Abstract
ObjectivesThis 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.MethodsThe 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.ResultsMultivariable 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).ConclusionCNSs 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.
Highlights
Advanced practice nurses (APNs) are required to improve the quality of patient care and the health care systems of hospitals and regions
Multivariable logistic regression analysis revealed that the presence of a Certified Nurse Specialist (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)
CNSs are defined as one type of advanced practice nurses
Summary
Advanced practice nurses (APNs) are required to improve the quality of patient care and the health care systems of hospitals and regions. APNs are registered nurses who hold master’s degrees and have acquired the expert knowledge base, complex decision making skills, and clinical competencies necessary for expanded practice [1]. They are known by various titles such as clinical nurse specialists, nurse practitioners, nurse anesthetists, and nurse midwives. Most CNSs work directly with patients or in a division of nursing education developing effective health care techniques based on clinical evidence, solving complex problems, and educating nurses [7,8,9,10]. One-fifth of CNSs work as full-time nurse administrators such as head nurses, nursing vice-directors, or nursing directors. [11]
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