Clinical Nurse Specialist最新文献_第2页

De-Implementation of Chlorhexidine Oral Care in the Intensive Care Unit: A Clinical Nurse Specialist Led Evidence-Based Project. 重症监护室氯己定口腔护理的非实施：临床护士专家领导的循证项目。

IF 0.9 4区医学

Clinical Nurse Specialist Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1097/NUR.0000000000000947

Sophia H Pan, Amanda J Golino

{"title":"De-Implementation of Chlorhexidine Oral Care in the Intensive Care Unit: A Clinical Nurse Specialist Led Evidence-Based Project.","authors":"Sophia H Pan, Amanda J Golino","doi":"10.1097/NUR.0000000000000947","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000947","url":null,"abstract":"Purpose: In 2022, updated strategies to reduce ventilator-associated pneumonia (VAP) were published that no longer recommend the routine use of chlorhexidine oral care in mechanically ventilated adult patients. The lack of evidence to support positive impact on patient outcomes prompted Clinical Nurse Specialists to lead a de-implementation initiative to align standard practice with the latest evidence-based literature.Methods: The CNSs led a multidisciplinary team including pharmacy, infection prevention, supply chain, physicians, and nursing informatics to revise VAP protocols, update critical care order sets, and implement a new oral care kit without chlorhexidine. The initiative was guided by the PDSA framework and de-implementation strategies. Outcome metrics were collected over the next 15 months to include infection rates and financial impact.Results: Ventilator adverse events (VAE) decreased by 27.8%, with infection rates steadily declining by 6.45% per quarter. The standard infection rate also decreased by 19.7% after de-implementation. Financial spending and usage data over the last 15 months indicated a direct cost avoidance of $125,000 if? chlorhexidine oral care kits continued to be used.Conclusions: The de-implementation successfully eliminated a low-value, non-evidence-based nursing task, while reducing infection rates and generating cost savings for the organization. This highlights the pivotal role of the CNS in evaluating nursing practices to ensure they are grounded in current evidence rather than historic precedent.","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"40 2","pages":"72-74"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654662","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

Harnessing an Evidence-Based Practice Toolkit and Organizational-Behavior Change Models to Advance EBP Cultures. 利用基于证据的实践工具包和组织行为变化模型来推进EBP文化。

IF 0.9 4区医学

Clinical Nurse Specialist Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1097/NUR.0000000000000950

Margo A Halm

{"title":"Harnessing an Evidence-Based Practice Toolkit and Organizational-Behavior Change Models to Advance EBP Cultures.","authors":"Margo A Halm","doi":"10.1097/NUR.0000000000000950","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000950","url":null,"abstract":"Description of the problem: Evidence-based practice competency among US nurses continues to lag. Thus, nurses' collective ability to contribute to the Quintuple Aim is weakened.Purpose: This article aims to increase clinical nurse specialists' awareness and utilization of a compendium of tools that build an evidence-based practice culture and improve patient and organizational outcomes.Actions and interventions: An EBP compendium includes 50 tools that assess key facets of an evidence-based practice culture-attitudes/beliefs, self-efficacy, knowledge/skills, and implementation. Using the Advancing Research through Close Collaboration and the Capability-Opportunity-Motivation-Behavior Models as organizing frameworks, clinical nurse specialists can select tools from this compendium to conduct a baseline assessment of nurses' capability, motivation, and opportunity to routinely implement evidence-based practice. Clinical nurse specialists can then craft interventions from the Behavior Change Wheel to enhance nurses' evidence-based practice capability, motivation and/or opportunity. Progress in advancing the culture can be measured over time with validated tools and competencies, as demonstrated by an exemplar from a magnet-designated health care system.Conclusions: Clinical nurse specialists have advanced clinical and systems expertise to harness the compendium toolkit to strengthen the culture of evidence-based practice in units and organizations. This indispensable leadership can narrow the research-to-practice gap and advance health outcomes.","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"40 2","pages":"47-56"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655108","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

Postoperative Complications Among Frail Older ICU Patients: A Scoping Review. 老年虚弱ICU患者术后并发症：一项范围综述。

IF 0.9 4区医学

Clinical Nurse Specialist Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1097/NUR.0000000000000946

Denise Schindele, Tilmann Mueller-Wolff, John McDonough, Irmela Gnass

{"title":"Postoperative Complications Among Frail Older ICU Patients: A Scoping Review.","authors":"Denise Schindele, Tilmann Mueller-Wolff, John McDonough, Irmela Gnass","doi":"10.1097/NUR.0000000000000946","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000946","url":null,"abstract":"Objectives: To map the types and incidences of postoperative complications reported among frail adults (≥65 y) during intensive care treatment.Methods: A scoping review conducted following the Joanna Briggs Institute (JBI) methodological guidance and reported following the PRISMA-ScR guidelines. Sources of evidence included Medline (through PubMed), CINAHL (through EBSCO), and the Cochrane Library. Eligible studies enrolled postoperative patients aged 65 years or older who were identified as frail using validated assessment tools.Two reviewers performed 2-stage screening and standardized data charting. Outcomes were categorized by organ system, mortality, length of hospital and intensive care stay, and readmission.Results: Of 1345 titles, 8 observational studies were included. Reporting of postoperative complications in frail cohorts was heterogeneous. Described events included acute kidney injury, atrial fibrillation, pneumonia, delirium, and infectious complications. Mortality and lengths of stay were frequently reported but definitions and time points varied.Conclusions: Evidence describing postoperative complications among frail older adults requiring intensive care remains limited and inconsistent. Standardized definitions and systematic reporting of complications in frail populations are needed to improve comparability and support evidence-based care planning for this vulnerable group.","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"40 2","pages":"63-71"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655123","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

