rhythm device treatment to decrease the risk of physical complications.</p>","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":" ","pages":"E1-E6"},"PeriodicalIF":1.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NUR.0000000000000293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34890267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Improvement in Clinical Nutrition: Screening and Mealtime Protection for the Hospitalized Patient.","authors":"Beverly Morgan Yordy,&nbsp;Sarah Roberts,&nbsp;Helen M Taggart","doi":"10.1097/NUR.0000000000000292","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000292","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the quality improvement project was to (1) enhance awareness, accuracy, and use of the validated nutrition screening tool by the nurse and (2) improve compliance to the nutrition care plan that included increasing patient meal intake percentage.</p><p><strong>Description of the project: </strong>Nurses were provided with an in-depth educational program focused on the implementation of the nutrition screening tool on patient admission to the clinical site. Second, a unit-level patient protected mealtime program was implemented in an effort to decrease unnecessary mealtime interruptions and promote nurses and nursing assistants to assist with meals during mealtime to improve patient meal intake percentage and, finally, to encourage collaboration between the clinical nurse specialist, unit level nurses, and registered dietitians to improve patient nutritional care.</p><p><strong>Outcome: </strong>The results indicate that the quality improvement strategies were successful in promoting the patient protected mealtime program and use of the nutrition screening tool.</p><p><strong>Conclusions: </strong>The clinical nurse specialist plays a valuable role in program development, implementation, and evaluation to achieve quality healthcare through interdisciplinary collaboration. Adhering to nutrition guidelines for the hospitalized adult patient improves nutrition care plan guidance and meal intake.</p>","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":" ","pages":"149-156"},"PeriodicalIF":1.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NUR.0000000000000292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34890265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orienting and Onboarding Clinical Nurse Specialists: A Process Improvement Project.","authors":"Mayra G Garcia,&nbsp;Jennifer L Watt,&nbsp;Karie Falder-Saeed,&nbsp;Brennan Lewis,&nbsp;Lindsey Patton","doi":"10.1097/NUR.0000000000000294","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000294","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical nurse specialists (CNSs) have a unique advanced practice role. This article describes a process useful in establishing a comprehensive orientation and onboarding program for a newly hired CNS.</p><p><strong>Description: </strong>The project team used the National Association of Clinical Nurse Specialists core competencies as a guide to construct a process for effectively onboarding and orienting newly hired CNSs. Standardized documents were created for the orientation process including a competency checklist, needs assessment template, and professional evaluation goals. In addition, other documents were revised to streamline the orientation process.</p><p><strong>Outcome: </strong>Standardizing the onboarding and orientation process has demonstrated favorable results. As of 2016, 3 CNSs have successfully been oriented and onboarded using the new process.</p><p><strong>Conclusion: </strong>Unique healthcare roles require special focus when onboarding and orienting into a healthcare system. The use of the National Association of Clinical Nurse Specialists core competencies guided the project in establishing a successful orientation and onboarding process for newly hired CNSs.</p>","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":" ","pages":"163-168"},"PeriodicalIF":1.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NUR.0000000000000294","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34890260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Nursing Practice: Management of Neuropathic Pain With Capsaicin 8% Without Physician Supervision.","authors":"Joanne O'Brien,&nbsp;Joseph Keaveny,&nbsp;Valerie Pollard,&nbsp;Linda Elizabeth Nugent","doi":"10.1097/NUR.0000000000000296","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000296","url":null,"abstract":"<p><strong>Purpose/aims: </strong>The purpose of this study was to examine the management of patient's neuropathic pain with capsaicin 8% in a nurse-led clinic when administered by 1 registered advanced nurse practitioner without physician supervision.</p><p><strong>Design: </strong>A longitudinal, single-group, descriptive research design was used to assess pain scores and quality of life 3 times over 3 months after treatment.</p><p><strong>Methods: </strong>Patients with a diagnosis of neuropathic pain were assessed and treated with capsaicin 8% by 1 advanced nurse practitioner with prescriptive authority in a nurse-led clinic. Pain scores were collected at baseline, and self-assessed pain, activity level, and quality of life were assessed at 1 week, 4 weeks, and 3 months after treatment. Twenty-four patients were recruited, and data were analyzed using Friedman's test. In post hoc analysis, Wilcoxon signed-rank test was used with Bonferroni correction.