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Clinical Nurse Specialist (clinical + nurse_specialist)
Selected AbstractsJustifying the expense of the cancer Clinical Nurse SpecialistEUROPEAN JOURNAL OF CANCER CARE, Issue 1 2010C.A. POLLARD ba POLLARD C.A., GARCEA G., PATTENDEN C.J., CURRAN R., NEAL C.P., BERRY D.P. & DENNISON A.R. (2009) European Journal of Cancer Care19, 72,79 Justifying the expense of the cancer Clinical Nurse Specialist In order to maximise patient care, assessment of the adequacy of the service provision by the Clinical Nurse Specialist (CNS) must be regularly undertaken. This study attempted to determine whether CNSs were providing an adequate service via retrospective and prospective audit. The results of a comprehensive audit of the work of the CNS within a tertiary referral Hepatobiliary Unit are presented. The audit involved postal and telephone questionnaires as well as prospective collection of data. The majority of responses from patients were positive, with many finding the CNS a useful and well-utilised contact. Overall, the CNSs performed well in each of their designated tasks; however, areas were still identified which could be further improved. Audit is essential in providing feedback to the CNS and to identify areas which require improvement. The CNS has evolved to meet a clinical gap in patient care, and as a result, the role of a CNS is frequently nebulous or poorly defined. This renders evaluation of the CNS problematic and fraught with difficulties. However, a thorough assessment can still be made using carefully constructed audit looking at each task of the CNS. [source] Acute and Critical Care Clinical Nurse Specialists: Synergy for Best PracticesJOURNAL OF CLINICAL NURSING, Issue 14 2008Janice Rattray [source] Matching a Graduate Curriculum in Public/Community Health Nursing to Practice Competencies: The Rush University ExperiencePUBLIC HEALTH NURSING, Issue 2 2006R.N.C., Susan Swider Ph.D. ABSTRACT An evidence-based approach to Public/Community Health Nursing (P/CHN) requires that P/CHN educators prepare practitioners with the relevant skills, attitudes, and knowledge. Such education should be competency-based and have measurable outcomes to demonstrate student preparation. In 2003, the Quad Council competencies were developed to be applied at two levels of public health nursing practice: the staff nurse/generalist role and the manager/specialist/consultant role. This paper describes a process for evaluation and revision of a graduate curriculum to prepare Advanced Practice Clinical Nurse Specialists (CNS) in P/CHN, to ensure that the educational program addresses and develops knowledge and proficiency in all relevant competencies. This paper documents the process of integrating the competencies throughout the P/CHN graduate curriculum at varying levels, guiding students to achieve proficiency in each competency by the end of the program. Measurement of achievement in these competencies will be discussed, and examples provided. Advanced Practice Public Health Nurses educated via this competency-based approach will be prepared to sit for national certification as a CNS in Public/Community Health, and to assume leadership roles in public health nursing. [source] Establishing a Case-Finding and Referral System for At-Risk Older Individuals in the Emergency Department Setting: The SIGNET ModelJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2001Lorraine C. Mion PhD Older emergency department (ED) patients have complex medical, social, and physical problems. We established a program at four ED sites to improve case finding of at-risk older adults and provide comprehensive assessment in the ED setting with formal linkage to community agencies. The objectives of the program are to (1) improve case finding of at-risk older ED patients, (2) improve care planning and referral for those returning home, and (3) create a coordinated network of existing medical and community services. The four sites are a 1,000-bed teaching center, a 700-bed county teaching hospital, a 400-bed community hospital, and a health maintenance organization (HMO) ED site. Ten community agencies also participated in the study: four agencies associated with the hospital/HMO sites, two nonprofit private agencies, and four public agencies. Case finding is done using a simple screening assessment completed by the primary or triage nurse. A geriatric clinical nurse specialist (GCNS) further assesses those considered at risk. Patients with unmet medical, social, or health needs are referred to their primary physicians or to outpatient geriatric evaluation and management centers and to community agencies. After 18 months, the program has been successfully implemented at all four sites. Primary nurses screened over 70% (n = 28,437) of all older ED patients, GCNSs conducted 3,757 comprehensive assessments, participating agency referrals increased sixfold, and few patients refused the GCNS assessment or subsequent referral services. Thus, case finding and community linkage programs for at-risk older adults are feasible in the ED setting. [source] A study of a training scheme for Macmillan nurses in Northern IrelandJOURNAL OF CLINICAL NURSING, Issue 2 2008BSocSc, Cert Ed., DipDN, Johnston Gail PhD Aim., To evaluate a one year training scheme for Macmillan Nurses. Background., The role of the clinical nurse specialist has evolved and expanded greatly over the past few years so that it now encompasses components far beyond the traditional nursing remit of direct clinical practice. While several studies have looked