CNS Competencies Influencing Professional Nursing Practice Culture Development, Implementation, and Evaluation of Unit-Based Diabetes Care Facilitators

2.50
Hdl Handle:
http://hdl.handle.net/10755/164158
Category:
Abstract
Type:
Presentation
Title:
CNS Competencies Influencing Professional Nursing Practice Culture Development, Implementation, and Evaluation of Unit-Based Diabetes Care Facilitators
Author(s):
Sitterding, Mary
Author Details:
Mary Sitterding, MSN, CNS, Columbus Regional Hospital, Columbus, Indiana, USA, email: nacnsorg@nacns.org
Abstract:
Background/Rationale: Driving forces that influenced this innovation include but were not limited to maintaining the professional nursing practice model and the need for management of diabetes and hyperglycemia in the hospital setting. Professional Nursing Practice models demonstrate the following organizational themes: 1) working with other nurses who are clinically competent; 2) good nurse-physician relationships; 3) nurse autonomy and accountability; 4) supportive nurse manager-supervisor; 5) control over nursing practice and practice environment; 6) support for education; 7) adequacy of nurse staffing; and 8) concern for the patient is paramount (McClure, M. & Hinshaw, A., 2002). The prevalence of diabetes in adults hospitalized in the United States is significant and predicted to be at 12.4 - 25% (Clement, S. et.al., 2004). Following a needs assessment, nursing knowledge, autonomy and control over practice in diabetes care were identified as opportunity areas for CNS intervention. The innovation was the development, implementation, and evaluation of bedside (sharp-end) RN Unit Based Diabetes Care Facilitators. Description: The development, implementation, and evaluation of this role integrated Social Cognitive Learning Theory (Bandura, A., 1986). The CNS recruited activated, interested bedside nurses who were interested in advancing the practice of diabetes care within their respective nursing unit. Traditional educational opportunities have included the development of written material, subsequent classes, followed by posttests, which are not clear measures of learning. The intent of the CNS and Diabetes Team was to provide information and experiences that stimulate learning resulting in diabetes nursing practice behavior change positively influencing a professional nursing practice model. Sub-processes governing observational learning include the following: Attentional Process; Retention Process, Production Process; and Motivational Process. Activities were designed to address each sub-process governing learning. What followed was Unit Based Diabetes Care Facilitator partnership with unit based nursing leadership, advanced practice, and unit based practice councils in the design, implementation, and evaluation of unit based plans aimed at advancing the practice of unit based diabetes nursing care. Outcome: Multiple outcomes were experienced within the three spheres of CNS practice. Professional nursing practice influencing the assessment and management of patients diagnosed with hyperglycemia has resulted in patient outcomes that include but are not limited to a decrease in sternal wound infections among CABG population influenced by continuous insulin infusion within the 1st 24 hours post operatively in the CVU; Nursing demonstrated increased confidence and competency to assess and meet the complex needs of persons diagnosed with diabetes. Examples of system outcomes include but are not limited to bedside nursing verbalizing and demonstrating nursing autonomy and control over nursing practice influencing Magnet designation. Interpretation Conclusion: The clinical nurse specialist is perfectly positioned to influence a professional nursing practice model positively influencing high quality nursing care. Without clinical nurse specialist competency support, the bedside nurse is limited to achieve and master control over their practice or to be able to collaborate with nursing peers or other disciplines to ensure high quality care. Control over nursing practice promotes recognition of the contribution of professional nursing to organizational goals and outcomes (Perley & Rabb, 1994). Implication for CNS Practice: Implications for CNS practice include but are not limited to the following competencies: 1) use methods and instruments to assess patterns of outcomes related to nursing practice within and across nursing units of care; 2) gathers and analyzes data to substantiate desirable and undesirable patient outcomes linked to nursing practice; 3) draws conclusions about the evidenced-base and outcomes of nursing practice that require change, enhancement, or maintenance; 4) anchors nursing practice to evidence-based information to achieve nurse-sensitive outcomes; 5) evaluates the ability of nurses and nursing personnel to implement changes in nursing practice with individual patients and populations (NACNS, 2004).
