Acute and Critical Care Clinical Nurse Specialists , livre ebook

Acute and Critical Care Clinical Nurse Specialists
Synergy for Best Practices
Mary G. McKinley, MSN, RN, CCRN
Partner, Critical Connections, Maxwell Center, Wheeling, West Virginia
American Association of Critical-Care Nurses
Table of Contents
Cover image
Title page
Copyright
Contributors
Preface
Acknowledgments
PART I: THE CLINICAL NURSE SPECIALIST IN ACUTE AND CRITICAL CARE
CHAPTER 1: Evolution of the Clinical Nurse Specialist in Acute and Critical Care
OVERVIEW
CRITICAL CARE NURSING
CNS IN ACUTE AND CRITICAL CARE
IMPLEMENTING THE ROLE OF THE CNS IN ACUTE AND CRITICAL CARE
CHAPTER 2: From Novice to Expert: CNS Competencies
CLINICAL NURSE SPECIALIST COMPETENCIES
EDUCATION
CNS ROLE DEVELOPMENT: THEORETICAL PERSPECTIVES
CONCLUSION
CHAPTER 3: Synergy Model: Guiding the Practice of the CNS in Acute and Critical Care
BACKGROUND
THE SYNERGY MODEL
PATIENT CHARACTERISTICS
NURSE COMPETENCIES
THE CLINICAL NURSE SPECIALIST
EXEMPLARS
CONCLUSION
Internet References
CHAPTER 4: Spheres of Influence: Defining the Impact of the CNS
SPHERES OF INFLUENCE FOR THE CNS
CONCLUSION
PART II: DIMENSIONS OF PRACTICE FOR THE CNS IN ACUTE AND CRITICAL CARE: SYNERGY IN MOTION
CHAPTER 5: Clinical Judgment
INTRODUCTION
DEFINITION OF CLINICAL JUDGMENT
IMPLEMENTATION WITHIN THE DIMENSION OF PRACTICE
INTEGRATION OF THE STANDARDS OF PROFESSIONAL PERFORMANCE
CONCLUSION
CHAPTER 6: Clinical Inquiry
INTRODUCTION
BACKGROUND
CREATING AN ENVIRONMENT OF CLINICAL INQUIRY
STRATEGIES FOR CLINICAL INQUIRY
FACILITATING CLINICIAN-LED RESEARCH
MEASURING OUTCOMES OF CI
CONCLUSION
CHAPTER 7: The Clinical Nurse Specialist as Facilitator of Learning
CNS LEVEL OF EXPERTISE
IMPLEMENTATION WITHIN THE DIMENSION OF PRACTICE
FORMAL INTERVENTIONS
FORMAL EDUCATION OPPORTUNITIES
EVALUATION
INTEGRATION OF THE STANDARDS OF PROFESSIONAL PRACTICE
SUMMARY
CHAPTER 8: Collaboration
INTRODUCTION
COLLABORATION IN EXPERT PRACTICE
IMPLEMENTING COLLABORATIVE PRACTICE
CASE STUDY
STANDARDS OF PROFESSIONAL PERFORMANCE
CHAPTER 9: Systems Thinking
INTRODUCTION
DEFINITION
CNS LEVEL OF EXPERTISE
IMPLEMENTATION WITHIN THE DIMENSION OF PRACTICE
INTEGRATION OF STANDARDS OF PROFESSIONAL PERFORMANCE
CONCLUSION
CHAPTER 10: Advocacy and Moral Agency: Quintessential Nursing
DEFINING ADVOCACY AND MORAL AGENCY: WHY IT IS IMPORTANT
A CASE FOR ADVOCACY: SETTING THE STAGE
INTEGRATION OF STANDARDS OF PRACTICE
ANALYSIS OF A CASE FOR ADVOCACY: CNS PERSPECTIVE
INTEGRATION OF THE STANDARDS OF PROFESSIONAL PERFORMANCE
CHAPTER 11: Caring Practices
INTRODUCTION
IMPLEMENTATION WITHIN THE DIMENSION OF PRACTICE
INTEGRATION OF THE STANDARDS OF PROFESSIONAL PERFORMANCE
SUMMARY
DISCUSSION
CHAPTER 12: Response to Diversity
INTRODUCTION
IMPLEMENTATION WITHIN THE RESPONSE TO DIVERSITY
INTEGRATION OF THE STANDARDS OF PROFESSIONAL PERFORMANCE
PART III: PROFESSIONAL DEVELOPMENT OF THE CNS IN ACUTE AND CRITICAL CARE
CHAPTER 13: Professional Development of the Clinical Nurse Specialist
INTRODUCTION
GETTING STARTED
ONGOING STRATEGIES FOR SUCCESS
SUMMARY
CHAPTER 14: Expanded Opportunities: The Clinical Nurse Specialist as Entrepreneur
INTRODUCTION
THE CNS AS ENTREPRENEUR
THE CURRENT HEALTH CARE ENVIRONMENT
EXPANDED CNS OPPORTUNITIES
GETTING STARTED
GOING FROM NOVICE TO EXPERT
PUTTING A PLAN INTO ACTION
CONCLUSION
CHAPTER 15: Current Issues and Future Trends
APPENDIX A: Standards of Practice and Performance for the Acute and Critical Care CNS
STANDARDS OF PRACTICE
STANDARDS OF PROFESSIONAL PERFORMANCE
APPENDIX B: CCNS Examination Blueprint
ADULT PROGRAM
PEDIATRIC PROGRAM
NEONATAL PROGRAM
APPENDIX C: AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence
ABOUT THE STANDARDS
SKILLED COMMUNICATION
TRUE COLLABORATION
EFFECTIVE DECISION MAKING
APPROPRIATE STAFFING
MEANINGFUL RECOGNITION
AUTHENTIC LEADERSHIP
About the Standards
Skilled Communication
True Collaboration
Effective Decision Making
Appropriate Staffing
Meaningful Recognition
Authentic Leadership
Index
Copyright

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ACUTE AND CRITICAL CARE CLINICAL NURSE SPECIALISTS: SYNERGY FOR BEST PRACTICES
ISBN: 978-1-4160-0156-0
Copyright © 2007 by Saunders, an imprint of Elsevier Inc.