at the barriers and facilitators to this process for clinical nurse specialists in particular, none has looked at the benefits of a structured training scheme which involves both a theoretical and clinical component. Methods., Tape recorded, semi-structured interviews were undertaken with a purposive sample of trainees who undertook the scheme, their practice-based facilitators and another person(s) involved in the trainee's support Analysis., Tapes were transcribed verbatim and each transcript anonymized to prevent identification of participants. Data were analysed thematically using the main headings of expectations, experience and impact and the structured prompts from the aide-memoir within these headings. Results., Results showed that the majority of respondents felt the scheme had been successful with one of the main achievements being that trainees were perceived to be adequately prepared to take on the role of a CNS on completion of the scheme. While the Role Development Programme was thought to provide a good academic structure for the scheme some participants thought that more theory on symptom control and communication skills and a placement in a specialist palliative care centre should also be included. Conclusion., The Macmillan Trainee Scheme has succeeded in its objectives to facilitate the transition from generalist to specialist nursing. It should be extended to include an induction and consolidation period and more theoretical input on communication skills and symptom control. Relevance to clinical practice., With these improvements, the scheme could be used as a standard model for training specialist practitioners and a means to address the current issues of workforce planning. [source] Role boundaries , research nurse or clinical nurse specialist?JOURNAL OF CLINICAL NURSING, Issue 4 2002A literature review ,,This paper focuses on issues relating to the role components of clinical nurse specialists and clinical research nurses working in breast cancer care. ,,Identified issues relate to the lack of agreement as to the role and definition of clinical nurse specialists. At the same time there has been an increase and emergence of clinical research nurses, both within the NHS and university departments. ,,The review fails to reveal the relationship between these two specialist groups in terms of role overlap and role boundaries. ,,The lack of knowledge in this area substantiates the need for further research to be carried out. [source] Development of an educational/support group for pregnant women in prisonJOURNAL OF FORENSIC NURSING, Issue 2 2008Ginette G. Ferszt Ph.D. Abstract It is estimated that 6,10% of women are pregnant when they enter the prison system. The majority have had little, if any, prenatal care and/or childbirth education. Given economic constraints, the educational and support needs of this population are often not met. In response to these needs, an educational/support group was developed and led by a social worker, a mental health clinical nurse specialist, and a nurse midwife in a women's correctional facility in the Northeast. Women in various stages of pregnancy and early postpartum voluntarily attended. The need for education and psychosocial support was overwhelming. This group fostered a safe space for women to discuss real-life issues in a supportive environment. Meeting the educational and support needs of incarcerated women is paramount. [source] Comparing and contrasting the clinical nurse specialist and the advanced nurse practitioner rolesJOURNAL OF NURSING MANAGEMENT, Issue 4 2001Sarah E. Ormond-Walshe BSc(HONS) There is currently a great deal of ambiguity regarding the difference between the role of clinical nurse specialist and advanced nurse practitioner. In distinguishing one title from another, factors such as the educational requirements of such, what the role involves, who the client is and whether the role encroaches on a doctor's role are discussed. This paper sets out the factors that are seen by some as significant in distinguishing between a clinical nurse specialist and advanced nurse practitioner. [source] Clinical nurse specialist care managers' time commitments in a disease-management program for bipolar disorderBIPOLAR DISORDERS, Issue 6 2004Henry A Glick Objectives:, As part of a cost-effectiveness analysis for Department of Veterans Affairs Cooperative Studies Program #430, ,Reducing the Efficacy-Effectiveness Gap in Bipolar Disorder,' we conducted a time and motion study to quantify the time psychiatric clinical nurse specialist (CNS) care managers spent providing care for patients. Methods:, Clinical nurse specialist care managers completed activity logs in which they recorded time spent implementing the Bipolar Disorders Program (BDP) during a 1-week period in spring, summer, fall and winter over a 1-year period when caseloads were at steady state. Mean service time was estimated by use of univariate analysis of means and by multivariable regression analysis. Results:, On average CNS care managers spent 40% of their clinical time in activities that typically are reimbursed (e.g. clinic visits) and spent the remaining 60% of their time in activities that are typically unreimbursed. Total clinic time increased as the number of visits per day increased; however, this increase got smaller with each additional visit per day. Conclusions:, As with other chronic illness management programs, CNS care managers expend a substantial portion of their clinical effort for the BDP in activities that are typically unreimbursed. Their activities have a fixed