Role Of Nurse Specialist Research Articles

The emerging role of a Stroke Clinical Nurse Specialist (CNS) in Early Supported Discharged: Developing a pathway for stroke nursing for secondary prevention in the community. A scoping review protocol.

Background Stroke represents a major source of mortality and morbidity globally. The role of a stroke Clinical Nurse Specialist (CNS) as an expert team member in early supported discharge (ESD) for stroke, is not well defined or described although it is well established in other models of after-hospital and out-reach specialist care in the community. A greater focus has been on patients receiving rehabilitation post-stroke, however there is a need for a more holistic approach to care which clinical nurse specialists can offer to patients as part of ESD. Nurses are often the cohesive point of contact for other after-hospital services, managing many aspects of secondary prevention. Objective The aim of this scoping review is to explore the evidence in relation to the role of the stroke nurse providing secondary prevention interventions to stroke patients in a community setting. Methods We will conduct a scoping review in accordance with the Arksey and O’Malley, 2005 1 scoping review framework and the PRISMA-ScR guidelines to map available literature on the role of the stroke nurse in post-stroke care of patients in the community. The Cochrane Central Register of Controlled Trials and Systematic literature searches including databases MEDLINE, EMBASE, CINAHL, google scholar and grey literature will be searched using keyword searches. Data will be charted and synthesised and a narrative synthesis will be conducted. Conclusions This scoping review will be used to identify gaps in the current literature and identify areas for future research in the role of the stroke nurse in ESD in relation to secondary prevention for stroke patients and inform the development of a pathway for stroke nursing in ESD.

Developing the clinical nurse specialist role in Indonesia: increasing high-quality nursing care

Developing the clinical nurse specialist role in Indonesia: increasing high-quality nursing care

Establishing The Role Of The Clinical Nurse Specialist For The Older Adult In A Model 2 Hospital

Abstract Background On average 87.5% of inpatients in our Model-2 Hospital are aged sixty-five years or above. Equally 57.5% of inpatients have medium to maximum dependency care needs. In order to meet the needs of this cohort of patients a new post “Clinical Nurse Specialist (CNS) For The Older Adult” was established in September 2023. Methods Using an online referral system, criteria for referral included i) new onset confusion or delirium, ii) clinical frailty score (CFS) of six or greater, iii) known Parkinson’s disease and iv) nursing or medical team clinical judgement. All reviewed patients received a comprehensive geriatric assessment using the Geriatric 5M framework (Mobility, Medications, Multi-Complexities, Mind and Matters Most) ensuring all aspects of patient care were assessed and promoting timely input from our multi-disciplinary team (Physiotherapy, Dietitian, Speech and Language Therapy, Occupational Therapy and Pharmacy). Results Over a period of 207 days the newly established CNS service received a total of 317 referrals. Two thirds (n=206, 65%) received CNS review, one third (n=111, 35%) did not; 45 (14%) were under the care of a consultant Geriatrician and not reviewed to avoid duplication and 66 (21%) were discharged before review could occur. Conclusion Referral numbers received since the established of the CNS post emphasises the need for the service in our hospital inpatient population. Development of the post has ensured that two-in-three referred patients receive a CNS lead CGA. Results from this pilot highlights the need to further develop and expand the service to target the one-in-five who missed review and further extension of the referral criteria.

The role of endocrine specialist nurses in the current NHS era

The role of endocrine specialist nurses in the current NHS era

Filling Gaps in Practice Leadership: Succession Planning for Clinical Nurse Specialist Positions.

To create a succession plan for clinical nurse specialist positions across multiple clinical settings. Mayo Clinic (Rochester, Minnesota) had multiple clinical nurse specialist position vacancies. However, standard recruitment methods and a collaboration between human resources and nursing managers to expand the applicant pool yielded few applicants. A work group was subsequently commissioned to identify innovative ways to fill the vacant clinical nurse specialist positions. Guiding principles for hiring and implementing the role were developed. During the 4-year project period (2016 through 2019), the time to fill positions decreased from 174 days to 83 days. Nurse managers and clinical nurse specialists reported an increased number of registered nurses seeking information about the profession. Twenty-eight clinical nurse specialist interns, titled clinical resource nurses, were hired, and 14 completed their graduate degree, obtained state licensure, and transitioned to clinical nurse specialist roles. Twelve clinical resource nurses were on schedule to transition to clinical nurse specialist positions, and 2 left their positions. A succession plan that used clinical nurse specialists to mentor clinical resource nurses to fill gaps in practice priorities while completing graduate education was a successful strategy to fill vacant clinical nurse specialist positions.

