Clinical Nurse Specialist最新文献_第10页

Antiviral Considerations for Monkeypox Infection - USE CAUTION! 猴痘感染的抗病毒注意事项--小心使用！

IF 1.2 4区医学

Clinical Nurse Specialist Pub Date : 2023-01-01 DOI: 10.1097/NUR.0000000000000715

Patricia Anne O'Malley

引用次数: 0

Enhancing Evidence-Based Practice Integration Into Clinical Practice: Using Policy as a Tool for Culture Change in a Large Urban Academic Medical Center. 加强循证实践与临床实践的整合:在大型城市学术医疗中心使用政策作为文化变革的工具。

IF 1.2 4区医学

Clinical Nurse Specialist Pub Date : 2023-01-01 DOI: 10.1097/NUR.0000000000000717

Megan D Snyder, Tracy Campbell, Kimberly A DiGerolamo

{"title":"Enhancing Evidence-Based Practice Integration Into Clinical Practice: Using Policy as a Tool for Culture Change in a Large Urban Academic Medical Center.","authors":"Megan D Snyder, Tracy Campbell, Kimberly A DiGerolamo","doi":"10.1097/NUR.0000000000000717","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000717","url":null,"abstract":"Purpose This article describes how a large urban medical center was able to enhance the integration of evidence-based practice in the clinical environment by reconfiguring its approach to policy and procedures documentation. Project Description Leaders at a large urban medical center observed that numerous nursing practice documents lacked a base of evidence. No standard process existed for building staff awareness of the evidence-based underlying practice, and there was uneven knowledge of evidence-based practice in the milieu. To address the problem, a team of Clinical Nurse Specialists developed a novel policy establishing procedures for document review, formal structures for policy assignment, and rigorous standards for the development and sharing of evidence tables. Outcome The proportion of nursing guidance documents connected to evidence tables increased from 45% to 77% in the first year and a half following implementation. The change has enabled streamlining and consolidation of nursing practice guidance documents and has led to significant increases in engagement with clinical inquiry at the bedside. Conclusion A policy specifically requiring evidence to be incorporated into nursing practice guidance documents can help enhance the understanding and uptake of evidence-based practice in a complex clinical environment. Clinical Nurse Specialists played a vital role in facilitating this organizational culture change.","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 1","pages":"14-19"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10342957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What the Joint Commission Medication Management Titration Standards Mean to Quality Care for Complex Patients. 联合委员会药物管理滴定标准对复杂患者质量护理的意义。

IF 1.2 4区医学

Clinical Nurse Specialist Pub Date : 2023-01-01 DOI: 10.1097/NUR.0000000000000722

Laura Chechel, Barbara McLean, Theresa Slazinski, Teresa Rincon

引用次数: 1

Nurses' Perceptions of the Clinical Nurse Specialist Role Implemented in a Highly Specialized University Hospital in Spain: A Qualitative Study. 西班牙某高度专科大学医院护士对临床专科护士角色的认知:一项质性研究。

IF 1.2 4区医学

Clinical Nurse Specialist Pub Date : 2022-11-01 DOI: 10.1097/NUR.0000000000000703

Mónica Vázquez-Calatayud, Cristina Oroviogoicoechea, Carmen Rumeu-Casares, Rosana Goñi-Viguria