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NOTICE
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment, and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Author assumes any liability for any injury and/or damage to persons or property arising out or related to any use of the material contained in this book.
The Publisher
Library of Congress Control Number: 2007924080
Executive Publisher: Barbara Nelson Cullen
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Printed in the United States of America
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Contributors
Foreword
Dorrie K. Fontaine, RN, DNSc, FAAN Associate Dean for Academic Programs, School of Nursing, University of California–San Francisco, San Francisco, California Chapter 1
Mary G. McKinley, RN, MSN, CCRN Partner, Critical Connections, Maxwell Center Wheeling, West Virginia Chapter 2
Deborah G. Klein, RN, MSN, CCRN, CS Clinical Nurse Specialist, The Cleveland Clinic, Cleveland, Ohio Chapter 3
Roberta Kaplow, RN, PhD, CCNS, CCRN, AOCNS Clinical Nurse Specialist, DeKalb Medical Center, Decatur, Georgia Chapter 4
Kathleen Vollman, MSN, RN, CCNS, FCCM Clinical Nurse Specialist/Educator/Consultant, ADVANCING NURSING LLC, Northville, Michigan
Brenda Lyon, DNS, FAAN School of Nursing, Indiania University, Indianapolis, Indiana Chapter 5
Marla J. De Jong, RN, PhD, CCNS, CCRN Co-Editor, AACN Advanced Critical Care , San Antonio, Texas Chapter 6
Christine Schulman, RN, MSN, CCRN Clinical Nurse Specialist Trauma and Critical Care Nursing Clinical Faculty, School of Nursing, Oregon Health and Science University, Portland, Oregon Chapter 7
Karen K. Carlson, RN, MN, CCNS Critical Care Clinical Nurse Specialist, Carlson Consulting Group, Bellevue, Washington Chapter 8
Jan Foster, RN, PhD, CCRN President, Nursing Inquiry and Intervention, Inc The Woodlands, Texas, Texas Woman's University Houston, Texas Chapter 9
Mary Fran Tracy, RN, PhD, CCRN, CCNS, FAAN Critical Care Clinical Nurse Specialist, School of Nursing, University of Minnesota, Minneapolis, Minnesota
Ruth Lindquist, RN, PhD, APRN, BC, FAAN Professor and Senior Associate Dean, School of Nursing, University of Minnesota, Minneapolis, Minnesota Chapter 10
Linda J. Bell, RN, MSN Clinical Nurse Specialist, American Association of Critical-Care Nurses, Aliso Viejo, California
Ramón Lavandero, RN, MA, MSN, FAAN Director of Development and Strategic Alliances, American Association of Critical-Care Nurses, Aliso Viejo, California Adjunct Associate Professor of Nursing, Indiana University, Indianapolis, Indiana Chapter 11
Elizabeth M. Nolan, RN, MS, APRN Clinical Nurse Specialist, Cardiovascular Center, University of Michigan Hospitals & Health Centers, Ann Arbor, Michigan Chapter 12
John F. Dixon, Jr., RN, MSN Baylor University Medical Center, Dallas, Texas Chapter 13
Mary Lou Sole, RN, PhD, CCRN, CCNS, FAAN Professor, University of Central Florida College of Health and Public Affairs School of Nursing, Orlando, Florida Chapter 14
Marcia Bixby, MS, CCRN Beth Israel Deaconess Medical Center, Boston, Massachusetts
Karen Giuliano, RN, PhD, FAAN Clinical Research Specialist, Philips Medical Systems, Bothell, Washington Chapter 15
Karla A. Knight, RN, MSN Writer, Nursing Spectrum, Boston, Massachusetts
Connie Barden, RN, MN, CCRN, CCNS Clinical Nurse Specialist, Mercy Medical Center, Miami, Florida
Gladys M. Campbell, RN, MSN Executive Director, NWONE, Seattle, Washington, Independent Consultant, Portland, Oregon
Preface
In today's health care environment, clinicians must focus on providing quality care through best practices in a cost-effective manner. Advanced practitioners are faced with the challenge to excel in clinical practice as well as in system analysis and insight—to be not only clinical experts but also organizational experts, whose skills are needed beyond the boundaries of the critical care unit to any general care areas where complex and acutely ill patients receive care. Such patients require strong clinical skills as well as advanced skills in analysis and problem solving.
This book will be valuable