Pub Date : 2021-11-24DOI: 10.1097/NUR.0000000000000650
Jennifer K Peterson, Jessica Viste
The National Association of Clinical Nurse Specialists (NACNS) supports and advocates for the role of the Clinical Nurse Specialist (CNS) in the provision of telehealth services. The diversity of CNS roles and practice settings creates challenges in precisely defining how telehealth is incorporated into the CNS role. Nevertheless, CNS practice foundations support competencies related to telehealth across the spheres of impact: direct patient care, nurses and nursing practice, healthcare systems and organizations. As one of the four advanced practice registered nursing (APRN) roles, CNSs lead healthcare and develop innovative and effective care solutions, including telehealth, in diverse healthcare settings to improve outcomes. This paper will use the broader term “telehealth” to encompass nursing practice across the continuum of health and healthcare.
{"title":"NACNS White Paper on Telehealth Competency for the Clinical Nurse Specialist: Gap Analysis and Recommendations","authors":"Jennifer K Peterson, Jessica Viste","doi":"10.1097/NUR.0000000000000650","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000650","url":null,"abstract":"The National Association of Clinical Nurse Specialists (NACNS) supports and advocates for the role of the Clinical Nurse Specialist (CNS) in the provision of telehealth services. The diversity of CNS roles and practice settings creates challenges in precisely defining how telehealth is incorporated into the CNS role. Nevertheless, CNS practice foundations support competencies related to telehealth across the spheres of impact: direct patient care, nurses and nursing practice, healthcare systems and organizations. As one of the four advanced practice registered nursing (APRN) roles, CNSs lead healthcare and develop innovative and effective care solutions, including telehealth, in diverse healthcare settings to improve outcomes. This paper will use the broader term “telehealth” to encompass nursing practice across the continuum of health and healthcare.","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134040378","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}
Pub Date : 2019-11-01DOI: 10.1097/01.NUR.0000604200.03201.6d
L. Wanzer, J. Oliver, Jose Rodriguez, David F Bradley, L. Taylor
{"title":"Impact of the Clinical Nurse Specialist in the Transformation of Military Healthcare From Bedside to Battlefield.","authors":"L. Wanzer, J. Oliver, Jose Rodriguez, David F Bradley, L. Taylor","doi":"10.1097/01.NUR.0000604200.03201.6d","DOIUrl":"https://doi.org/10.1097/01.NUR.0000604200.03201.6d","url":null,"abstract":"","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114886530","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}
Pub Date : 2019-11-01DOI: 10.1097/NUR.0000000000000482
Erica Fischer-Cartlidge, N. Houlihan, Kevin P Browne
PURPOSE This article will describe the outcomes associated with restructuring clinical nurse specialists (CNSs) into a centralized model with dedicated efforts focused on team and individual development. METHODS A multiphase journey was undertaken to rebuild a team of CNSs after years of open vacancies and role confusion. After restructuring to a centralized model, a multiphase approach was taken that included innovative recruitment strategies, development of a talent pipeline through enhancement of student clinical placements, team and individual development activities, and value identification. Description of methods used for individual and team development is discussed in depth within this article, including achieving role standardization and optimization. OUTCOMES Numerous outcomes were associated with this effort and are described within this article. Among them were the hiring of 21 CNSs, increased representation on hospital-wide committees and councils, quantification of the work contribution of CNSs within the organization, and a $1 568 229.36 cost avoidance associated with CNS work efforts, all in the first 24 months. CONCLUSION As challenges facing the role put it at risk and healthcare becomes increasingly value based, the need for expert clinicians who can demonstrate their value becomes essential. Clinical nurse specialists and hospital leadership can benefit from exploring successful interventions to rebuild CNS teams to achieve these goals.