component per day as well as a component that systematically varies with the number of visits per day. These findings should be considered when costing out and disseminating psychiatric and other medical chronic illness management programs. [source] Development of a diagnostic role for a clinical nurse specialistBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2007N.N. Goyal No abstract is available for this article. [source] A study of a training scheme for Macmillan nurses in Northern IrelandJOURNAL OF CLINICAL NURSING, Issue 2 2008BSocSc, Cert Ed., DipDN, Johnston Gail PhD Aim., To evaluate a one year training scheme for Macmillan Nurses. Background., The role of the clinical nurse specialist has evolved and expanded greatly over the past few years so that it now encompasses components far beyond the traditional nursing remit of direct clinical practice. While several studies have looked at the barriers and facilitators to this process for clinical nurse specialists in particular, none has looked at the benefits of a structured training scheme which involves both a theoretical and clinical component. Methods., Tape recorded, semi-structured interviews were undertaken with a purposive sample of trainees who undertook the scheme, their practice-based facilitators and another person(s) involved in the trainee's support Analysis., Tapes were transcribed verbatim and each transcript anonymized to prevent identification of participants. Data were analysed thematically using the main headings of expectations, experience and impact and the structured prompts from the aide-memoir within these headings. Results., Results showed that the majority of respondents felt the scheme had been successful with one of the main achievements being that trainees were perceived to be adequately prepared to take on the role of a CNS on completion of the scheme. While the Role Development Programme was thought to provide a good academic structure for the scheme some participants thought that more theory on symptom control and communication skills and a placement in a specialist palliative care centre should also be included. Conclusion., The Macmillan Trainee Scheme has succeeded in its objectives to facilitate the transition from generalist to specialist nursing. It should be extended to include an induction and consolidation period and more theoretical input on communication skills and symptom control. Relevance to clinical practice., With these improvements, the scheme could be used as a standard model for training specialist practitioners and a means to address the current issues of workforce planning. [source] Role boundaries , research nurse or clinical nurse specialist?JOURNAL OF CLINICAL NURSING, Issue 4 2002A literature review ,,This paper focuses on issues relating to the role components of clinical nurse specialists and clinical research nurses working in breast cancer care. ,,Identified issues relate to the lack of agreement as to the role and definition of clinical nurse specialists. At the same time there has been an increase and emergence of clinical research nurses, both within the NHS and university departments. ,,The review fails to reveal the relationship between these two specialist groups in terms of role overlap and role boundaries. ,,The lack of knowledge in this area substantiates the need for further research to be carried out. [source] Critical care nurse practitioners and clinical nurse specialists interface patterns with computer-based decision support systemsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 11 2007APRN (Assistant Professor of Health, Community Systems, Coordinator of the Nursing Education Graduate Program), PhD(c), Scott Weber EdD Abstract Purpose: The purposes of this review are to examine the types of clinical decision support systems in use and to identify patterns of how critical care advanced practice nurses (APNs) have integrated these systems into their nursing care patient management practices. The decision-making process itself is analyzed with a focus on how automated systems attempt to capture and reflect human decisional processes in critical care nursing, including how systems actually organize and process information to create outcome estimations based on patient clinical indicators and prognosis logarithms. Characteristics of APN clinicians and implications of these characteristics on decision system use, based on the body of decision system user research, are introduced. Data sources: A review of the Medline, Ovid, CINAHL, and PubMed literature databases was conducted using "clinical decision support systems,""computerized clinical decision making," and "APNs"; an examination of components of several major clinical decision systems was also undertaken. Conclusions: Use patterns among APNs and other clinicians appear to vary; there is a need for original research to examine how APNs actually use these systems in their practices in critical care settings. Because APNs are increasingly responsible for admission to, and transfer from, critical care settings, more understanding is needed on how they interact with this technology and how they see automated decision systems impacting their practices. Implications for practice: APNs who practice in critical care settings vary significantly in how they use the clinical decision systems that are in operation in their practice settings. These APNs must have an understanding of their use patterns with these systems and should critically assess whether their patient care decision making is affected by the technology. [source] | ||||||||||