</p><p><strong>Results: </strong>Pain scores differed from pretreatment to posttreatment at each of the 3 time points, at rest (χ3 = 20.54, P = .001) and on movement (χ3 = 23.644, P = .001), and remained significant after Bonferroni correction. Overall, 62.5% (n = 15) of patients achieved at least a 30% reduction in self-reported pain at rest from pretreatment to 3 months, and 54% (n = 13) achieved the same reduction in pain on movement. Most improvements in patient's quality of life occurred between 1 and 4 weeks. Patient satisfaction was high, with 83% stating that they would be happy to have the treatment repeated.</p><p><strong>Conclusion: </strong>Single-dose capsaicin 8% decreased neuropathic pain after being administered in an outpatient setting by an experienced registered advanced nurse practitioner. Further multicenter research led by advanced nurse practitioners is needed to support high-quality, safe treatment of neuropathic pain with high-concentration capsaicin in nurse-led chronic pain clinics.</p>","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":" ","pages":"157-162"},"PeriodicalIF":1.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NUR.0000000000000296","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34890262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Technologies and Educational Practices for Innovation and Change.","authors":"Cathy J Thompson","doi":"10.1097/NUR.0000000000000288","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000288","url":null,"abstract":"The goal of the university is to prepare its students for the current and future world. Twenty-first century nurses need to be prepared using 21stcentury teaching and learning techniquesVand thatmeans using technology to teach, engage, and evaluate students. Current technologies, such as use of the Internet, social networks, 3D video, Smartphones, bibliometric and citation technologies, mobile and online learning, virtual reality, and enabling technologies, can be used as effectivemethods to engage students in deeper learning and in the critical skills of critical reasoning, problem solving, collaboration, and lifelong learning required of the modern nurse. Faculty ‘‘who teach in colleges and universities must adjust their skills to meet the needs of the students they will be serving in the 21st century.’’ Students today are technologically savvy; Generation X (Gen X) and Generation Y (Gen Y) students expect faculty to use technology in their teaching and learning strategies.","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":" ","pages":"169-173"},"PeriodicalIF":1.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NUR.0000000000000288","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34890261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Triage Accuracy: A Staff Development Approach.","authors":"Carmen M Brosinski,&nbsp;Autumn J Riddell,&nbsp;Sherwin Valdez","doi":"10.1097/NUR.0000000000000291","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000291","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the process improvement initiative was to improve the percentage of undertriaged patients to less than 10% (benchmark) using the Emergency Severity Index tool. Undertriaged patients have an increased potential for poor outcomes due to a lengthier waiting room stay, which results in delay of care.</p><p><strong>Description of the project: </strong>An evidence-based project designed for staff development was conducted for a 7-month period. Project procedures consisted of triage chart reviews for a 3-month period during pre- and post-Emergency Severity Index training. Emergency Severity Index refresher training for nurses triaging in the emergency department was conducted for a 1-month period.</p><p><strong>Outcome: </strong>Chart reviews revealed that 102 of 388 patients (26.3%) were undertriaged before Emergency Severity Index training. After Emergency Severity Index training, chart reviews depicted that 41 of 440 patients (9.3%) were undertriaged. This difference was statically significant (P < .001), when tested using a 1-sided t test at the 95% confidence level and achieving at least 80% power.</p><p><strong>Implications: </strong>Regardless of previous training or years of emergency department nursing experience, triage refresher training has been shown to increase accuracy of triage categorization, thus leading to a decreased risk of poor patient outcomes.</p>","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":" ","pages":"145-148"},"PeriodicalIF":1.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NUR.0000000000000291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34890259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Poet Wilfred Owen's Warning to the World.","authors":"J. Young-Mason","doi":"10.1097/NUR.0000000000000275","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000275","url":null,"abstract":"","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116562285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sharing Your Knowledge in an Online Environment.","authors":"S. Alexander","doi":"10.1097/NUR.0000000000000252","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000252","url":null,"abstract":"Entering the key word nursing in any search engine yields pages of Web sites targeting all aspects of nursing. Web sites continue to establish a place in the education of nurses. Valuable tools for nursing