Beyond the Bundle: The Value of the Clinical Nurse Specialists in Continuing Evidence-based Practice Changes

2.50
Hdl Handle:
http://hdl.handle.net/10755/164106
Category:
Abstract
Type:
Presentation
Title:
Beyond the Bundle: The Value of the Clinical Nurse Specialists in Continuing Evidence-based Practice Changes
Author(s):
Richardson, Jenny; Tjoelker, Rita
Author Details:
Jenny Richardson, MS, RN, CNS, CCRN, CNRN, Portland VA Medical Center, Portland, Oregon, USA, email: jeannette.richardson@va.gov; Rita Tjoelker, MS, RN, CNS, CIC
Abstract:
PURPOSE/OBJECTIVES: To describe an opportunity for the Clinical Nurse Specialist (CNS) as an internal consultant to optimize patient care and outcomes through the continued monitoring of previously implemented evidence-based practice (EBP) projects and the reestablishment of workgroups as needed. SIGNIFICANCE: Once an EBP project has been successfully implemented, the CNS may hand off the project to a responsible individual for maintenance over time. Although it can be resource-intensive, there is value in the CNS maintaining project leadership long after implementation. BACKGROUND/RATIONALE: The internal CNS is uniquely qualified for sustained EBP project management and can offer system-oriented leadership for further improvements needed over time. DESCRIPTION: In 2006, our Intensive Care Unit (ICU) fully implemented use of the Central Line Bundles for prevention of catheter-related bloodstream infections. This practice change was led by the critical care and infection control CNSs and was strongly supported by both nursing and medical leadership as well as the healthcare system as a whole. Data collection and audits for infection rate and compliance with bundle elements were incorporated into the workflow of the unit. Over the next three years, the CNSs reinforced education at least every 6 months, monitored data, and modified the data collection form and process as needed. In fall 2008, a spike in the infection rate and concomitant publication of updated guidelines prompted the CNSs to coordinate a thorough analysis of the data and a reevaluation of processes. The initial implementation workgroup was reestablished but hospital-wide strategies were now being considered so interdepartmental personnel were added. Use of the bundles was expanded into the medical-surgical areas, evaluation of connectors for dialysis was completed, and dressings were modified. Infection data was organized and collected in all areas. OUTCOME: Central line infection data as well as compliance with central line bundle elements is now monitored for ICU, the medical-surgical areas, and Dialysis. Infection rates have decreased in critical care to 1.0 per 1000 device days for November to April as compared to the previous 6 month rate of 1.9. INTERPRETATION/CONCLUSION: CNS project surveillance and management is valuable for continued optimal patient outcomes. IMPLICATIONS FOR PRACTICE: CNSs should continue leading and maintaining EBP projects after implementation.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2010
Conference Name:
CNS as Interal Consultant: Influencing Local to Global Systems
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Portland, Oregon, USA
Description:
Conference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleBeyond the Bundle: The Value of the Clinical Nurse Specialists in Continuing Evidence-based Practice Changesen_GB
dc.contributor.authorRichardson, Jennyen_US
dc.contributor.authorTjoelker, Ritaen_US
dc.author.detailsJenny Richardson, MS, RN, CNS, CCRN, CNRN, Portland VA Medical Center, Portland, Oregon, USA, email: jeannette.richardson@va.gov; Rita Tjoelker, MS, RN, CNS, CICen_US
dc.identifier.urihttp://hdl.handle.net/10755/164106-
dc.description.abstractPURPOSE/OBJECTIVES: To describe an opportunity for the Clinical Nurse Specialist (CNS) as an internal consultant to optimize patient care and outcomes through the continued monitoring of previously implemented evidence-based practice (EBP) projects and the reestablishment of workgroups as needed. SIGNIFICANCE: Once an EBP project has been successfully implemented, the CNS may hand off the project to a responsible individual for maintenance over time. Although it can be resource-intensive, there is value in the CNS maintaining project leadership long after implementation. BACKGROUND/RATIONALE: The internal CNS is uniquely qualified for sustained EBP project management and can offer system-oriented leadership for further improvements needed over time. DESCRIPTION: In 2006, our Intensive Care Unit (ICU) fully implemented use of the Central Line Bundles for prevention of catheter-related bloodstream infections. This practice change was led by the critical care and infection control CNSs and was strongly supported by both nursing and medical leadership as well as the healthcare system as a whole. Data collection and audits for infection rate and compliance with bundle elements were incorporated into the workflow of the unit. Over the next three years, the CNSs reinforced education at least every 6 months, monitored data, and modified the data collection form and process as needed. In fall 2008, a spike in the infection rate and concomitant publication of updated guidelines prompted the CNSs to coordinate a thorough analysis of the data and a reevaluation of processes. The initial implementation workgroup was reestablished but hospital-wide strategies were now being considered so interdepartmental personnel were added. Use of the bundles was expanded into the medical-surgical areas, evaluation of connectors for dialysis was completed, and dressings were modified. Infection data was organized and collected in all areas. OUTCOME: Central line infection data as well as compliance with central line bundle elements is now monitored for ICU, the medical-surgical areas, and Dialysis. Infection rates have decreased in critical care to 1.0 per 1000 device days for November to April as compared to the previous 6 month rate of 1.9. INTERPRETATION/CONCLUSION: CNS project surveillance and management is valuable for continued optimal patient outcomes. IMPLICATIONS FOR PRACTICE: CNSs should continue leading and maintaining EBP projects after implementation.en_GB
dc.date.available2011-10-27T11:42:08Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:42:08Z-
dc.conference.date2010en_US
dc.conference.nameCNS as Interal Consultant: Influencing Local to Global Systemsen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationPortland, Oregon, USAen_US
dc.descriptionConference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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