Taking outcomes to the next level: The clinical nurse specialist as a partner in changing practice

High reliability pediatric heart centers: Always working toward getting better

PURPOSE OF REVIEW

The purpose of this review is to examine high reliability through the lens of a contemporary pediatric heart center, noting that continuous improvement, rather than perfection, should be embraced. Aiming to elevate topics with lesser attention, this review elaborates on key concepts and proposed considerations for maintaining a high reliability heart center.

RECENT FINDINGS

As provision of care reaches a new complexity, programs are called upon to evaluate how they can bring their teams into the future of pediatric cardiac care. Although much has been written about high reliability in healthcare, it has not been explored within pediatric heart centers. Practical application of high reliability enables a shared mental model and aligns teams toward eliminating patient harm. Suggested facilitators of high reliability within heart center teams include interprofessional collaboration, recognition of nursing expertise, psychological safety, and structural empowerment void of hierarchy.

SUMMARY

As the pediatric cardiac population evolves, care becomes more complex with a narrow margin of error. High reliability can guide continuous improvement. Acknowledging culture as the underpinning of all structure and processes allows teams to rebound from failure and supports the mission of rising to exceptional patient challenges.

Oncology Clinical Nurse Specialists Practice in the Outpatient Setting

PURPOSE/OBJECTIVES

With rapidly evolving oncology care, the role of the outpatient clinical nurse specialist is most valuable and essential. The purpose of this article is to describe the role of the clinical nurse specialist in the ambulatory oncology settings and highlight the clinical nurse specialists' unique influence across the spheres of impact.

DESCRIPTION OF THE PROJECT/PROGRAM

This article shares several contributions of an outpatient clinical nurse specialist, which include ways this role impacts nursing practice, patient care, and standardizing organizational guidelines. A method of recording the clinical nurse specialists' encounters or indirect consults was also utilized to provide a process to log consultation received in the day-to-day practice. Work exemplars were included to further demonstrate the impact of this role in this setting.

CONCLUSION

Outpatient clinical nurse specialist need is rising especially in the oncology setting where the majority of cancer care and treatment is delivered. It is important to continue to disseminate and highlight the value it brings to the organization.

Maximizing Nurse Scientist Role Potential in Health Care Organizations

Before Magnet designation, nurse scientists functioned primarily in academia. The Magnet model's emphasis on new knowledge required that health care organizations demonstrate knowledge generation to achieve and sustain designation. The nurse scientist role definition and function within health care organizations continues to evolve, which contributes to a lack of clarity about who and how nurses generate new knowledge. The purpose of this scoping review was to (1) identify nurse scientist role components in the context of 2 theoretical models (Thompson's Knowledge Brokering Model and Edward's Research Appreciation, Accessibility, and Application Model), (2) explore the strengths and barriers associated with existing nurse scientist practice models in US health care organizations, and (3) describe a unique, expanded practice model applied within Stanford Health Care's Office of Research and its implications for building new knowledge and innovation capacity with recommendations for ongoing role development.

Nurses' Perceptions of the Clinical Nurse Specialist Role Implemented in a Highly Specialized University Hospital in Spain: A Qualitative Study

PURPOSE/AIMS

To explore nurses' perceptions of clinical nurse specialist practice as implemented in a highly specialized university hospital in Spain.

DESIGN

A descriptive qualitative study was carried out in 3 inpatient wards, with a clinical nurse specialist within the team, at a high specialized university hospital in Spain.

METHOD

Semistructured interviews were conducted by purposive sampling with 17 selected nurses with at least 2 years of professional experience who voluntarily agreed to participate and signed the informed consent form. Analysis of the qualitative data was conducted according to Burnard's method of content analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used.

RESULTS

Four main categories emerged from the analysis of the data: "qualities of the role-holder," "role competencies in practice," "integration with the team," and "impact of the role" on nursing, the patient, and the organization.

CONCLUSIONS

The findings of this study have interesting implications for the development and implementation of clinical nurse specialist practice in healthcare organizations. They also provide evidence of the benefit of implementing clinical nurse specialist practice for improving the quality of care, patient outcomes, and healthcare efficiency.