{"title":"Nurses' Perceptions of the Clinical Nurse Specialist Role Implemented in a Highly Specialized University Hospital in Spain: A Qualitative Study.","authors":"Mónica Vázquez-Calatayud, Cristina Oroviogoicoechea, Carmen Rumeu-Casares, Rosana Goñi-Viguria","doi":"10.1097/NUR.0000000000000703","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000703","url":null,"abstract":"Purpose/aims: To explore nurses' perceptions of clinical nurse specialist practice as implemented in a highly specialized university hospital in Spain.Design: A descriptive qualitative study was carried out in 3 inpatient wards, with a clinical nurse specialist within the team, at a high specialized university hospital in Spain.Method: Semistructured interviews were conducted by purposive sampling with 17 selected nurses with at least 2 years of professional experience who voluntarily agreed to participate and signed the informed consent form. Analysis of the qualitative data was conducted according to Burnard's method of content analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used.Results: Four main categories emerged from the analysis of the data: \"qualities of the role-holder,\" \"role competencies in practice,\" \"integration with the team,\" and \"impact of the role\" on nursing, the patient, and the organization.Conclusions: The findings of this study have interesting implications for the development and implementation of clinical nurse specialist practice in healthcare organizations. They also provide evidence of the benefit of implementing clinical nurse specialist practice for improving the quality of care, patient outcomes, and healthcare efficiency.","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"36 6","pages":"317-326"},"PeriodicalIF":1.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10788189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Clinical Nurse Specialist Transition to Practice. 临床护理专家向实践过渡。

IF 1.2 4区医学

Clinical Nurse Specialist Pub Date : 2022-11-01 DOI: 10.1097/NUR.0000000000000702

Rosina Bloomingdale, Julie V Darmody, Julie L Ellis

{"title":"Clinical Nurse Specialist Transition to Practice.","authors":"Rosina Bloomingdale, Julie V Darmody, Julie L Ellis","doi":"10.1097/NUR.0000000000000702","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000702","url":null,"abstract":"Purpose: A quality improvement/evidence-based practice project identified the critical components of clinical nurse specialist (CNS) transition-to-practice (TTP) needs based on the experiences and perceptions of entry-level CNSs (n = 4), experienced CNSs (n = 7), and directors of nursing (n = 6) employed in a tertiary healthcare center. Structured 60- to 90-minute face-to-face discussions were conducted.Description: As knowledge workers, CNSs are critical to investigating, solving, and transforming some of the most challenging current and future healthcare problems. Lack of standardized CNS TTP may result in variable levels of practice, knowledge, skill attainment, and ability to attain interdisciplinary practice competencies.Outcomes: Findings included identification of entry-level CNS TTP key components: 16 categories with 8 critical categories identified as imminent needs. Challenges identified included stakeholders' lack of knowledge/understanding of the CNS role and scope; enormous TTP expectations of entry-level CNSs; transdisciplinary relationships and collaboration; leadership culture and collaboration; organizational culture; deliberate practice; and lack of support, resources, and basic needs.Conclusion: Critical components for advanced deliberate practice within a CNS TTP program include an organizational culture and subculture that understands and values the CNS, along with tiered sustainable support from preceptors, mentors, and support CNSs across the setting and system.","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"36 6","pages":"327-343"},"PeriodicalIF":1.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9216702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tolstoy's A Calendar of Wisdom: Daily Thoughts to Nourish the Soul Written and Selected From the World's Sacred Texts. 托尔斯泰的智慧日历:滋养灵魂的日常思想从世界神圣的文本中写作和选择。

IF 1.2 4区医学

Clinical Nurse Specialist Pub Date : 2022-09-01 DOI: 10.1097/NUR.0000000000000689

Jeanine Young-Mason

引用次数: 0

Clinical Nurse Specialist Practice: Impact on Improving Sedation Practice in Critical Care. 临床专科护士实践:对改善重症护理镇静实践的影响。

IF 1.2 4区医学

Clinical Nurse Specialist Pub Date : 2022-09-01 DOI: 10.1097/NUR.0000000000000693

