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Clinical nurse specialist

Hsiao-Yen Hsieh, Richard Henker, Dianxu Ren, Wan-Yi Chien, Jia-Ping Chang, Lifan Chen, Patricia K Tuite
PURPOSE/OBJECTIVES: An efficient but comprehensive documentation system is essential for reducing nursing workload and ensuring adequate time for direct patient care. A "focus" is a nursing diagnosis or patient problem. The purpose of this project is to review and revise the focuses in the electronic charting system and to develop new focuses for documentation of clinical pathways. In addition, this project evaluated the impact of these changes on time required for documentation and nurse satisfaction...
November 2016: Clinical Nurse Specialist CNS
Duygu Sönmez Düzkaya, Gülçin Bozkurt, Gülzade Uysal, Tülay Yakut
BACKGROUND: There are few studies in the literature from developing countries regarding the rates of catheter-associated urinary tract infection (CAUTI), which is frequently encountered in pediatric intensive care units (PICUs). AIM: The aim of this study is to evaluate the 2-year rates of CAUTI in a PICU where a CAUTI Prevention Bundle was implemented. DESIGN: This was an interventional prospective study. METHODS: The study was conducted with 390 patients in the PICU of Istanbul Faculty of Medicine, Turkey, from July 2013 to July 2015...
November 2016: Clinical Nurse Specialist CNS
Terri L Ares
PURPOSE: The purpose of this study is to ascertain if clinical nurse specialist students differed on measures of professional socialization based on employment in a Magnet-oriented hospital. DESIGN: A secondary analysis of data from a previous national study of the socialization of clinical nurse specialist students was used. Anticipatory socialization variables (nursing leadership, workplace exposure to the role, and preconceived impression of the role), mentorship by a clinical nurse specialist, and socialization outcomes (self-concept, perceived preparedness for practice, and nursing specialty certification) were explored...
November 2016: Clinical Nurse Specialist CNS
Ann M Mayo, Melodee Harris, Bill Buron
Specific changes to the national clinical nurse specialist (CNS) certification are necessitating a move away the psychiatric/mental health (P/MH) CNS population focus. However, a rapidly increasing older adult population with P/MH comorbidities such as depression and anxiety means that the adult-gerontology CNS (AGCNS) will likely be coordinating much of the complex care needs of this vulnerable population. Therefore, strategies are needed to ensure AGCNSs are competent in advanced practice P/MH nursing. In addition, at this critical time in the redesign of healthcare, the Institute of Medicine has made interprofessional practice center stage for healthcare professional education...
November 2016: Clinical Nurse Specialist CNS
Mimi Jenko, Nancy M Short
Bereavement services for families are an established part of hospice and palliative care. However, patients also die in the acute care and long-term care environments. Often, hospice is not involved, creating a potential gap in care. This article recounts a journey to improve care for all families of deceased patients, despite the presence or absence of hospice. A palliative care clinical nurse specialist led a quality improvement team, which used a systems thinking approach to develop and implement a downloadable bereavement booklet for families...
November 2016: Dimensions of Critical Care Nursing: DCCN
Melissa C Brouwers, Marija Vukmirovic, Jennifer R Tomasone, Eva Grunfeld, Robin Urquhart, Mary Ann O'Brien, Melanie Walker, Fiona Webster, Margaret Fitch
OBJECTIVE: To report on the findings of the CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum) Casebook project, which systematically documented Canadian initiatives (ie, programs and projects) designed to improve or support coordination and continuity of cancer care between primary care providers (PCPs) and oncology specialists. DESIGN: Pan-Canadian environmental scan. SETTING: Canada. PARTICIPANTS: Individuals representing the various initiatives provided data for the analysis...
October 2016: Canadian Family Physician Médecin de Famille Canadien
Tiziana Ansell
Tiziana Ansell, Clinical Nurse Specialist in Continence, Health Innovation Network, discusses recent research into catheter securement and some of the considerations for nurses.
