Follow-up services and the development of a clinical nurse specialist in intensive care

1997 ◽  
Vol 13 (5) ◽  
pp. 243-248 ◽  
Author(s):  
Jess Hall-Smith ◽  
Carol Ball ◽  
John Coakley
Keyword(s):  
Intensive Care ◽  
Clinical Nurse Specialist ◽  
Nurse Specialist ◽  
Clinical Nurse

Improving Family Communications at the End of Life: Implications for Length of Stay in the Intensive Care Unit and Resource Use

2003 ◽  
Vol 12 (4) ◽  
pp. 317-324 ◽  
Author(s):  
Tom Ahrens ◽  
Valerie Yancey ◽  
Marin Kollef
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
End Of Life ◽  
Resource Utilization ◽  
Intervention Group ◽  
Clinical Nurse Specialist ◽  
Control Group ◽  
Nurse Specialist ◽  
Clinical Nurse

• Background Inadequate communication persists between healthcare professionals and patients and patients’ families in intensive care units. Unwanted or ineffective treatments can occur when patients’ goals of care are unknown or not honored, increasing costs and care. Having the primary physician provide medical information and then having a physician and clinical nurse specialist team improve opportunities for patients and their families to process that information could improve the situation. This model has not been tested for its effect on patients’ outcomes and resource utilization.• Objectives To evaluate the effect of a communication team that included a physician and a clinical nurse specialist on length of stay and costs for patients near the end of life in the intensive care unit.• Methods During a 1-year period, patients judged to be at high risk for death (N = 151) were divided into 2 groups: 43 patients who were cared for by the medical director teamed with a clinical nurse specialist and 108 patients who received standard care, provided by an attending physician.• Results Compared with the control group, patients in the intervention group had significantly shorter stays in both the intensive care unit (6.1 vs 9.5 days) and the hospital (11.3 vs 16.4 days) and had lower fixed ($15 559 vs $24 080) and variable ($5087 vs $8035) costs.• Conclusions Use of a physician and a clinical nurse specialist focused on improving communication with patients and patients’ families reduced lengths of stay and resource utilization.

scholarly journals 099 Do clinical nurse specialist led stroke follow-up clinics reduce post-stroke hospital readmissions and recurrent vascular events?

2019 ◽  
Vol 90 (e7) ◽  
pp. A32.2-A32
Author(s):  
Alex Kao ◽  
Jeremy Lanford ◽  
Lai-Kin Wong ◽  
Anna Ranta
Keyword(s):  
Hospital Readmission ◽  
Readmission Rate ◽  
Clinical Nurse Specialist ◽  
Vascular Event ◽  
Nurse Specialist ◽  
Vascular Events ◽  
Clinical Nurse ◽  
One Year ◽  
The One

IntroductionPost-discharge stroke follow-up clinics have been associated with improved outpatient care and reduced readmission. Pre-2014 there was no consistent follow-up care offered at Wellington Hospital. Our aim was to determine whether the establishment of a clinical nurse specialist (CNS) follow-up clinic reduced the readmission 12-monthrate.MethodsThis is a sequential comparison of patient admitted with stroke one year prior and one year after the clinic was established in 2013. The primary outcome was hospital 12-month hospital readmission rate; main secondary outcome was recurrent vascular event. Patients were identified from the hospital discharge records and underwent detailed electronic chart review. Results were adjusted for differences in baseline characteristics.ResultsWe identified 874 patients; 439 pre- and 435 post-nurse clinic implementation. There was no significant difference between the one-year readmission rate after the establishment of the stroke follow up clinic (adjusted OR=1.06; 95% CI, 0.85–1.64; p=0.804) and no difference in recurrent composite vascular events at one-year (adjusted OR=1.20; 95% CI, 0.68–2.11; p=0.528). The median (IQR) time to follow-up to clinic after discharge was 85 (63–98.5) days. There was a trend towards a reduction in vascular events when limiting the analysis to patients who actually attended clinic, but this trend disappeared when adjusting for baseline inter-group differences.ConclusionsThere was no reduction in the one-year hospital readmission or vascular event recurrence rate for patients with stroke following the establishment of a nurse specialist led stroke follow up clinic. Earlier timed follow-up and the psychosocial value offered by these clinics requires further evaluation.

