Problem and Significance
Today, patients who come to the hospital are very sick and need multidisciplinary care. A multidisciplinary approach can potentially shorten the patient's length of stay and decrease costs for the facility.
Purpose
The purpose of multidisciplinary rounds is to hear other disciplines' short and long-term plans and goals for the patient while hospitalized.
Description of the Project
The multidisciplinary team meets at 8:30 every morning to discuss the patients and the plan of care. Also discussed is how each discipline can impact each other.
Methods
This project was initiated and implemented by the CNS after consultation with various care managers. Once the managers agreed, discussions followed with the various disciplines that agreed to pilot the project. Rounds, facilitated by the CNS and the case manager, have been successfully conducted for the past 9 months. In addition, the team consists of the charge nurse, the nurse caring for the patient, a respiratory therapist, a dietician, a pharmacist, attending physician (if available), the infection control nurse, the medical resident (who changes every month), 2 interns, a medical student, and the family, if interested. The walking rounds are conducted outside the patient room. The nurses provide an update on the patient and then the multidisciplinary team discusses its plans.
Outcomes
All disciplines have seen rounds as a positive step in terms of patient care. We all work together to see that the patient receives quality care and leaves the hospital as soon as possible. The CNS works with the nursing staff to make accurate assessments, achieve nursing goals, and implement other disciplines' goals.
Conclusions/Implications for Nursing Practice
All disciplines work together toward a common goa-quality care for the patient. The families are pleased with this approach and understand the basis for the care that is being delivered. There is a great respect between the disciplines and each appreciates what the other brings to the team. The planned outcome is that the patient is discharged quickly.
Section Description
This year's annual NACNS conference is planned for Orlando, Fla, March 9-12, 2005. Over 300 clinical nurse specialists (CNSs) are expected to attend, and as with past conferences, attendees will also include graduate faculty from CNS programs, nurse administrators, and nurse researchers. The theme of the conference, CNS Leadership: Navigating the Healthcare Environment Toward Excellence, was selected to showcase the many ways CNSs acquire and disseminate knowledge and innovative practices in their specialty areas. Two preconference sessions are scheduled. One session, sponsored by NACNS Legislative/Regulatory Committee, targets information for CNSs interested in understanding the legislative/regulatory process as it deals with the practice of nursing, and will also help build skills CNSs need to engage in the process. The second session, sponsored by NACNS Education Committee, focuses on CNS education issues, and as with the education preconferences of past years, anticipates informative dialogue and much sharing among CNS educators around curriculum design, teaching strategies, and indicators of quality in the curriculum that link to the NACNS education standards to program review and excellence. The conference planning committee is proud and pleased to have Jeanette Ives Erickson, MS, RN, CNA, Senior Vice President for Patient Care Services and Chief Nurse Executive of Massachusetts General Hospital as the opening keynote speaker. She will begin the conference by highlighting the importance of CNS practice on patient safety. The planning committee is equally proud and pleased to have NACNS past-president Rhonda Scott, PhD, RN, Chief Nursing Officer of Grady Health System as the closing speaker. Dr Scott will challenge attendees to use the information from the conference to shape quality care delivered in a safe environment and to advance the profession of nursing through direct care to clients, influencing standards of care delivered by other nurses, and influencing the healthcare delivery system to be to support innovative, cost-effective, quality nursing care. A total of 64 abstracts for podium and poster presentations were selected in addition to graduate student posters. The abstracts address the 3 spheres of CNS practice with a strong emphasis on clinical practice improvements. As you will note from the abstracts published in this issue of the journal, specialty practice areas represented in the abstracts include children, adults, and gerontological patient groups; hospital, outpatient, and home care settings, and community health. In addition, a wide variety of specialty topics including smoking cessation programs, end-of-life care issues, and protocols outlining nursing approaches to improved diabetes, cardiovascular and ventilator management. A number of the abstracts described hospital and healthcare system level innovations that resulted from CNS practice. Collectively, these abstracts reflect the breadth, depth, and richness of CNS contributions to the well-being of individuals, families, groups, and communities. The following abstracts are from those presenters who elected to have their work published in the journal so those who are unable to attend this year's conference can share in the knowledge of the conference. As you read each abstract, consider the talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to improved outcomes for patients and healthcare organizations. You may want to contact individual presenters to network, collaborate, consult, or share your own ideas about these topics. Watch for next year's call for abstracts and consider submitting an abstract for presentation at NACNS's next conference in Salt Lake City, Utah, March 15-18, 2006.