October 13, 2016: British Journal of Nursing: BJN
Neeraj Nagpal
Physicians and Internists in India have tended to brush under the carpet legal issues affecting their profession. Of concern to all Physicians is the judgment in a recent case where the NCDRC has stated that if MD Medicine Physicians write Physician & Cardiologist on their letterhead it is Quackery. What is MD Medicine degree holder in India qualified and trained to treat ? These are issues which need debate and that can only be initiated once we recognize that there is a problem. Either an MD Medicine is a cardiologist or he is not...
February 2016: Journal of the Association of Physicians of India
Hannah Burke, Jenny Davis, Sian Evans, Laura Flower, Andrew Tan, Ramesh J Kurukulaaratchy
Up to 10% of asthmatics have "difficult asthma"; however, they account for 80% of asthma-related expenditure and run the highest risk of acute severe exacerbations. An estimated 75% of admissions for asthma are avoidable. Guidelines advise that these patients be managed by an experienced specialist multidisciplinary team (MDT). We aimed to assess the impact of a case management strategy delivered via specialist MDTs on acute healthcare utilisation of patients with frequent asthma admissions. An MDT (consultant, specialist nurse, physiotherapist and psychologist) case management strategy was introduced in 2010 at University Hospital Southampton Foundation Trust (Southampton, UK) to support patients with frequent asthma admissions during admission and then in clinic...
July 2016: ERJ Open Research
Andrea Driscoll, Sharon Meagher, Rhoda Kennedy, Melanie Hay, Jayant Banerji, Donald Campbell, Nicholas Cox, Debra Gascard, David Hare, Karen Page, Voltaire Nadurata, Rhonda Sanders, Harry Patsamanis
BACKGROUND: Hospital admissions for heart failure are predicted to rise substantially over the next decade placing increasing pressure on the health care system. There is an urgent need to redesign systems of care for heart failure to improve evidence-based practice and create seamless transitions through the continuum of care. The aim of the review was to examine systems of care for heart failure that reduce hospital readmissions and/or mortality. METHOD: Electronic databases searched were: Ovid MEDLINE, EMBASE, CINAHL, grey literature, reviewed bibliographies and Cochrane Central Register of Controlled Trials for randomised controlled trials, non-randomised trials and cohort studies from 1(st) January 2008 to 4(th) August 2015...
October 11, 2016: BMC Cardiovascular Disorders
Lori Marshall, Anna Fischer, Allison Noyes Soeller, Richard Cordova, Yvonne R Gutierrez, Luis Alford
BACKGROUND: Children's Hospital Los Angeles (CHLA), a metropolitan academic medical center, recognized limitations in how the professional interpreters from the Diversity Services Department were used to support effective patient-provider communication across the organization. Given the importance of mitigating language and communication barriers, CHLA sought to minimize clinical and structural barriers to health care for limited English proficiency populations through a comprehensive restructuring of the Diversity Services Department...
2016: Joint Commission Journal on Quality and Patient Safety
Elizabeth Jestico, Teresa Finlay
BACKGROUND: In the UK children with cancer are cared for by children's nurses in a variety of settings, specialist and non-specialist. Whilst post-registration specialist education is available to some nurses, many nurses rely solely on pre-registration education to competently care for these children. This study explores whether nurses perceive that this adequately prepares them. OBJECTIVES: To explore the extent to which qualified nurses perceive that pre-registration nurse education prepares them to care for children with cancer; to consider the implications for children's nursing pre-registration curricula...
September 30, 2016: Nurse Education Today
Kate Beckett, Ellen M Henderson, Sarah Parry, Peter Stoddart, Margaret Fletcher
AIM: To assess Acute Pain Service and paediatric pain management efficacy in a UK specialist paediatric hospital to inform wider recommendations for future sustainability. BACKGROUND: UK paediatric acute pain services vary. Although comprehensive pain management guidelines exist, consensus on the best model of care is lacking. Worldwide, medical and pharmacological advances and rapid patient turnover have increased the challenges of managing hospitalized children's pain...