The Clinical Nurse Specialist: Maximizing Return on Investment.

The United States health care system is facing an unprecedented nursing shortage, increasing complexity of care, and fewer experienced nurse mentors. These factors contribute to a cycle of burnout, turnover, decreased quality and safety, and a worsening financial bottom line. Improving these contributing factors depends on our ability to mitigate the structural causes of burnout and turnover. The clinical nurse specialist role is essential to improving the work environment, advancing evidence-based nursing practice, reducing turnover, and stabilizing the bottom line.

Standards, Competencies, and Clinical Nurse Specialist Role

Standards, Competencies, and Clinical Nurse Specialist Role

P429 The role of Cystic Fibrosis Nurse Specialist in the Annual Reviewprocess for adults living with CF in the post-modulator era: A single centre experience

P429 The role of Cystic Fibrosis Nurse Specialist in the Annual Reviewprocess for adults living with CF in the post-modulator era: A single centre experience

Hirschsprung Disease: The Role of the Clinical Nurse Specialist.

Hirschsprung disease is a life-long condition that can have a significant impact on both children and their families. This article explores the role of the clinical nurse specialist and the support they can provide from initial diagnosis through the patient's surgical journey and right through to transition into adult services. Through the provision of education, training, signposting of social and psychological support, and linking in with community-based services, the clinical nurse specialist can help the child and family to limit that impact of the disease.

Role development and utilization of master’s-prepared omani nurses working in clinical settings: A multiple case study

Background and aim: The roles of master’s-prepared nurses in clinical settings differ by country. Examples include nurse practitioners, clinical nurse specialists, nurse managers, educators, and researchers. Little is known regarding the role development and utilization of master’s-prepared nurses in Oman. The aim is to explore the role development and utilization of master’s-prepared Omani nurses working in clinical settings in Oman’s governmental healthcare system.Methods: Multiple case study methodology involving two governmental acute care hospitals in Oman. Individual semi-structured interviews were conducted with master's-prepared Omani nurses (n = 19), policymakers (n = 8), and co-workers (n = 8). Relevant documents, including job descriptions and nursing career pathway were reviewed. Interviews and documents were analyzed using thematic analysis.Results: Master's-prepared Omani nurses were mainly utilized in management, education, and nurse specialist roles. Four overarching themes were identified: 1) Drivers for master's-preparation in clinical settings, 2) The journey after pursuing a master's education, 3) Master’s- prepared nurses' roles, their development, and their scope of practice, and 4) Perspectives about the current utilization of master's-prepared Omani nurses. Participants indicated utilization of master’s-prepared Omani nurses in clinical settings could be enhanced.Conclusions: Master’s-prepared nurses could play a vital role in supporting the needs of patients and addressing gaps in clinical settings if their advanced knowledge and competencies were fully utilized. Linking master’s-prepared nurses’ roles to patient, organization, and system needs and engaging stakeholders in developing their roles will enable optimum utilization of this valuable human resource.

109 Developing the role of the Lung Cancer Nurse Specialist (CNS) to support wider Clinical Practice beyond traditional role boundaries

109 Developing the role of the Lung Cancer Nurse Specialist (CNS) to support wider Clinical Practice beyond traditional role boundaries

Clinical Nurse Specialist Role Advocacy: Quantifying the Financial Contributions Via Development of a Scorecard.

The purpose of this article is to guide the clinical nurse specialist in constructing a scorecard to track clinical outcomes and identify the associated financial impact. Creation of a scorecard highlighting the financial impact of the clinical nurse specialist team was used to disseminate financial outcomes to hospital executive stakeholders, allowing the clinical nurse specialist team to demonstrate its clinical and financial value. During development and ongoing maintenance of the scorecard, the clinical nurse specialist team cultivated skills to identify the financial impact of projects. The team also utilized financial implications of individual and group projects to prioritize work. At the end of fiscal year 2022, the clinical nurse specialist team demonstrated revenue generation of $29 890 and cost avoidance of $2 854 807.30. The clinical nurse specialist scorecard was presented quarterly to the chief nursing officer, who shared with executive leadership. Clinical nurse specialists are positioned to make significant and positive financial impact to organizations. A scorecard presented to executive leadership offers a clinical nurse specialist team a tool to capture and disseminate a clinical nurse specialist team's unique financial contribution at the system level.