{"title":"Building a Renowned Clinical Nurse Specialist Team: Recruitment, Role Development, and Value Identification.","authors":"Erica Fischer-Cartlidge, N. Houlihan, Kevin P Browne","doi":"10.1097/NUR.0000000000000482","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000482","url":null,"abstract":"PURPOSE\u0000This article will describe the outcomes associated with restructuring clinical nurse specialists (CNSs) into a centralized model with dedicated efforts focused on team and individual development.\u0000\u0000\u0000METHODS\u0000A multiphase journey was undertaken to rebuild a team of CNSs after years of open vacancies and role confusion. After restructuring to a centralized model, a multiphase approach was taken that included innovative recruitment strategies, development of a talent pipeline through enhancement of student clinical placements, team and individual development activities, and value identification. Description of methods used for individual and team development is discussed in depth within this article, including achieving role standardization and optimization.\u0000\u0000\u0000OUTCOMES\u0000Numerous outcomes were associated with this effort and are described within this article. Among them were the hiring of 21 CNSs, increased representation on hospital-wide committees and councils, quantification of the work contribution of CNSs within the organization, and a $1 568 229.36 cost avoidance associated with CNS work efforts, all in the first 24 months.\u0000\u0000\u0000CONCLUSION\u0000As challenges facing the role put it at risk and healthcare becomes increasingly value based, the need for expert clinicians who can demonstrate their value becomes essential. Clinical nurse specialists and hospital leadership can benefit from exploring successful interventions to rebuild CNS teams to achieve these goals.","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123476772","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}
Pub Date : 2017-05-01DOI: 10.1097/NUR.0000000000000295
Beata Jankowska-Polańska, Marta Brzykowska, Izabella Uchmanowicz, Magdalena Lisiak, Joanna Rosinczuk
: On the basis of management guidelines, multidisciplinary treatments are essential in the care of patients with heart failure (HF) to improve quality of life and clinical outcomes.
Purpose: The aim of the study was to assess nurses' knowledge of HF self-care principles as a way to be prepared for educating patients about HF self-care maintenance and management.
Methods: Nurses providing cardiology intensive care (n = 48), nonintensive hospital care (n = 129), and family practices care (n = 50) completed the Nurses' Knowledge of HF Education Principles survey. Data were analyzed using descriptive statistics, Student t test, analysis of variance for qualitative variables, the Kruskal-Wallis correlation test, simple linear regression, and Pearson rank correlation for continuous variables.
Results: Mean (SD) HF self-care maintenance knowledge score was 12.1 (2.7) that equated to 60.4% (13.4%). Scores were highest among nurses working in cardiology intensive care (12.39 [2.7]) and noninvasive care (12.3 [2.7]) and lowest in family medicine (10.74 [2.3]), P < .001. Nurses' knowledge was associated with level of education (r = 0.1399, P = .05), number of graduate courses (r = 0.1483, P = .05), and specialization in cardiac nursing (r = 0.1457, P = .05).
Conclusions: Polish nurses' knowledge deficits in HF self-care principles may lead to problems in providing patients with adequate education.
