Purpose/Objectives:
To delineate CNS involvement at the hospital and unit level to successfully reduce the incidence and prevalence of pressure ulcers by changing nursing practice.
Significance:
Recent regulatory changes in the way that hospital-acquired pressure ulcers are reimbursed put nursing practice front and center in the skin care arena. The rules may have tightened, but nursing interventions remain the key in preventing and treating pressure ulcers.
Background/Rationale:
Decisions made by the bedside nurse are at the heart of pressure ulcer care, and the CNS needs to be a resource when it comes to staging and recommending treatment. CNS presence at the unit level is an effective approach to implement evidence-based practice at the bedside.
Description:
Strategies implemented in a 1,300-bed major medical center will be presented. Discussion will include dissemination of a hospital-wide education program, encouraging the development of unit-based skin care resource nurses, and CNS involvement at the unit level to improve pressure ulcer prevention and care, in collaboration and partnership with the management team.
Outcome:
Multifaceted interventions resulted in a 50% reduction in pressure ulcers rates in 1 year. The CNS approach proved to be the key in continuity of pressure ulcer care and prevention.
Interpretation/Conclusion:
Pressure ulcer prevention is a nurse-sensitive indicator of quality of care. The CNS role is ideally suited to drive practice change and therefore improve quality.
Implications for Practice:
Participants will come away with a method for demonstrating the impact of the CNS in enhancing reimbursement and implementing cost-saving tactics in the acute care environment. Participants will be able to translate this experience into their own practice settings.
Section Description
The 2010 National Association of Clinical Nurse Specialists (NACNS) Annual National Conference is planned for Portland, Oregon, on March 3 to 6. More than 375 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are expected to attend. This year's theme, "CNS as Internal Consultant: Influencing Local to Global Systems," demonstrates the breadth and depth of CNS practice and leadership at multiple levels in organizations and on healthcare.
A total of 142 abstracts were submitted for review, and 58 (not including student posters) were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session; student abstracts will appear in a later issue of the journal. The abstracts addressed CNS practice in all 3 practice domains as described in the Spheres of Influence Framework for CNS Practice. Abstracts emphasized patient safety and quality care outcomes, leadership, CNS education, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into the 3 Spheres of Influence, the role of the CNS in developing clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, the role of the CNS in National Database for Nursing Quality Indicators (NDNQI) activities, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNS's contribution to the well-being of individuals, families, and communities, as well as contributing to the advancement of the nursing profession.
The conference abstracts are published to share new knowledge with those 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 for next year's call for abstracts and consider submitting for presentation at the next NACNS annual conference scheduled for March 9-12, 2011, in Baltimore, Maryland.