Clinical nurse specialist CNS
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The focus on recovery for persons with severe and persistent mental illness is leading state psychiatric hospitals to transform their method of care delivery. This article describes a quality improvement project involving a hospital's administration and multidisciplinary state-university affiliation that collaborated in the development and implementation of a nursing care delivery model in a state psychiatric hospital. ⋯ The role of the advanced practice nurse can influence the recovery of clients in state psychiatric hospitals. Future research should consider the impact on clients and their perceptions of the new service models.
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Family presence (FP) during resuscitation is a controversial practice that leads to disagreement among health care professionals. A systematic review of the literature was performed to answer the question: What are the attitudes of health care providers regarding family presence during resuscitation of adults? ⋯ More research is needed to determine if FP is evidence based; however, there is sufficient evidence to consider implementing FP. There is wide variation in support for FP among health care professionals, although nurses generally are more favorable. If an institution elects to implement an FP policy or evidence-based practice guideline, it must carefully consider the many provider, patient, family, and system-level factors that can hinder or promote the success of this initiative.
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The purpose of this quality improvement project was to determine if the use of standardized insulin orders versus the use of nonstandardized insulin orders improved glucose results in a hospital's critical care unit. A clinical nurse specialist-led interdisciplinary team developed standardized insulin orders with the goal of improving glucose control. ⋯ A mean glucose of 175 mg/dL and median glucose of 149 mg/dL were the outcomes when standardized insulin orders were used versus a mean glucose of 206 mg/dL and median glucose of 190 mg/dL when standardized orders were not used. System change efforts to improve glucose control resulted in improved staff nurse empowerment, improved provider knowledge of glucose control methods, and improved patient glucose control in this Midwestern hospital.