Clinical Nurse Specialist最新文献

Purpose/objectives: During the COVID-19 pandemic, a large Midwest tertiary care medical center had prolonged hospitalizations due to strained staffing and few options for post-acute care recovery. Patients deemed medically ready for discharge were receiving the same care interventions as all other hospitalized medical-surgical patients. The study objective was to appropriately match care assessment frequency for these patients with their individual needs by reducing the frequency of routine nursing assessments.

Description of the project/program: This quality improvement initiative reduced the frequency of nursing assessments, including routine monitoring of vital signs, to once daily for medically stable patients whose discharge was delayed.

Outcome: During the 4-week pilot, 40 hospitalized patients were enrolled; 960 assessments were eliminated, and nurses were able to reallocate approximately 500 hours to other nursing tasks. No adverse outcomes were observed among patients who received once-daily assessment.

Conclusion: By decreasing nursing assessment frequency for hospitalized patients with discharge delays, nurses appropriately matched care interventions with the patient's needs.

Purpose/objectives: The purpose of this article is to illustrate, using exemplars, the practice of clinical nurse specialists (CNSs) in Michigan who are credentialed and privileged as providers by hospital/healthcare agencies to practice in acute inpatient and ambulatory settings.

Description: The CNS provides expert specialty direct patient care to improve patient outcomes. They hold a graduate degree as a CNS, are professionally certified as a CNS in a specialty practice population, and are licensed or otherwise recognized to practice as an advanced practice nurse by the state nursing practice regulatory agency.

Outcome: The exemplars illustrate CNS practice as an independent provider within a health system.

Conclusion: Hospital-based credentialing and privileging facilitates CNS practice within the full scope of practice authority that consists of education, certification, and licensure and is a valuable contribution to cost-effective, high-quality clinical care for specialty populations.

Purpose/aims: 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.

Design: 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.

Methods: 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.

Results: 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.

Conclusions: 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.