January 2016: Nurs Open
Ana Martins, Susie Aldiss, Faith Gibson
PURPOSE: To describe the development and implementation of the specialist nurse key worker role across 18 children's cancer centres in the United Kingdom, and draw out significant factors for success to inform future development of the role across a range of specialities. METHOD: Data were obtained through 42 semi-structured interviews and a focus group with 12 key workers. Framework analysis revealed two main themes: models of care and key workers' perspectives of the role...
October 2016: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Rasmus Bo Jansen, Ole Lander Svendsen, Klaus Kirketerp-Møller
INTRODUCTION: Charcot foot is a severe complication to diabetes mellitus and treatment involves several different clinical specialities. Our objective was to describe the current awareness, knowledge and treatment practices of Charcot foot among doctors who handle diabetic foot disorders. METHODS: This study is based on a questionnaire survey sent out to healthcare professionals, primarily doctors, working with diabetic foot ulcers and Charcot feet in the public sector of the Danish healthcare system...
October 2016: Danish Medical Journal
Sarah Larney, Wilson Lai, Kate Dolan, Deborah Zador
BACKGROUND AND AIMS: Opioid substitution therapy (OST) is an effective treatment for opioid dependence that is provided in many correctional settings, including New South Wales (NSW), Australia. In 2011, changes to the clinical governance of the NSW prison OST program were implemented, including a more comprehensive assessment, additional specialist nurses, and centralization of program management and planning. This study aimed to document the NSW prison OST program, and assess the impact of the enhanced clinical governance arrangements on retention in treatment until release, the provision of an OST prescription to patients at release, and presentation to a community OST clinic within 48 hours of release from custody...
November 2016: Journal of Substance Abuse Treatment
Anna Boyles, Sharon Hunt
It is estimated that around one in 500 people in the UK are living with a stoma, with approximately 21 000 operations that result in stoma formation being performed each year ( Colostomy Association, 2016 ). These people face a unique set of challenges in maintaining the integrity of their peristomal skin. This article explores the normal structure and function of skin and how the care and management of a stoma presents challenges for maintaining peristomal skin health. Particular focus is paid to the incidence of skin problems for those living with a stoma, whether it is temporary or permanent, and the factors that contribute to skin breakdown in this population...
September 22, 2016: British Journal of Nursing: BJN
Lesley Dibley, Palle Bager, Wladyslawa Czuber-Dochan, Dawn Farrell, Lars-Petter Jelsness-Jørgensen, Karen Kemp, Christine Norton
BACKGROUND: Robust research evidence should inform clinical practice of inflammatory bowel disease [IBD] specialist nurses, but such research is currently very limited. With no current agreement on research priorities for IBD nursing, this survey aimed to establish topics to guide future IBD nursing research across Europe. METHODS: An online modified Delphi survey with nurse and allied health professional members of the Nurses European Crohn's and Colitis Organisation [n = 303] was conducted...
September 23, 2016: Journal of Crohn's & Colitis
Shelley Potter, Sara T Brookes, Christopher Holcombe, Joseph A Ward, Jane M Blazeby
BACKGROUND: The development and use of core outcome sets (COSs) in trials may improve data synthesis and reduce outcome reporting bias. The selection of outcomes in COSs is informed by views of key stakeholders, yet little is known about the role and influence of different stakeholders' views during COS development. We report an exploratory case study examining how stakeholder selection and incorporation of stakeholders' views may influence the selection of outcomes for a COS in reconstructive breast surgery (RBS)...
2016: Trials
Hilary Piercy, Gill Bell, Charlie Hughes, Simone Naylor, Christine A Bowman
This study aimed to examine what specialist nursing contributes to HIV service delivery across England and how it could be optimised. A three part multi-method qualitative study was undertaken, involving (1) interviews with 19 stakeholders representing professional or service user groups; (2) interviews with nurse/physician pairs from 21 HIV services; and (3) case studies involving site visits to five services. A framework analysis approach was used to manage and analyse the data. There was substantial variability in specialist nursing roles and the extent of role development...
September 22, 2016: International Journal of STD & AIDS
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