Clinical Nurse Specialist最新文献

Purpose: This study aimed to determine the effects of laughter yoga and mindfulness on nurses' fatigue, attention levels, and work performance.

Methods: This was a 3-arm, parallel-group, randomized controlled study. Data were collected using the Information Form containing questions about nurses' demographic and professional characteristics, the Chalder Fatigue Scale, the Computerized Sustained Attention Test, and the Individual Work Performance Questionnaire. Nurses completed the tools preintervention, midtest, and postintervention.

Results: The study included 101 nurses. At the end of the eight-week interventions, fatigue levels among nurses in the laughter yoga and mindfulness groups were lower compared with the control group (F = 8.805, P < .001). In terms of attention levels, there was no overall difference between the groups; however, in the fourth week only, the hard-level attention scores of the laughter yoga group were higher than those of the control group (F = 5.431, P < .05). Additionally, job performance scores were higher in both intervention groups compared with the control group (F = 9.879, P < .01). Moreover, laughter yoga was more effective than the mindfulness practice in reducing nurses' fatigue and improving their attention levels (P < .05).

Conclusions: Laughter yoga and mindfulness were effective in reducing nurses' fatigue and improving their attention levels and work performance.

Purpose: This study identifies key factors in nontraumatic intracerebral hemorrhage outcomes, highlighting clinical nurse specialists' role in precision care and genomic-based patient management.

Design: This was a retrospective study conducted in Taiwan from 2019 to 2023, involving 892 patients diagnosed with intracerebral hemorrhage. Diagnoses were confirmed by neurologists, and patient data included neurological scales (National Institutes of Health Stroke Scale), symptom-to-door time, and overall function assessed via the modified Rankin Scale.

Methods: Logistic regression analysis was used to identify predictors of outcomes using demographic, physical, and biomarker data.

Results: Mortality risk was 1.69 times higher with diabetes, 1.79 times higher with heart disease, and 2.91 times higher with low-density lipoprotein cholesterol <70 versus >130 mg/dL. Symptom-to-door time >2 hours increased mortality risk by 1.58 times. Key outcome predictors included diabetes, heart disease, low-density lipoprotein cholesterol, and delayed hospital arrival.

Conclusions: Clinical nurse specialists can combine genetic assessment and blood biomarker analysis results to formulate personalized precision care plans for patients with nontraumatic cerebral hemorrhage and targeted precision health education and care. Through precise case management and regular follow-up, we help patients maintain a healthy lifestyle, reduce disease recurrence risk, and promote physical and mental health across ages, ultimately improving patients' quality of life and extending healthy lifespans.

Purpose: Because of the lack of institutional standards, variation in practice for administering chemotherapy and biologics, including clinical trial infusions, was detected. This article describes a National Cancer Institute-designated cancer center's successful education and training of nurses on a new standard method for administering small-volume infusion using the circle priming technique.

Description of the project: A team of clinical nurse specialists (CNSs) led a system-wide practice change to standardize the administration of chemotherapy and biologic treatments using the circle priming method. The CNSs partnered with an interprofessional group that included pharmacy staff, physicians, and nursing leadership to implement this new nursing practice for administering chemotherapy. Circle priming is a practice supported by literature for giving small-volume medications. The team secured approval from stakeholders and conducted a 2-week soft rollout in a high-volume acute care unit. Nursing policies and chemotherapy guidelines were updated, and a 20-minute education module with hands-on training was provided to nursing staff. After the rollout, CNSs supported nurses in real time by employing a train-the-trainer model to educate nurse champions and other staff members. Daily debriefs were held to address any issues and troubleshoot effectively.

Outcome: Fifteen CNSs educated 91% of frontline staff (643 out of 714 nurses) on circle priming for small-volume chemotherapy. The training included didactic and practical methods, focusing on safety, intravenous flushing, pump programming, handling practices, and patient education. Furthermore, this new standardized method was shared internally with various chemotherapy and biotherapy committees to raise awareness among the interdisciplinary team. Patients were also educated on the practice change with newly developed patient education materials.

Conclusion: Clinical nurse specialists are well equipped to define best practices and implement evidence-based recommendations, such as circle priming, which ensures full drug delivery and supports the highest-quality patient care.

Purpose/objectives: The purpose of this article is to introduce the clinical nurse specialist to the Frailty Care Model. This model can be used by the clinical nurse specialist as a framework to guide nurses as they provide care to older adults predisposed to frailty progression while hospitalized.

Description: The Frailty Care Model is used as a framework to plan the care of the hospitalized older adult. Examples of frailty screening tools are presented to inform the clinical nurse specialist of the older adult's needs for intervention while hospitalized, and a case study is used. Known targets for frailty interventions include low physical activity, malnutrition, and depression, and recommendations for each are given.

Outcome: The clinical nurse specialist can use and support specific interventions to improve mobility and physical activity, address depression, and improve nutritional intake in hospitalized older adults.

Conclusion: The clinical nurse specialist is essential to the care of the hospitalized older adult who has frailty or is at risk for frailty. Frailty screening and an awareness of risks as well as modifiable factors can set the stage for supportive care that can help to prevent or stabilize frailty in the hospitalized older adult.