scholarly journals An observational study of the effects of a clinical nurse specialist quality improvement project for clinical reminders for sepsis on patient outcomes and nurse actions

2018 ◽  
Vol 2 ◽  
pp. 99-99 ◽  
Author(s):  
Dawn Marie Drahnak
Keyword(s):  
Quality Improvement ◽  
Observational Study ◽  
Patient Outcomes ◽  
Clinical Nurse Specialist ◽  
Quality Improvement Project ◽  
Nurse Specialist ◽  
Improvement Project ◽  
Clinical Nurse ◽  
Clinical Reminders

A Clinical Nurse Specialist–Led Interprofessional Quality Improvement Project to Reduce Hospital-Acquired Pressure Ulcers

2016 ◽  
Vol 30 (2) ◽  
pp. 110-116 ◽  
Author(s):  
Christina Fabbruzzo-Cota ◽  
Monica Frecea ◽  
Kathryn Kozell ◽  
Katalin Pere ◽  
Tamara Thompson ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Pressure Ulcers ◽  
Clinical Nurse Specialist ◽  
Quality Improvement Project ◽  
Nurse Specialist ◽  
Improvement Project ◽  
Clinical Nurse ◽  
Hospital Acquired

The Clinical Nurse Specialist Role and its Relevance to Vascular Access: A Canadian Perspective

2021 ◽  
Vol 26 (3) ◽  
pp. 25-30
Author(s):  
Andrea Raynak ◽  
Brianne Wood
Keyword(s):  
Quality Improvement ◽  
Clinical Outcomes ◽  
Vascular Access ◽  
Organizational Outcomes ◽  
Clinical Nurse Specialist ◽  
Nurse Specialist ◽  
Care Hospital ◽  
Improvement Project ◽  
Clinical Nurse ◽  
The Impact

Highlights Abstract Purpose: The purpose of this quality improvement study was to examine the impact of a Vascular Access Clinical Nurse Specialist (VA-CNS) on patient and organizational outcomes. Description of the Project/Program: The VA-CNS role was created and implemented at an acute care hospital in Thunder Bay, Ontario, Canada. The VA-CNS collected data on clinical activities and interventions performed from April 1 to March 29, 2019. The dataset and its associated qualitative clinical outcomes were analyzed using deductive content analysis. Furthermore, a cost analysis was performed by the hospital accountant on these clinical outcomes. Outcome: Over a 1-year period, there were 547 patients protected from an unwarranted peripherally inserted central catheter (PICC) insertion among 302 patient consultations for the VA-CNS. A total of 322 ultrasound-guided peripheral intravenous catheters were inserted and 45 PICC insertions completed at the bedside. The cost associated with the 547 patients not receiving a PICC line result in an estimated savings of $113,301. The VA-CNS role demonstrated a positive payback of $417,525 to the organization. Conclusion: The results of this quality improvement project have demonstrated the positive impacts of the VACNS on patient and organizational outcomes. This role may be of benefit and worth its adoption for other health systems with similar patient populations.

scholarly journals Nurse’s Knowledge of Early Ambulation of the Post Operative Patient and Complication Prevention: A Quality Improvement Project

2021 ◽  
Author(s):  
Meghan Carides
Keyword(s):  
Quality Improvement ◽  
Patient Outcomes ◽  
Nursing Intervention ◽  
Educational Programs ◽  
Quality Improvement Project ◽  
Complication Rates ◽  
Improvement Project ◽  
Nursing Knowledge ◽  
Early Ambulation ◽  
The Mean

Ambulation is the single most important nursing intervention in the prevention of postoperative complications. It is also a key component in maintaining optimal patient outcomes. Current literature has revealed that when ambulation is initiated early there is a marked decrease in pain, length of hospital admission, and overall complication rates. However, even with this depth of evidence early postoperative ambulation on the two surgical units at a teaching hospital in Rhode Island, patient ambulation continues to be inconsistent. The purpose of this quality improvement project is to improve nursing knowledge regarding early ambulation after surgery for the prevention of post-operative complications. This project utilized a pretest, educational in-service intervention, and posttest design. Seventeen out of a possible 22 surgical nurses participated in this project (N= 17, 77%). The educational in-service sessions combined information from an extensive literature review in the form of a 10-minute Power Point presentation. Pre and post tests were made up of 5 knowledge-based and 5 opinion-based questions. The mean scores for the pretest were 74% while the mean scores for the posttest were 95.2%. There was a 35% increase in overall scores following the educational intervention. APRNs play a pivotal role in establishing and implementing educational programs. This project aimed to recognize a need for ongoing education about postoperative ambulation for the surgical unit nurses. Educational programs about postoperative ambulation and complication prevention should be routinely incorporated in future trainings to ensure improved nursing knowledge and patient outcomes.