在管理指南的基础上,多学科治疗在心衰患者的护理中是必不可少的,以改善生活质量和临床结果。目的:本研究的目的是评估护士对心衰自我保健原则的了解,为教育患者心衰自我保健的维持和管理做准备。方法:提供心内科重症监护(n = 48)、非重症医院护理(n = 129)和家庭护理(n = 50)的护士完成心衰教育原则的护士知识调查。数据分析采用描述性统计、学生t检验、定性变量方差分析、Kruskal-Wallis相关检验、简单线性回归和连续变量Pearson秩相关。结果:HF患者自我护理维护知识得分均值(SD)为12.1分(2.7分),占60.4%(13.4%)。心内科重症监护护士得分最高(12.39[2.7]),无创护理护士得分最高(12.3[2.7]),家庭医学护士得分最低(10.74 [2.3]),P < 0.001。护士的知识与教育程度(r = 0.1399, P = 0.05)、研究生课程数(r = 0.1483, P = 0.05)和心脏护理专业相关(r = 0.1457, P = 0.05)。结论:波兰护士在心衰自我保健原则方面的知识不足可能导致在为患者提供足够的教育方面存在问题。
{"title":"Polish Nurses' Knowledge of Heart Failure Self-Care Education Principles.","authors":"Beata Jankowska-Polańska, Marta Brzykowska, Izabella Uchmanowicz, Magdalena Lisiak, Joanna Rosinczuk","doi":"10.1097/NUR.0000000000000295","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000295","url":null,"abstract":"<p><p>: On the basis of management guidelines, multidisciplinary treatments are essential in the care of patients with heart failure (HF) to improve quality of life and clinical outcomes.</p><p><strong>Purpose: </strong>The aim of the study was to assess nurses' knowledge of HF self-care principles as a way to be prepared for educating patients about HF self-care maintenance and management.</p><p><strong>Methods: </strong>Nurses providing cardiology intensive care (n = 48), nonintensive hospital care (n = 129), and family practices care (n = 50) completed the Nurses' Knowledge of HF Education Principles survey. Data were analyzed using descriptive statistics, Student t test, analysis of variance for qualitative variables, the Kruskal-Wallis correlation test, simple linear regression, and Pearson rank correlation for continuous variables.</p><p><strong>Results: </strong>Mean (SD) HF self-care maintenance knowledge score was 12.1 (2.7) that equated to 60.4% (13.4%). Scores were highest among nurses working in cardiology intensive care (12.39 [2.7]) and noninvasive care (12.3 [2.7]) and lowest in family medicine (10.74 [2.3]), P < .001. Nurses' knowledge was associated with level of education (r = 0.1399, P = .05), number of graduate courses (r = 0.1483, P = .05), and specialization in cardiac nursing (r = 0.1457, P = .05).</p><p><strong>Conclusions: </strong>Polish nurses' knowledge deficits in HF self-care principles may lead to problems in providing patients with adequate education.</p>","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":" ","pages":"E7-E13"},"PeriodicalIF":1.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NUR.0000000000000295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34890191","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}
Pub Date : 2017-05-01DOI: 10.1097/NUR.0000000000000289
Bob Dawson
My approach is based on listening to the connection between thought, emotion, spirit, and body. This is the natural kinetic process whereby our inner landscape translates into electrical impulses that transmit to the muscles the message as to how and with what quality to move. I explore the physical manifestation of this pure experience of being; the neuromuscular interrelationship. VMargie Gillis
{"title":"Dancers Talk About Neurology More Than Neurologists Talk About Dancing. The Neurologists Are Imbalanced.","authors":"Bob Dawson","doi":"10.1097/NUR.0000000000000289","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000289","url":null,"abstract":"My approach is based on listening to the connection between thought, emotion, spirit, and body. This is the natural kinetic process whereby our inner landscape translates into electrical impulses that transmit to the muscles the message as to how and with what quality to move. I explore the physical manifestation of this pure experience of being; the neuromuscular interrelationship. VMargie Gillis","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":" ","pages":"174-175"},"PeriodicalIF":1.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NUR.0000000000000289","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34890266","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}
Pub Date : 2017-05-01DOI: 10.1097/NUR.0000000000000297
Patricia Anne O'Malley
Few scientists acquainted with the chemistry of biological systems at the molecular level can avoid being inspired. The development of biologics for the past 20 years has changed the treatment paths for cancer and autoimmune disorders across the life span. Rather than beginningwith the disease, biotechnology-based care begins with the identification of genetic variation and uses cell-based therapies to modify the variation. Biologics are directed to specific genotypes or protein receptors. Some of the targets for biologic therapies include anemia, cystic fibrosis, diabetes, hemophilia, hepatitis, genital warts, transplant rejection, cancers, and tissue reconstitution for wounds. Biologic development is not a new science. Human growth hormone, insulin, and red blood cellYstimulating agents have been on the market for decades. However, with the deepening understanding of genetics and disease, there has been significant expansion in the development of genomics, proteomics, microarray, cell cultures, and monoclonal antibody technologies. The increasing number of biologic development platforms across the pharmacy industry worldwide suggests that this pharmacotherapy will bring even more options for therapy options for the future. There is no simple definition for biologics. A strict definition of biologics would include only agents produced by living systems consisting of large molecules containing hundreds of amino acids. Another definition would describe a biologic as any substance composed of organic molecules no matter the size. Still, others would include products created in other organisms such estrogen hormone from pregnant mare urine. Finally, biologic can be defined as a product created by a microorganism or mammalian cell, which are large complex molecules, most of which are proteins or polypeptides. Biologics are described as large complexmolecules such as a virus, toxin, antitoxin, therapeutic serum, vaccine, blood productor component, or trivalent organic arsenic compound used for the prevention, treatment, or cure of a disease. The complex molecules and/or mixture are not easily labeled because of construction from bacteria, yeast, insects, plants, other purified natural sources, or mammalian cells. The Table describes the most commonly prescribed biologics, based on these broad definitions. Also included is the biologic type, approval date, Web site address for specific information for use and prescribing, and indications for use.
