Clinical Nurse Specialist最新文献

Purpose: 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.

Description of the project: 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.

Outcomes: 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.

Conclusions: 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.

Abstract: There are eerie similarities between the 1918 Spanish influenza and 2019 COVID-19 pandemics that are somewhat surprising and disheartening, given that the time interval between the 2 pandemics is more than 100 years. This article covers the national response, etiology and pathophysiology, disease course and treatments, nursing shortages, healthcare responses, sequelae following infections, and economic and social impacts of both pandemics. Understanding the development and course of both pandemics will inform clinical nurse specialists about the changes that need to be made to be better prepared to recognize the changes that need to be made to prepare for the next pandemic.

Purpose/objectives: Primary healthcare (PHC) is a clinical frontier full of opportunities for clinical nurse specialists (CNSs) to improve population outcomes, facilitate smooth care transitions, and overcome challenges through a unique lens. Clinical nurse specialist practice in primary care is exceedingly rare, and there is a paucity of literature on the topic. This article provides exemplary projects implemented by a CNS student in a primary care clinic.

Description of the project/program: Primary healthcare has been described as the "front door" of the health system. It has increasingly relied on nursing to deliver health services, yet PHC and nursing practice in this setting remain poorly defined. Clinical nurse specialists are well-positioned to define these concepts, standardize processes used to deliver services, and impact patient outcomes in PHC. The CNS student successfully supported a primary care clinic in these activities.

Outcome: Reviewing the impact of the CNS student's experience offers a better understanding of CNS practice in PHC.

Conclusion: Gaps exist in the literature regarding best practices and care delivery in PHC. Clinical nurse specialists are educationally prepared to address these gaps and improve patient outcomes at the health system's "front door." Utilizing a CNS's unique skill set achieves cost-effective and efficient healthcare delivery in a new way that bolsters the strategy of utilizing nurse practitioners to meet the challenge of provider shortages.

Purpose: The purpose of this study was to examine the perceived self-efficacy of the clinical nurse specialist working in the United States during the COVID-19 pandemic and explore whether there was any difference in self-efficacy based on practice focus (spheres of impact) and if differences existed between self-efficacy and demographics.

Design: This study used a nonexperimental, correlational, cross-sectional design utilizing a voluntary, anonymous, 1-time survey administered through Qualtrics (Qualtrics, Provo, UT).

Methods: The National Association of Clinical Nurse Specialists and 9 state affiliates distributed the electronic survey starting late October 2021 through January 2022. Survey content consisted of demographics and the General Self-efficacy Scale, which measures the individual's perceived ability to cope and execute tasks when faced with hardship or adversity. Sample size was 105.

Results: Results included a high perception of self-efficacy of the clinical nurse specialist working during the pandemic, no statistical significance in practice focus, and a statistically significant difference in the scores of self-efficacy for participants with previous infectious disease experience compared with those without experience.

Conclusions: Clinical nurse specialists with previous infectious disease experience can guide policy, be utilized in multifaceted roles to support future infectious disease outbreaks, and develop training to prepare and support clinicians during crises such as pandemics.