Description of work processes used by clinical nurse specialists to improve patient outcomes

Fulton, Janet S.; Mayo, Ann M.; Walker, James H.; Urden, Linda D.

doi:10.1016/j.outlook.2019.03.001

Cited by 32 publications

(34 citation statements)

References 32 publications

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“…Furthermore, participants in this study described practice change as a lot of work and indicated it is often under recognised. This aligns with descriptions of efforts to improve patient outcomes, which was likened to articulation work -the important yet invisible work that is taken for granted and undervalued (Fulton et al, 2019). This sense of feeling undervalued is compounded when nurses do not sense efforts for planned ways to minimise the impact of changes on nurses' workflow and assuring adequate resources, such as reminders and monitoring.…”

Section: Discussionmentioning

confidence: 58%

The realities of practice change: Nurses' perceptions

Knudsen

King

Steege

2021

Journal of Clinical Nursing

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Aims and Objectives: To explore registered nurses' perceptions of practice change and describe factors that influence the adoption of practice changes.Background: Nurses play a critical role in optimising patient outcomes. Healthcare organisations and nurses must do their part to achieve the Quadruple Aim, which requires nurses to change their practice. Nurses are ideally positioned to improve patient outcomes by changing their practice to align it with research evidence and organisational initiatives; however, this experience of practice change by nurses is grossly under-studied.Design: A qualitative design, inductive content analysis, was used to understand nurses' perceptions of practice change.Methods: Eleven registered nurses, who worked in one hospital system, participated in one-on-one semi-structured interviews. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) were followed. Findings: The 11 participants described 63 distinct experiences with practice changes. Their experiences with and perceptions of practice change are categorised as (1) There is A History; (2) It's A Lot of Work; (3) It Happens to Nurses; and (4) Doing Right for the Patient. Conclusion: Nurses experience practice change as a central part of the work they do; it occurs frequently and multiple practice changes may co-occur. Nurses identify strategies, such as thoughtful planning, engaging nurses, and communicating the rationale for and the outcomes of the practice change, to facilitate changing practice.

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Section: Discussionmentioning

confidence: 58%

The realities of practice change: Nurses' perceptions

Knudsen

King

Steege

2021

Journal of Clinical Nursing

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“…Fulton, Mayo, Walker, and Urden’s (2019) model provides a process for situating mirror interventions in practice. ‘Beginning with the end in sight’ (p. 514), the overarching goal is to mitigate mirror trauma and subsequent psychological and physical fallout.…”

Section: Implications For Nursingmentioning

confidence: 99%

Demystifying the mirror taboo: A neurocognitive model of viewing self in the mirror

Freysteinson

2020

Nursing Inquiry

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Research has consistently demonstrated that viewing one's body in a mirror after an amputation or other perceived or visible body disfigurements can be a traumatic experience. Mirror viewing or mirroring is a taboo subject, which may be the reason this trauma has not been previously detected or acknowledged. Traumatic mirror viewing may lead to mirror discomfort, mirror avoidance, and a host of psychosocial concerns, including post-traumatic stress. As mirroring is complex, four qualitative mirror viewing studies, embodiment concepts, polyvagal theory, and memory theories were used to develop a model. In this article, foundational knowledge that led to the development of the model is shared. A neurocognitive model of mirror viewing is offered together with implications for nursing research, practice, and education.

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“…A CNS conducts daily activities with a background of specialized medical and nursing knowledge and experience. The CNS contributes to patient outcomes through identifying problems and providing high-level practice, and through decision support and team building for dealing with difficult problems and patients in complex situations [21]. CNSs support stakeholders (i.e., patients and all ICU-related personnel) in addressing clinical problems and managing the care and treatment of patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of having a certified nurse specialist in critical care nursing as head nurse on ICU patient outcomes

2020

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This study evaluated the impact of the presence of a certified nurse specialist in critical care (CNS) as ICU head nurse in an open ICU on clinical outcomes. Methods The presence of a CNS as ICU head nurse was implemented in practice in April 2017. To evaluate the impact on patient outcomes before and after the implementation, patients were divided into two groups: before (April 2014 to March 2017; 1988 patients) and after (April 2017 to March 2019; 1664 patients). Patients' demographic data were collected from the ICU database. Results Multivariable logistic regression analysis revealed that the presence of a CNS as ICU head nurse was associated with lower ICU mortality (odds ratio (OR): 0.52, 95% CI: 0.36-0.73, p < .001) and fewer patients receiving mechanical ventilation in the ICU (OR: 0.20, 95% CI: 0.15-0.26, p < .001). Conclusion CNSs are defined as one type of advanced practice nurses. Having a CNS as a head nurse in the ICU may have helped improve patient outcomes by leveraging these practical skills in nursing management.

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Description of work processes used by clinical nurse specialists to improve patient outcomes

Cited by 32 publications

References 32 publications

The realities of practice change: Nurses' perceptions

The realities of practice change: Nurses' perceptions

Demystifying the mirror taboo: A neurocognitive model of viewing self in the mirror

Impact of having a certified nurse specialist in critical care nursing as head nurse on ICU patient outcomes

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