{"title":"Large Molecule Pharmacotherapy: Biologics in Clinical Nurse Specialist Practice.","authors":"Patricia Anne O'Malley","doi":"10.1097/NUR.0000000000000297","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000297","url":null,"abstract":"Few scientists acquainted with the chemistry of biological systems at the molecular level can avoid being inspired. The development of biologics for the past 20 years has changed the treatment paths for cancer and autoimmune disorders across the life span. Rather than beginningwith the disease, biotechnology-based care begins with the identification of genetic variation and uses cell-based therapies to modify the variation. Biologics are directed to specific genotypes or protein receptors. Some of the targets for biologic therapies include anemia, cystic fibrosis, diabetes, hemophilia, hepatitis, genital warts, transplant rejection, cancers, and tissue reconstitution for wounds. Biologic development is not a new science. Human growth hormone, insulin, and red blood cellYstimulating agents have been on the market for decades. However, with the deepening understanding of genetics and disease, there has been significant expansion in the development of genomics, proteomics, microarray, cell cultures, and monoclonal antibody technologies. The increasing number of biologic development platforms across the pharmacy industry worldwide suggests that this pharmacotherapy will bring even more options for therapy options for the future. There is no simple definition for biologics. A strict definition of biologics would include only agents produced by living systems consisting of large molecules containing hundreds of amino acids. Another definition would describe a biologic as any substance composed of organic molecules no matter the size. Still, others would include products created in other organisms such estrogen hormone from pregnant mare urine. Finally, biologic can be defined as a product created by a microorganism or mammalian cell, which are large complex molecules, most of which are proteins or polypeptides. Biologics are described as large complexmolecules such as a virus, toxin, antitoxin, therapeutic serum, vaccine, blood productor component, or trivalent organic arsenic compound used for the prevention, treatment, or cure of a disease. The complex molecules and/or mixture are not easily labeled because of construction from bacteria, yeast, insects, plants, other purified natural sources, or mammalian cells. The Table describes the most commonly prescribed biologics, based on these broad definitions. Also included is the biologic type, approval date, Web site address for specific information for use and prescribing, and indications for use.","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":" ","pages":"134-137"},"PeriodicalIF":1.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NUR.0000000000000297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34890856","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}
Pub Date : 2017-05-01DOI: 10.1097/NUR.0000000000000290
Heather Schoonover
Purpose: The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007.
Description of the project: The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes.
Outcome: On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses.
Conclusions: Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.
{"title":"The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.","authors":"Heather Schoonover","doi":"10.1097/NUR.0000000000000290","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000290","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007.</p><p><strong>Description of the project: </strong>The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes.</p><p><strong>Outcome: </strong>On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses.</p><p><strong>Conclusions: </strong>Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.</p>","PeriodicalId":145249,"journal":{"name":"Clinical nurse specialist CNS","volume":" ","pages":"138-144"},"PeriodicalIF":1.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NUR.0000000000000290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34890857","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}