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
CNS Leadership: Navigating the Healthcare Environment Toward Excellence
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Orlando, Florida, USA
Description:
Conference theme: CNS Leadership: Navigating the Healthcare Environment Toward Excellence, held on March 9�12, 2005 in Orlando, Florida, 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.titleCNS Competencies Influencing Professional Nursing Practice Culture Development, Implementation, and Evaluation of Unit-Based Diabetes Care Facilitatorsen_GB
dc.contributor.authorSitterding, Maryen_US
dc.author.detailsMary Sitterding, MSN, CNS, Columbus Regional Hospital, Columbus, Indiana, USA, email: nacnsorg@nacns.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164158-
dc.description.abstractBackground/Rationale: Driving forces that influenced this innovation include but were not limited to maintaining the professional nursing practice model and the need for management of diabetes and hyperglycemia in the hospital setting. Professional Nursing Practice models demonstrate the following organizational themes: 1) working with other nurses who are clinically competent; 2) good nurse-physician relationships; 3) nurse autonomy and accountability; 4) supportive nurse manager-supervisor; 5) control over nursing practice and practice environment; 6) support for education; 7) adequacy of nurse staffing; and 8) concern for the patient is paramount (McClure, M. & Hinshaw, A., 2002). The prevalence of diabetes in adults hospitalized in the United States is significant and predicted to be at 12.4 - 25% (Clement, S. et.al., 2004). Following a needs assessment, nursing knowledge, autonomy and control over practice in diabetes care were identified as opportunity areas for CNS intervention. The innovation was the development, implementation, and evaluation of bedside (sharp-end) RN Unit Based Diabetes Care Facilitators. Description: The development, implementation, and evaluation of this role integrated Social Cognitive Learning Theory (Bandura, A., 1986). The CNS recruited activated, interested bedside nurses who were interested in advancing the practice of diabetes care within their respective nursing unit. Traditional educational opportunities have included the development of written material, subsequent classes, followed by posttests, which are not clear measures of learning. The intent of the CNS and Diabetes Team was to provide information and experiences that stimulate learning resulting in diabetes nursing practice behavior change positively influencing a professional nursing practice model. Sub-processes governing observational learning include the following: Attentional Process; Retention Process, Production Process; and Motivational Process. Activities were designed to address each sub-process governing learning. What followed was Unit Based Diabetes Care Facilitator partnership with unit based nursing leadership, advanced practice, and unit based practice councils in the design, implementation, and evaluation of unit based plans aimed at advancing the practice of unit based diabetes nursing care. Outcome: Multiple outcomes were experienced within the three spheres of CNS practice. Professional nursing practice influencing the assessment and management of patients diagnosed with hyperglycemia has resulted in patient outcomes that include but are not limited to a decrease in sternal wound infections among CABG population influenced by continuous insulin infusion within the 1st 24 hours post operatively in the CVU; Nursing demonstrated increased confidence and competency to assess and meet the complex needs of persons diagnosed with diabetes. Examples of system outcomes include but are not limited to bedside nursing verbalizing and demonstrating nursing autonomy and control over nursing practice influencing Magnet designation. Interpretation Conclusion: The clinical nurse specialist is perfectly positioned to influence a professional nursing practice model positively influencing high quality nursing care. Without clinical nurse specialist competency support, the bedside nurse is limited to achieve and master control over their practice or to be able to collaborate with nursing peers or other disciplines to ensure high quality care. Control over nursing practice promotes recognition of the contribution of professional nursing to organizational goals and outcomes (Perley & Rabb, 1994). Implication for CNS Practice: Implications for CNS practice include but are not limited to the following competencies: 1) use methods and instruments to assess patterns of outcomes related to nursing practice within and across nursing units of care; 2) gathers and analyzes data to substantiate desirable and undesirable patient outcomes linked to nursing practice; 3) draws conclusions about the evidenced-base and outcomes of nursing practice that require change, enhancement, or maintenance; 4) anchors nursing practice to evidence-based information to achieve nurse-sensitive outcomes; 5) evaluates the ability of nurses and nursing personnel to implement changes in nursing practice with individual patients and populations (NACNS, 2004).en_GB
dc.date.available2011-10-27T11:43:07Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:43:07Z-
dc.conference.date2005en_US
dc.conference.nameCNS Leadership: Navigating the Healthcare Environment Toward Excellenceen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationOrlando, Florida, USAen_US
dc.descriptionConference theme: CNS Leadership: Navigating the Healthcare Environment Toward Excellence, held on March 9�12, 2005 in Orlando, Florida, 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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