Student Simulation Professional Development: Adding Value to the Pediatric/Neonatal Clinical Nurse Specialist Role.

Student Simulation Professional Development: Adding Value to the Pediatric/Neonatal Clinical Nurse Specialist Role.

Mapping advanced practice nurses' scope of practice, satisfaction, and drivers of role performance.

Background: Advanced Practice Nurse (APN) roles in Switzerland include Clinical Nurse Specialist (CNS), Nurse Practitioner (NP) and blended roles. The variety contributes to unclear profiles and scope of practice. Aim: To describe a) the performance of APN tasks according to Hamric's competencies, b) job satisfaction, and c) barriers and facilitators to role performance. Methods: Nationwide cross-sectional survey among clinically working APNs. Inclusion criteria: academic degree, role with advanced nursing competency. Analysis of quantitative and qualitative data using inferential statistics and content analysis. Results: Of the 222 APNs, 49% (n = 108) described themselves as CNSs, 37% (n = 81) as working in a blended role, and 15% (n = 33) as NP. APNs provided the greatest proportion of their tasks in the competency direct clinical practice and the least in ethical decision-making. Group comparisons between roles revealed significant differences in the competencies: direct clinical practice, guidance and coaching, leadership, and evidence-based practice. Job satisfaction was high (76%, n = 165), most often described by the category work content/role (e.g., defined scope of practice). The most frequent barrier to role performance was the category scope of practice (e.g., unclear responsibilities); the most frequent facilitator was the category professional recognition (e.g., respect). Conclusion: The study highlights current APN scope of practice and can support the advancement of the role through clinical practice, educational institutions, and research.

Unmasking impostor phenomenon: a study of nurses in specialist roles.

This cross-sectional study aimed to explore the incidence of impostor phenomenon among 79 nurses in specialist roles in a single NHS trust in England, using an online anonymous questionnaire that included the Clance Imposter Phenomenon Scale and free-text responses. Results indicated a high prevalence of impostor phenomenon, with no specific variables predicting its occurrence. Four main themes emerged: self-doubt, role expectations, fear of exposure as an impostor, and factors leading to burnout. The study highlights the need for targeted support and training for this cohort, particularly as impostor phenomenon was found to be prevalent during career transitions and was not limited by gender. The findings have implications for nursing management and education, offering the opportunity to develop specific support mechanisms to alleviate impostor phenomenon and potentially reduce attrition rates in specialist nursing roles.

A Compendium of Clinical Nurse Specialist Roles in a Canadian Health Authority.

Interior Health in British Columbia advocates for and supports advanced practice nurses, inclusive of regional clinical nurse specialists (CNSs). CNSs develop evidence-informed programs, education, policies and practice standards. The article uses an advanced practice nursing framework to anchor two case studies: (1) the operationalization and implementation of a regional CNS role in primary care and (2) the use of a knowledge translation strategy to build clinical capacity in serious illness conversations. These case studies embody the CNS role and provide a voice for CNSs to communicate the ways in which their advanced practice nursing role is pivotal in healthcare system transformation and for providing quality patient care.

1879 On a knife's edge: role of a Clinical Nurse Specialist on balancing complex treatment decisions in acute surgery

Abstract Introduction 1 in 4 older individuals having emergency general surgery live with frailty, are more likely to have a longer hospital stay, readmission rate, morbidity and mortality. This underscores the importance of individualised approaches to care through Shared Decision Making (SDM). We introduced SDM into our surgical liaison service aiming to measure effectiveness and patient outcomes. Methods Between October 2021 and September 2022, patients aged >70 years living with frailty admitted to the surgical unit were identified by an Older Persons Clinical Nurse Specialist (CNS). Involvement in treatment decisions was measured by using the patient and clinician SDM-Q9 questionnaire. Pre-admission as well as follow-up quality of life scores at 6 months using the EQ-5D-5L (0-100) as well as Decision Regret were obtained on subsets of patients. Results Of a total of 76 patients seen by the CNS, follow-up data were available for 61 patients, clinician and patient SM-Q9 were completed in 54 patients. Clinicians were 10% more likely to strongly or completely agree that they explained choice available, 16% more likely to feel they explained treatment options compared with patients. Patients were less likely to feel completely involved in decision making. However, they were more likely to agree they understood clinical information presented them. Low levels of decision regret were ascertained at follow up where 18 patients agreed and 32 patients strongly agreed that a right decision was made of their care. Of 15 patients who underwent emergency laparotomy, mean EQ-5D scores across all domains from improved from baseline (69 vs 78). Conclusions CNS led implementation of SDM is feasible, acceptable. Patients felt involved in their care and had lower levels of decisional regret. Encouraging and investing in an environment where health professionals take time to determine what is important to their patient can be associated with better outcomes.

