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Quality Improvement and Clinical Audits: What Is the Ethical Oversight? 质量改进和临床审核：什么是道德监督？
IF 1.2 4区 医学
Clinical Nurse Specialist Pub Date : 2023-09-01 DOI: 10.1097/NUR.0000000000000765
Elizabeth Ann Scruth, Robin K Betts, Laure Lisk
{"title":"Quality Improvement and Clinical Audits: What Is the Ethical Oversight?","authors":"Elizabeth Ann Scruth, Robin K Betts, Laure Lisk","doi":"10.1097/NUR.0000000000000765","DOIUrl":"10.1097/NUR.0000000000000765","url":null,"abstract":"INTRODUCTION Quality improvement (QI) is described by the Agency for Healthcare Research and Quality as the process to test, understand, and revise processes constantly to improve the way care is delivered to patients. A high-reliability healthcare organization (HRO) is one that participates in QI and clinical audits as part of standard work. To achieve this, real and potential threats to reliability are solved quickly through both cognitive and behavioral standards used every time. Patient outcomes including reduction in patient harm, empowering patient decision-making, and improving health equity and delivery of services are enhanced through ongoing QI initiatives. Quality improvement has often been described as existing in a zone between clinical practice and health research. There is confusion of what constitutes the foundations of QI and what is required in terms of ethical oversight and by whom. There is limited international collaboration to achieve consensus on what ethical oversight or frameworks should apply to QI initiatives. A systematic qualitative review exploring the ethical issues in a learning healthcare system revealed the following:","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 5","pages":"211-213"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028508","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
Artificial Intelligence, Digital Health Research, and the Clinical Nurse Specialist. 人工智能、数字健康研究和临床护理专家。
IF 1.2 4区 医学
Clinical Nurse Specialist Pub Date : 2023-09-01 DOI: 10.1097/NUR.0000000000000763
Sandra L Siedlecki
{"title":"Artificial Intelligence, Digital Health Research, and the Clinical Nurse Specialist.","authors":"Sandra L Siedlecki","doi":"10.1097/NUR.0000000000000763","DOIUrl":"10.1097/NUR.0000000000000763","url":null,"abstract":"In this age of digital technology, many new and exciting opportunities exist for nurses to become involved in research using digital interventions and digital outcome measures. Artificial intelligence and wearable sensors are enhancing our ability to capture data in real time and use it to assess the impact of our actions and interventions on patients. Because the clinical nurse specialist is most often the resource for nurses interested in research projects, it is important that they become versed in these new interventions and new ways of collecting data. The purpose of this article is to explore how digital technology can be used to improve recruitment and retention of subjects in clinical trials and how it can be used to enhance data capture, providing a better and more complete picture of the results of our interventions. Finally, the benefits and limitations of the use of digital health resources in research will be discussed.","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 5","pages":"214-217"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028511","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
"How Can I Keep From Singing?" “我怎样才能不唱歌？”
IF 1.2 4区 医学
Clinical Nurse Specialist Pub Date : 2023-09-01 DOI: 10.1097/NUR.0000000000000764
Jeanine Young-Mason
{"title":"\"How Can I Keep From Singing?\"","authors":"Jeanine Young-Mason","doi":"10.1097/NUR.0000000000000764","DOIUrl":"10.1097/NUR.0000000000000764","url":null,"abstract":"(sing g) |C . F . |C . . . | G . . . | C . . My life goes on---in endless song a-bove Earth’s lamen-tations . | C . F . |C . . . |G . . . |C . . I hear the real, though far off song, that hails a new cre-ation. . | Em . . . |Am . . . |C . . . | G . . Through all the tu-------mult and the strife, I hear that music ringing. . |C . F . |C . . . |Am . G . |C . . It sounds an e------cho in my soul. How can I keep from singing?","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 5","pages":"247-248"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10023068","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
Project to Publication-A Writing Mentorship Program. 出版项目——写作指导计划。
IF 1.2 4区 医学
Clinical Nurse Specialist Pub Date : 2023-09-01 DOI: 10.1097/NUR.0000000000000766
Sarah Harne-Britner, Cynthia A Leaver
{"title":"Project to Publication-A Writing Mentorship Program.","authors":"Sarah Harne-Britner,&nbsp;Cynthia A Leaver","doi":"10.1097/NUR.0000000000000766","DOIUrl":"10.1097/NUR.0000000000000766","url":null,"abstract":"<p><strong>Purpose/aims: </strong>Evidence is required to inform effective interventions promoting publication among clinical nurses. This study examined the effect of a mentored writing program on clinical nurse perceptions of writerly self-efficacy and publication.</p><p><strong>Design: </strong>A mixed-methods, pretest-posttest study design with an education intervention was implemented. The Revised for Nursing Practice - Postsecondary Writerly Self-efficacy Scale (RNP-PSWSES) measured perception of writerly self-efficacy before and after intervention. Manuscripts submitted for publication were counted.</p><p><strong>Methods: </strong>The purposive, convenience sample included registered nurses with completed research, evidence-based practice, or quality improvement projects. Subjects participated in a 3-month structured mentored writing program and completed the RNP-PSWSES survey before and after program completion. A Wilcoxon signed rank test was performed to determine the significance of difference between the pretest and posttest, and the number of published manuscripts was reported.</p><p><strong>Results: </strong>The RNP-PSWSES items identified pretest-posttest Cronbach's α (.728, .818). Posttest RNP-PSWSES scores were statistically significantly higher than pretest scores (z = -1.96, P = .050) with a large effect size of r = 0.69. Two manuscripts were accepted for publication, and 1 manuscript was withdrawn after the third request for revisions.</p><p><strong>Conclusions: </strong>In this study, mentored writing workshops improve nurses' perceptions of writing ability and increase publications. Generalization of findings is limited by small sample size. Clinical nurse specialists are critical to champion writing and publication.</p>","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 5","pages":"237-243"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10016584","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