scholarly journals Reducing door-to-needle times in stroke thrombolysis to 13 min through protocol revision and simulation training: a quality improvement project in a Norwegian stroke centre

2019 ◽  
Vol 28 (11) ◽  
pp. 939-948 ◽  
Author(s):  
Soffien Chadli Ajmi ◽  
Rajiv Advani ◽  
Lars Fjetland ◽  
Kathinka Dehli Kurz ◽  
Thomas Lindner ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Patient Outcomes ◽  
Treatment Protocol ◽  
Team Training ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
In Situ Simulation ◽  
Simulation Based ◽  
Stroke Thrombolysis

BackgroundIn eligible patients with acute ischaemic stroke, rapid revascularisation is crucial for good outcome. At our treatment centre, we had achieved and sustained a median door-to-needle time of under 30 min. We hypothesised that further improvement could be achieved through implementing a revised treatment protocol and in situ simulation-based team training sessions. This report describes a quality improvement project aiming to reduce door-to-needle times in stroke thrombolysis.MethodsAll members of the acute stroke treatment team were surveyed to tailor the interventions to local conditions. Through a review of responses and available literature, the improvement team suggested changes to streamline the protocol and designed in situ simulation-based team training sessions. Implementation of interventions started in February 2017. We completed 14 simulation sessions from February to June 2017 and an additional 12 sessions from November 2017 to March 2018. Applying Kirkpatrick’s four-level training evaluation model, participant reactions, clinical behaviour and patient outcomes were measured. Statistical process control charts were used to demonstrate changes in treatment times and patient outcomes.ResultsA total of 650 consecutive patients, including a 3-year baseline, treated with intravenous thrombolysis were assessed. Median door to needle times were significantly reduced from 27 to 13 min and remained consistent after 13 months. Risk-adjusted cumulative sum charts indicate a reduced proportion of patients deceased or bedridden after 90 days. There was no significant change in balancing measures (stroke mimics, fatal intracranial haemorrhage and prehospital times).ConclusionsImplementing a revised treatment protocol in combination with in situ simulation-based team training sessions for stroke thrombolysis was followed by a considerable reduction in door-to-needle times and improved patient outcomes. Additional work is needed to assess sustainability and generalisability of the interventions.

Clinical Nurse Specialist: A Critical Member of the ICU Team

2021 ◽  
Vol 32 (4) ◽  
pp. 413-420
Author(s):  
Erika R. Gabbard ◽  
Deborah Klein ◽  
Kathleen Vollman ◽  
Tracy B. Chamblee ◽  
Lisa M. Soltis ◽  
...  
Keyword(s):  
Critical Care ◽  
Patient Outcomes ◽  
Data Extraction ◽  
Clinical Nurse Specialist ◽  
Nurse Specialist ◽  
Advanced Practice ◽  
Clinical Nurse ◽  
Clinical Nurse Specialists ◽  
Study Selection ◽  
Certification Requirements

Objectives To describe the role of the clinical nurse specialist, an advanced practice registered nurse in the intensive care setting. The value and impact of the clinical nurse specialist role as a member of the ICU is presented along with a review of clinical nurse specialist education, licensure, and certification requirements as well as a description of the clinical nurse specialist role, scope of practice, and competencies. In addition, a selected review of clinical nurse specialist–led quality improvement and research that resulted in improved patient outcomes is provided. Data sources Review of published medical and nursing literature and expert opinion guidance from a collaborative effort between the Society of Critical Care Medicine, American Association of Critical-Care Nurses, and National Association of Clinical Nurse Specialists. Study selection Not applicable. Data extraction Not applicable. Data synthesis Not applicable. Conclusions The utilization of a clinical nurse specialist, an advanced practice role, in the ICU is a unique and valuable approach for organizations who strive to move evidence into sustainable practice and drive quality through an interprofessional approach. The valuable contributions made by the clinical nurse specialist efficiently and effectively meet the needs of patients, clinicians, and organizations while improving patient outcomes and optimizing cost avoidance strategies, which further lower economic demands on the healthcare system.

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