Clinical Nurse Specialist Contributions to Care Delivery: Creating a Pain Management Registered Nurse Model of Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/164107
Category:
Abstract
Type:
Presentation
Title:
Clinical Nurse Specialist Contributions to Care Delivery: Creating a Pain Management Registered Nurse Model of Care
Author(s):
Roberts, Meghann; Smith, Nancy J.; Brendlen, Virginia; Madara, Kimberly; Salyer, Jessica; Love, Alene
Author Details:
Meghann Roberts, MSN, BSN, RN, Duke University Hospital, Durham, North Carolina, USA, email: meghann.roberts@duke.edu; Nancy J. Smith; Virginia Brendlen; Kimberly Madara; Jessica Salyer; Alene Love
Abstract:
PURPOSE/OBJECTIVES: The purpose of this initiative was to develop staff nurses into Pain Management Registered Nurses (PMRNs) to provide night coverage for the Acute Pain Service (APS) patients receiving either epidural or regional catheters for post-operative analgesia. SIGNIFICANCE: Research has shown that effective pain management promotes earlier mobilization, reduces hospital length of stay, postoperative complications and costs. BACKGROUND/RATIONALE: At Duke University Hospital, anesthesiology residents covered the APS patients from 11 pm to 7 am, while also responsible for operating rooms. Consequently, APS patients did not consistently receive prompt and adequate pain management. In recognition of this barrier to effective pain management, administrators, physicians and the APS Clinical Nurse Specialists (CNSs) collaborated to develop the PMRN role. DESCRIPTION: The initiative involved recruiting and educating staff nurses to deliver care based on the same protocols that the APS CNSs utilize. Four night shift orthopedic charge nurses participated in the six week APS orientation. The orientation consisted of didactic readings and classes, one-to-one clinical experience, case studies and a skills day to demonstrate and validate clinical competencies. Ongoing competency maintenance and assessment is achieved through quarterly meetings and an annual refresher week with the APS CNSs. OUTCOME: Outcomes measured included I) quantity and distribution of pain calls throughout the hospital, 2) response time and duration of intervention, 3) impact on staff satisfaction, 4) PMRN satisfaction with orientation, and 5) overall care of the APS patients. These outcomes will be described in the presentation. INTERPRETATION/CONCLUSION: Outcomes demonstrated that experienced staff nurses were able to follow CNS pain management protocols after completing an extensive, structured educational program. Within staffing and budget constraints, this program expanded the impact of the CNS role through staff nurse development, resulted in growth opportunities for experienced staff nurses, and improved staff and patient satisfaction. IMPLICATIONS FOR PRACTICE: CNSs can improve pain management through effectively educating staff nurses in complex skills and decision-making. By working creatively with both the medical and administrative teams, CNSs can develop alternative staffing models to improve patient and staff satisfaction.
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.titleClinical Nurse Specialist Contributions to Care Delivery: Creating a Pain Management Registered Nurse Model of Careen_GB
dc.contributor.authorRoberts, Meghannen_US
dc.contributor.authorSmith, Nancy J.en_US
dc.contributor.authorBrendlen, Virginiaen_US
dc.contributor.authorMadara, Kimberlyen_US
dc.contributor.authorSalyer, Jessicaen_US
dc.contributor.authorLove, Aleneen_US
dc.author.detailsMeghann Roberts, MSN, BSN, RN, Duke University Hospital, Durham, North Carolina, USA, email: meghann.roberts@duke.edu; Nancy J. Smith; Virginia Brendlen; Kimberly Madara; Jessica Salyer; Alene Loveen_US
dc.identifier.urihttp://hdl.handle.net/10755/164107-
dc.description.abstractPURPOSE/OBJECTIVES: The purpose of this initiative was to develop staff nurses into Pain Management Registered Nurses (PMRNs) to provide night coverage for the Acute Pain Service (APS) patients receiving either epidural or regional catheters for post-operative analgesia. SIGNIFICANCE: Research has shown that effective pain management promotes earlier mobilization, reduces hospital length of stay, postoperative complications and costs. BACKGROUND/RATIONALE: At Duke University Hospital, anesthesiology residents covered the APS patients from 11 pm to 7 am, while also responsible for operating rooms. Consequently, APS patients did not consistently receive prompt and adequate pain management. In recognition of this barrier to effective pain management, administrators, physicians and the APS Clinical Nurse Specialists (CNSs) collaborated to develop the PMRN role. DESCRIPTION: The initiative involved recruiting and educating staff nurses to deliver care based on the same protocols that the APS CNSs utilize. Four night shift orthopedic charge nurses participated in the six week APS orientation. The orientation consisted of didactic readings and classes, one-to-one clinical experience, case studies and a skills day to demonstrate and validate clinical competencies. Ongoing competency maintenance and assessment is achieved through quarterly meetings and an annual refresher week with the APS CNSs. OUTCOME: Outcomes measured included I) quantity and distribution of pain calls throughout the hospital, 2) response time and duration of intervention, 3) impact on staff satisfaction, 4) PMRN satisfaction with orientation, and 5) overall care of the APS patients. These outcomes will be described in the presentation. INTERPRETATION/CONCLUSION: Outcomes demonstrated that experienced staff nurses were able to follow CNS pain management protocols after completing an extensive, structured educational program. Within staffing and budget constraints, this program expanded the impact of the CNS role through staff nurse development, resulted in growth opportunities for experienced staff nurses, and improved staff and patient satisfaction. IMPLICATIONS FOR PRACTICE: CNSs can improve pain management through effectively educating staff nurses in complex skills and decision-making. By working creatively with both the medical and administrative teams, CNSs can develop alternative staffing models to improve patient and staff satisfaction.en_GB
dc.date.available2011-10-27T11:42:09Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:42:09Z-
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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