The tracheostomy clinical nurse specialist: an essential member of the multidisciplinary team

2014 ◽  
Vol 128 (2) ◽  
pp. 171-173 ◽  
Author(s):  
R Crosbie ◽  
J Cairney ◽  
N Calder
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidisciplinary Team ◽  
Clinical Nurse Specialist ◽  
Nurse Specialist ◽  
Intensive Care Unit Treatment ◽  
Common Procedure ◽  
Clinical Nurse ◽  
The Creation

AbstractBackground:Tracheostomies are a common procedure within the specialties of otolaryngology and intensive care. The ENT department at Monklands Hospital has developed the position of tracheostomy clinical nurse specialist to improve the management of tracheostomy patients. There is evidence to support the development of a multidisciplinary team for the management of tracheostomy patients following intensive care unit treatment; however, the creation of a specific tracheostomy clinical nurse specialist position has not been widely endorsed in the literature.Objective:This paper describes the role of the tracheostomy clinical nurse specialist, advocating this position within the multidisciplinary team.

«Wie ein ANP-Team laufen lernt» – Herausforderungen und Chancen von ANP-Teams am Universitätskinderspital Zürich

Pflege ◽  
2011 ◽  
Vol 24 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Andrea Ullmann-Bremi ◽  
Anna-Barbara Schlüer ◽  
Gabriela Finkbeiner ◽  
Yvonne Huber
Keyword(s):  
Nurse Practitioner ◽  
Nursing Practice ◽  
Clinical Nurse Specialist ◽  
Nurse Specialist ◽  
Advanced Nursing Practice ◽  
Clinical Nurse

Im angloamerikanischen und nordeuropäischen Raum wurden verschiedene ANP-Einzelrollen entwickelt, unter anderem die der Clinical Nurse Specialist und der Nurse Practitioner. Diese universitär ausgebildeten Pflegespezialisten sind in der Schweiz weiterhin sehr rar. Um vor diesem Hintergrund die Praxis dennoch nachhaltig weiterentwickeln zu können, wurden in den letzten acht Jahren im Kinderspital Zürich kontinuierlich Advanced-Nursing-Practice-Teams (ANP-Teams) aufgebaut. Dieser Ansatz bewährte sich durch gezielte und angemessene Leistungserbringung in hochkomplexen Situationen. In diesem Artikel wird die Zusammensetzung der ANP-Teams diskutiert, wobei der Personalmix einen Schlüsselfaktor darstellt. Unterstützende Elemente stellen dabei sowohl die Aufgabendefinition als auch Aufgabenteilung in Klinik- und Konzeptteams dar. Die ANP-Teams arbeiten motiviert und zielgerichtet, sie integrieren Pflegende verschiedenster Erfahrungs- und Ausbildungsniveaus, wodurch gegenseitiges Lernen gefördert wird.

Rationalisation of non-sterile latex disposable gloves in clinical settings – a brief study using the purchase of expertise consultancy model

2003 ◽  
Vol 4 (1) ◽  
pp. 10-19
Author(s):  
Duncanson V
Keyword(s):  
Secondary Care ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Clinical Nurse Specialist ◽  
Small Study ◽  
Clinical Settings ◽  
Nurse Specialist ◽  
Benefit Analysis ◽  
Clinical Nurse

T his article describes a small study aimed at making a purchasing recommendation to the purchasing manager, providing a cost-benefit analysis of the most commonly used brands of non-sterile latex examination gloves. One of the nine makes of glove tested remained consistent with the agreed criteria for assessment and, if introduced as the only option available, would result in a saving of $15,150 per annum on Site A of a recently merged secondary care Trust. Also, the importance of the consultancy role of the clinical nurse specialist in improving practice was demonstrated.

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