Using a Clinical Triggers System to Improve Early Recognition of Clinical Changes. 使用临床触发系统来提高对临床变化的早期识别。
IF 1.2 4区 医学
Clinical Nurse Specialist Pub Date : 2023-09-01 DOI: 10.1097/NUR.0000000000000769
Betty Lee, Jennifer Leng, Russell Kerbel
{"title":"Using a Clinical Triggers System to Improve Early Recognition of Clinical Changes.","authors":"Betty Lee,&nbsp;Jennifer Leng,&nbsp;Russell Kerbel","doi":"10.1097/NUR.0000000000000769","DOIUrl":"10.1097/NUR.0000000000000769","url":null,"abstract":"<p><strong>Purpose: </strong>A medical-surgical telemetry unit implemented a clinical triggers system for early recognition of clinical deterioration and bedside management between nurses and providers. The goal was to decrease cardiopulmonary arrest events.</p><p><strong>Description of the project: </strong>A clinical triggers system was developed to help nurses to identify clinical markers early and advocate for prompt bedside assessment and interventions. When clinical triggers were identified, the nurse notified the provider, who performed a bedside assessment within 15 minutes. If the provider did not respond promptly, the rapid response team was activated.</p><p><strong>Outcomes: </strong>Before intervention, the unit experienced 14 cardiopulmonary arrest events (rate of 1.37 per 1000 patient days). Incidences decreased annually to 5, 4, and 3 events (rates of 0.49, 0.39, and 0.3 per 1000 patient days) during the 3-year implementation period.</p><p><strong>Conclusions: </strong>The clinical triggers system was successful in achieving the project objective of decreasing unit cardiopulmonary arrest events through early recognition and response to patient deterioration during the implementation period. The clinical nurse specialist helped nurses to use the clinical triggers system to detect and respond to clinical changes. Nurses were empowered to address concerns and promote patient safety.</p>","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 5","pages":"228-236"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10023061","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 Unique Practice of the Clinical Nurse Specialist. 临床专科护士的独特实践。
IF 1.2 4区 医学
Clinical Nurse Specialist Pub Date : 2023-07-01 DOI: 10.1097/NUR.0000000000000762
Phyllis Whitehead
{"title":"The Unique Practice of the Clinical Nurse Specialist.","authors":"Phyllis Whitehead","doi":"10.1097/NUR.0000000000000762","DOIUrl":"10.1097/NUR.0000000000000762","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 4","pages":"154-155"},"PeriodicalIF":1.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807911","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
Utilizing Your Expertise as a Nurse Consultant. 利用你作为护士顾问的专业知识。
IF 1.2 4区 医学
Clinical Nurse Specialist Pub Date : 2023-07-01 DOI: 10.1097/NUR.0000000000000754
Pamela Jane Nye
{"title":"Utilizing Your Expertise as a Nurse Consultant.","authors":"Pamela Jane Nye","doi":"10.1097/NUR.0000000000000754","DOIUrl":"10.1097/NUR.0000000000000754","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 4","pages":"166-168"},"PeriodicalIF":1.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807920","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
Rising Xylazine Drug Abuse in Humans: A Deep and Lingering High With Wounds, Amputations, and Death. 人类中不断上升的噻嗪类药物滥用:伴随着伤口、截肢和死亡的深刻而挥之不去的高潮。
IF 1.2 4区 医学
Clinical Nurse Specialist Pub Date : 2023-07-01 DOI: 10.1097/NUR.0000000000000761
{"title":"Rising Xylazine Drug Abuse in Humans: A Deep and Lingering High With Wounds, Amputations, and Death.","authors":"","doi":"10.1097/NUR.0000000000000761","DOIUrl":"10.1097/NUR.0000000000000761","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 4","pages":"E4"},"PeriodicalIF":1.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807919","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
President's Letter. 主席的信。
IF 1.2 4区 医学
Clinical Nurse Specialist Pub Date : 2023-07-01 DOI: 10.1097/NUR.0000000000000760
Mitzi M Saunders
{"title":"President's Letter.","authors":"Mitzi M Saunders","doi":"10.1097/NUR.0000000000000760","DOIUrl":"10.1097/NUR.0000000000000760","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 4","pages":"149-153"},"PeriodicalIF":1.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807913","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
Rising Xylazine Drug Abuse in Humans: A Deep and Lingering High With Wounds, Amputations, and Death. 人类中不断上升的噻嗪类药物滥用:伴随着伤口、截肢和死亡的深刻而挥之不去的高潮。
IF 1.2 4区 医学
Clinical Nurse Specialist Pub Date : 2023-07-01 DOI: 10.1097/NUR.0000000000000758
Patricia Anne O'Malley
{"title":"Rising Xylazine Drug Abuse in Humans: A Deep and Lingering High With Wounds, Amputations, and Death.","authors":"Patricia Anne O'Malley","doi":"10.1097/NUR.0000000000000758","DOIUrl":"10.1097/NUR.0000000000000758","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 4","pages":"164-165"},"PeriodicalIF":1.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807916","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
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