The emerging role of a Stroke Clinical Nurse Specialist (CNS) in Early Supported Discharged: Developing a pathway for stroke nursing for secondary prevention in the community. A scoping review protocol.

Background Stroke represents a major source of mortality and morbidity globally. The role of a stroke Clinical Nurse Specialist (CNS) as an expert team member in early supported discharge (ESD) for stroke, is not well defined or described although it is well established in other models of after-hospital and out-reach specialist care in the community. A greater focus has been on patients receiving rehabilitation post-stroke, however there is a need for a more holistic approach to care which clinical nurse specialists can offer to patients as part of ESD. Nurses are often the cohesive point of contact for other after-hospital services, managing many aspects of secondary prevention. Objective The aim of this scoping review is to explore the evidence in relation to the role of the stroke nurse providing secondary prevention interventions to stroke patients in a community setting. Methods We will conduct a scoping review in accordance with the Arksey and O’Malley, 2005 1 scoping review framework and the PRISMA-ScR guidelines to map available literature on the role of the stroke nurse in post-stroke care of patients in the community. The Cochrane Central Register of Controlled Trials and Systematic literature searches including databases MEDLINE, EMBASE, CINAHL, google scholar and grey literature will be searched using keyword searches. Data will be charted and synthesised and a narrative synthesis will be conducted. Conclusions This scoping review will be used to identify gaps in the current literature and identify areas for future research in the role of the stroke nurse in ESD in relation to secondary prevention for stroke patients and inform the development of a pathway for stroke nursing in ESD.

Viewpoint: Nurses educating patients about drugs.

Educating patients about the drugs they take is essential for them to take them safely and effectively. This education is now commonly given by nurses as part of the huge expansion in the nurse specialist role. However, training for this role has not kept pace with practice. Nurses have expressed variable confidence in this role and expressed a wish for more formal training. Current practice often puts the information rather than the patient at the centre of the consultation with the nurse dominating the conversation. Cues to address the patient agenda are commonly missed. An animated patient who interrupts is probably not having their educational needs met. Education of the professionals around how to perform this task in an optimal way is necessary and should result in better efficacy and safety of the drugs. This could be achieved by incorporating features of Shared Decision Making and the Calgary-Cambridge consultation techniques into training and the consultation. Personalization by attention to patient preferences, language and health literacy is essential.

Rheumatology nurses' perceptions of undertaking a postgraduate education programme: A phenomenological study.

The expansion of the role of the rheumatology nurse specialist led to the instigation, in 1999, of the first Masters programme in rheumatology nursing, with the aim of supporting clinical advancement with evidence-based practice. This study explored the experience of rheumatology nurses undertaking postgraduate study at Masters level. (1) To explore the perceptions and experiences of clinical nurse specialists undertaking a Masters programme in Rheumatology Nursing, including perceptions of impact. (2) To identify future educational needs. Ten rheumatology nurses who had completed a Masters degree in rheumatology nursing participated in a semi-structured video link or telephone interview conducted between 17th March 2021-17th May 2021. Interpretive phenomenological analysis was undertaken by two researchers and two public contributors. Four themes were identified: (i) Increased confidence and the development of new clinical skills. (ii) The perceived impact on the organisation; (iii) Benefits of face-to-face learning; and (iv) Continuing evolution of the rheumatology nurse specialist role. Participants reported increased confidence in clinical skills and felt that their learning had benefited their employing organisation. However, lack of time and insufficient managerial support could impede the implementation of new skills. Learning examination techniques, engagement in learning and peer support were seen as advantages of face-to-face learning. Future educational needs focused on diagnostic and prescribing skills. Participant learners perceived that completing a face-to-face Masters in rheumatology increased confidence in delivering new clinical skills and fostered peer networks, whilst also benefiting their employing organisations. There is a need for organisational support to apply learning to the clinical setting.