Nicole Seyller, Mary Beth Flynn Makic

{"title":"Clinical Nurse Specialist Practice: Impact on Improving Sedation Practice in Critical Care.","authors":"Nicole Seyller, Mary Beth Flynn Makic","doi":"10.1097/NUR.0000000000000693","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000693","url":null,"abstract":"Purpose/objectives: Prolonged mechanical ventilation results from deeper levels of sedation. This may lead to impaired respiratory muscle functioning that develops into pneumonia, increases antibiotic use, increases delirium risk, and increases length of hospitalization. A trauma and surgical intensive care unit interdisciplinary team conducted a quality improvement project to lighten sedation levels and shorten mechanical ventilation time.Description of the project: The project included multimodal elements to improve sedation practice. Standardizing the spontaneous awakening trial algorithm, creation of electronic health record tools, integration of sedation practices into daily rounds, and focused education for nursing were implemented in April 2021 through October 2021.Outcome: A reduction of median hours spent on mechanical ventilation was achieved. Mechanical ventilation hours decreased from 77 to 70. Richmond Agitation Sedation Scale levels improved from a median of -2 to -1, and daily spontaneous awakening trials increased from 10% to 27% completed.Conclusion: The quality improvement project demonstrated that, with increased daily spontaneous awakening trials and lighter sedation levels, the time patients spent on mechanical ventilation was shortened. There was no increase to self-extubation with lighter sedations levels. Shorter time on mechanical ventilation can reduce patient harm risks.","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"36 5","pages":"264-271"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40710385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Impact of COVID-19 on Clinical Nurse Specialists and Patients With Cancer: A Pan-Specialty Cross-sectional Survey. COVID-19对临床专科护士和癌症患者的影响:一项泛专科横断面调查。

IF 1.2 4区医学

Clinical Nurse Specialist Pub Date : 2022-09-01 DOI: 10.1097/NUR.0000000000000691

Alice S Forster, Janine Zylstra, Christian von Wagner, Yasemin Hirst, Martin Forster, Rebecca Walshe, Zainab Kazzaz, Andrew Steptoe, Martin Birchall, Neill Patani

{"title":"The Impact of COVID-19 on Clinical Nurse Specialists and Patients With Cancer: A Pan-Specialty Cross-sectional Survey.","authors":"Alice S Forster, Janine Zylstra, Christian von Wagner, Yasemin Hirst, Martin Forster, Rebecca Walshe, Zainab Kazzaz, Andrew Steptoe, Martin Birchall, Neill Patani","doi":"10.1097/NUR.0000000000000691","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000691","url":null,"abstract":"Purpose/Aims Uptake and delivery of cancer services across the United Kingdom have been significantly impacted by the COVID-19 pandemic. This study aimed to understand the impact of the pandemic on the working practices of clinical nurse specialists and their patient interactions across different cancer specialties. Design We performed a cross-sectional survey exploring nurses' experiences of delivering care during the pandemic, as well as their perceptions of the concerns that cancer patients were experiencing. Methods Clinical nurse specialists working in London cancer services were invited to complete an online questionnaire. Nurses' experiences and their perceptions of patients' concerns were analyzed descriptively. Results Fifty-four nurses participated. Almost half had been redeployed to other clinical areas during the pandemic (n = 19). COVID-19 discussions added 5 to 10 minutes on average to most consultations, with nurses either working longer/unpaid hours (34%) or spending less time talking to patients about cancer (39%) to deal with this. Approximately 50% of nurses would have liked additional information and support from their hospital. Conclusions Clinical nurse specialist time and resources have been stretched during the COVID-19 pandemic. Hospitals need to work with nursing staff to ensure the specific information needs of cancer patients are being met.","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"36 5","pages":"272-277"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9377363/pdf/cns-36-272.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40427409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Project Proposal to Publication. 从项目提案到出版。

IF 1.2 4区医学

Clinical Nurse Specialist Pub Date : 2022-09-01 DOI: 10.1097/NUR.0000000000000700

Janet S Fulton

引用次数: 0

Speaking Up for Patient Safety: Will Nurses Report Errors Now a Nurse Has Been Convicted of a Criminal Act? 为病人的安全大声疾呼:如果护士被判有罪，护士会报告错误吗?

IF 1.2 4区医学

Clinical Nurse Specialist Pub Date : 2022-09-01 DOI: 10.1097/NUR.0000000000000688

Cyndi Evans, Jovie Jabla, Geary A Gardner, Taranjeet Rathore, Elizabeth Ann Scruth

引用次数: 1