Purpose/Objectives:

Partnering with nurses, patients, and families ensures a safe environment when developing a patient/family-initiated rapid response program. Patient safety is the driving motivator behind the design, implementation, and evaluation of this program.

Significance:

Patient/family members are often the first to detect subtle changes in medical conditions. The patient/family-initiated rapid response team (P/FRRT) provides an avenue to address healthcare concerns. Activating P/FRRT can potentially decrease adverse events such as falls, complications, codes, and mortality. Joint Commission National Patient Safety Goal 16A3 states, "The organization empowers the staff, patients, and/or families to request additional assistance when they have a concern about the patient's condition."

Design/Background/Rationale:

A large, midwestern hospital seized the opportunity to implement a P/FRRT program that demonstrates commitment to patients and families by including them as integral participants of the healthcare team. In 2006, there were fewer than 10 hospitals across the country that had implemented such programs. The clinical nurse specialist (CNS) was the catalyst in the creation of an innovative process that would lead to a truly unique program.

Methods/Description:

The process of prepare, educate, implement, and evaluate are foundational steps that were used by the CNS repetitively to provide the structure to support a P/FRRT program.

Prepare: [white square]Network [white square]Project management [white square]Focus groups

Educate: [white square]In-services [white square]Computer based training [white square]Admission packet

[white square]Laminated signage

Implement: [white square]Pilot unit [white square]House-wide rollout

Evaluate: [white square]Monthly meetings [white square]Event Reporting System [white square]Monthly data report [white square]Rapid response consortium

Findings/Outcomes:

The CNS ensures that practice changes are evidencebased and/or data driven. From data collected, the CNS tracks number and types of calls, monitors utilization trends, patient outcomes, and systems-level impact. Root-cause analysis identifies opportunities for system improvement and service recovery.

Conclusions:

The P/FRRT ensures safe environment, improves patient outcomes, encourages patient/family participation among the healthcare team, and promotes patient/family-centered care.

Section Description

The 2009 NACNS National Conference will be held in St Louis, Missouri, on March 5 to 7. More than 350 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are registered. This year's theme, "Clinical Nurse Specialists: Vision, Value, Voice," demonstrates the essential leadership skills of the CNS as well as the CNS role in implementing evidence-based practice.

Seventy abstracts were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session. The abstracts addressed CNS practice in 3 practice domains (spheres of influence), emphasizing patient safety and quality care outcomes, leadership, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into 3 spheres of influence-patients, nursing practice, organization/system-including the development of clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, CNS practice in end-of-life care decisions, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNSs' contribution to the well-being of individuals, families, communities, as well as to the advancement of the nursing profession.

The conference abstracts were published here to facilitate sharing this emerging new knowledge with those who were unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics. Watch out for next year's call for abstracts and consider submitting for presentation at NACNS' next annual conference in Portland, Oregon, on March 4 to 6, 2010.