students, across a range of educational levels, now exist to enhance knowledge acquired in curricula. Although once limited to textbooks, students now can easily find online resources to assist in tasks such as interpretation of lab values, examinationpreparation, andothers. Nurseswith advanced preparation are finding novelways to disseminate their knowledge to students, increasing chances of success in the classroom and skill at the bedside. Prelicensure nurses frequently facemultiple computerized exams in educational curricula, culminating in the National Council Licensure ExaminationYRegisteredNurse, which is required for licensure in the United States. In addition to clinical knowledge and test-taking skills, nursing students benefit from a greater degree of skill and comfort in taking online tests, which can be facilitated by addition of technology to the classroom. A systematic review of literature on the comparison of online and traditional face-to-face learning suggests that online learning is of equal benefit in the acquisition of clinical skill knowledge by students in prelicensure programs, particularly if used in a supplementary fashion to traditional educational methods. Responding to the need for increased use of technology in nursing programs has created opportunities for nurses who are willing to create technological resources for students. The continuous need for improved technological skills related to nursing practice has been addressed in the literature. Integration of evidence-based practice, (EBP) a key skill for advanced practice nurses, necessitates regular exercise in searching and critically reviewing current research, which can be enhanced by use of technological tools. Both prelicensure and graduate nursing students who participated in the implementation of aWeb-based technological tool to boost skills needed for successful integration of EBP participants (n = 226) demonstrated correct application of PICOT to a clinical question (72.1%; n = 163; 49.2%, n = 63).","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128031619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Nurse as Author: Is Publishing for You?","authors":"S. Alexander","doi":"10.1097/NUR.0000000000000206","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000206","url":null,"abstract":"Why don’t more nurses write? It would seem that plenty of material exists on the topic of nurses and nursing care. A recent survey of Amazon using the search term ‘‘nurses’’ yielded 48 531 results ranging from novels to textbooks and including items such as socks with electrocardiogram tracings. At the top of the search list was a book described as ‘‘investigative journalism,’’ offering intimate details of hazing, sex, painkiller addiction, and bullying in the everyday lives of hospital nurses. While this book was not written by a nurse, there were several books present in the search that were authored by nurses, including textbooks, fiction, nonfiction, and others. For nurses who are employed as faculty members in academic settings, there is often an expectation of publication that accompanies the position, yet the practice of writing is certainly not limited to nurse researchers and faculty. Writing and publishing can be a viable career choice for nurses, and there are strategies that may assist nurses in overcoming the hurdle of experiencing their first publication. For Marijke Vroomen Durning, a nurse-author/editor based in Montreal, Quebec, Canada, writing was an early interest, so much so that ‘‘Iif I was given a choice I would choose essay exams instead of multiple-choice items every time’’ (oral communication, M.V. Durning, January 21, 2016). Durning managed to successfully combine her years of expertise in nursing with a lifelong passion for writing into a successful career in the publishing industry. Beginning as a registered nurse in the 1980s, in her first work experience on the postpartum floor, and retiring from the palliative care field, she has literally cared for patients from birth to death and attributes her success in publishing to the rich experiences gained from her career as a nurse. Throughout her nursing career, Durningwas a freelance writer from time to time. Eventually, as her expertise began to establish her reputation in the publishing field, she was offered a position managing a team of writers, as editor for The Doctor’s Guide to the Internet, an online news website for physicians. Durning went on to author chapters in several books, one of which was translated into Spanish, and to publish articles in lay health magazines and magazines for the nursing profession, such as Nursing2013. At present, she works with a roster of clients for whom she provides weband print-basedwriting services, social outreach and content, and manages email correspondences on healthcare sites. Durning credits her experiences with patients as key to informing her interest and assisting her in developing a niche in the writing industry. She believes that her success as awriter was due to her nursing background. Despite her deep interest in writing and publishing, achieving initial successes in the writing industry was not easy. Writing can be lonely work, a feeling that has been voiced by other nurse authors. According to Tina Shalof, author ","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":"213 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115579149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}