Background

There is a growing need to provide staff nurses with education and resources related to caring for patients who experience trauma and are cared for outside of the ICUs. A team headed by the CNS agreed on the need to provide basic information to new trauma nurses on a busy trauma/surgical floor.

Purpose

The purpose of the practice innovation was to develop, implement, and evaluate a clinical guide that provided basic concepts to new nurses during their initial orientation to a large medical center. The guide contained information that would extend current nursing knowledge and include issues that arise with the surgical/trauma patient population.

Innovation

Data used to support the development of the learning guide were generated from nurses experiences and conversations with new nurses and senior nurses as they tried to determine what was missing from orientation and the orientation literature. New nurses wanted to know the nuances of trauma care on the floor. This included general information about monitoring certain types of patients and their expected response. They also expressed interest in bedside emergencies that may arise and complications that are commonly seen in the trauma population. Content included in the guide was determined by reviewing trauma program guidelines, textbooks on the topic, and reflecting on clinical knowledge about the population cared for on the trauma/surgical floors. The team decided to organize the content in the guide using a head-to-toe assessment approach and to discuss a typical trauma patient and trauma experiences seen on the hospital units. The team described the patient's experiences from the time EMS arrived on the scene, and to include the sequence of events once a patient enters the ED. Building on this information, a patient assessment was created to guide care when the patient is admitted to the trauma unit and specific injuries are documented. Major body systems review included a review of signs and symptoms, physical and psychosocial assessment, and potential injuries and treatment. Each presentation was followed by several questions to help reinforce the material covered.

Validation

The content was validated and discussed with senior nurses, new nurses, CNS, and other experts in the trauma field. Literature used to develop the guide came from resources such as ATLS, ACLS, Trauma Nursing Text, and TNCC text. Experts in the field of trauma nursing will review it and the final draft will be honed by and in collaboration by the aforementioned staff.

Implementation

The guide will be piloted and distributed to assess for effectiveness and usefulness. The team will evaluate learning by using pre-post test measures following exposure to the guide. A case study review will be used to evaluate knowledge acquisition. Following this effort, the guide will become included in the orientation materials to better address the needs of the trauma nurses who are working with this ever-changing population.

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.