Celebrating Excellence: The Role of Awards and Recognition in Advancing Clinical Nurse Specialist Practice. 庆祝卓越：奖励和认可在推进临床护士专科实践中的作用。

IF 0.9 4区医学

Clinical Nurse Specialist Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1097/NUR.0000000000000944

Sagie De Guzman

{"title":"Celebrating Excellence: The Role of Awards and Recognition in Advancing Clinical Nurse Specialist Practice.","authors":"Sagie De Guzman","doi":"10.1097/NUR.0000000000000944","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000944","url":null,"abstract":"Background: Clinical nurse specialists (CNSs) are pivotal in advancing patient outcomes, guiding evidence-based practice, and leading system-level improvements. Recognition and awards programs play an important role in elevating CNS visibility, strengthening professional identity, and celebrating excellence in advanced practice nursing.Purpose: This article explores how recognition initiatives contribute to professional growth, leadership, and engagement among CNSs.Methods: Drawing on the author's experience as Chair of the National Association of Clinical Nurse Specialists (NACNS) Awards Committee, published exemplars of recognition in nursing, and organizational trends, this article synthesizes effective approaches for celebrating excellence and sustaining participation within the CNS community.Findings: Recognition serves as a catalyst for engagement and innovation by highlighting CNS achievements that exemplify leadership, mentorship, and quality improvement. Trends from the NACNS Awards Program demonstrate increasing participation and diversification of award categories, reflecting the expanding scope and influence of CNS practice.Implications: Structured recognition validates the impact of CNSs, fosters professional pride, and inspires the next generation of clinical leaders. By maintaining rigor and integrity in award processes, professional organizations like NACNS ensure that recognition remains a meaningful lever for advancing the visibility, credibility, and sustained growth of the CNS role.","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"40 2","pages":"41-46"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655478","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

Key Components and Theoretical Foundations of Online Learning Modules for Primary Prevention in Occupational Health. 职业健康初级预防在线学习模块的关键组成部分和理论基础。

IF 0.9 4区医学

Clinical Nurse Specialist Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1097/NUR.0000000000000945

Scarlet R Spain

{"title":"Key Components and Theoretical Foundations of Online Learning Modules for Primary Prevention in Occupational Health.","authors":"Scarlet R Spain","doi":"10.1097/NUR.0000000000000945","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000945","url":null,"abstract":"Purpose/objectives: This paper explores the development of an online learning module for primary prevention in occupational health, highlighting the role of clinical nurse specialists in designing and delivering effective education. The primary objective is to identify key components and theoretical foundations that enhance virtual health promotion programs.Description: Drawing from a clinical nurse specialist-led initiative to develop an online module for back pain prevention, the paper outlines 6 essential components of effective module design. It emphasizes evidence-based practices that promote engagement and retention in adult learners. The discussion includes how adult learning theory and related frameworks support behavior change and knowledge transfer in occupational health and other group learning settings.Outcome: The integration of theory-based strategies and instructional design principles resulted in an educational module that improved learner engagement and knowledge retention. The approach supports scalable and adaptable education across occupational settings. Results from the online module showed that participants' knowledge of back pain and its prevention improved. Participants also reported that the module was valuable for understanding anatomy, preventing and managing injuries, and applying practical examples through visual and shared resources.Conclusions: Clinical nurse specialists are well-positioned to lead educational initiatives that impact individual and organizational health. By applying adult learning theory and best practices in online module design, health literacy can be strengthened, preventive behaviors promoted, and safer work environments created.","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"40 2","pages":"57-62"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655125","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

A Call to Action. 行动的号召。

IF 0.9 4区医学

Clinical Nurse Specialist Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1097/NUR.0000000000000951

Janet S Fulton

引用次数: 0

The Possible Relationship Between Tattoo Ink and Cancer: Implications for Advanced Practice and Research. 纹身墨水与癌症之间可能的关系：对高级实践和研究的启示。

IF 0.9 4区医学

Clinical Nurse Specialist Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1097/NUR.0000000000000952

引用次数: 0

Transforming Clinical Nurse Specialist Student Evaluation: A Comprehensive Guide to Revising Rubrics for Competency-Based Assessment. 转变临床专科护士学生评价：修改基于能力的评估标准的综合指南。

IF 0.9 4区医学

Clinical Nurse Specialist Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1097/NUR.0000000000000948

Jennifer M Manning

引用次数: 0

The Possible Relationship Between Tattoo Ink and Cancer: Implications for Advanced Practice and Research. 纹身墨水与癌症之间可能的关系：对高级实践和研究的启示。

IF 0.9 4区医学

Clinical Nurse Specialist Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1097/NUR.0000000000000949

Patricia Anne O'Malley

引用次数: 0

Bringing the Clinical Nurse Specialist Voice to the Policy Table: Lessons in Advocacy and Engagement. 将临床护士专家的声音带入政策表：倡导和参与的经验教训。

IF 0.9 4区医学

Clinical Nurse Specialist Pub Date : 2026-01-01 Epub Date: 2025-11-21 DOI: 10.1097/NUR.0000000000000941

Jackeline Iseler

引用次数: 0