• Nena Bonuel, Sandra Cesario, and Alma Degracia Cabading.
• The Methodist Hospital, The Center for Professional Excellence, Houston, Texas, USA. nbonuel@tmhs.org
• Crit Care Nurs Q. 2010 Oct 1; 33 (4): 356-60.

AbstractWith the relentless pursuit of patient care quality and patient safety, one has to explore every possible avenue to transform and redesign care delivery to remain solvent and meet the health care needs of patients in the future. Keeping patients undergoing renal transplantation in the same room from admission to discharge positively impacts clinical care outcomes on length of stay and cost. The success of this kind of care delivery lies on 1-week didactic structured training of the transplant nurses based on critical care concepts to manage fluctuations in patients' condition. With an added 3 months clinical rotation in the critical care areas, the competent transplant nurses were able to care for the patients undergoing renal transplantation in the acuity-adaptable medical-surgical transplant floor with confidence. A hybrid nurse was created who possessed both critical care and medical-surgical skills. This can be a potential trend in the professional nurse model to address the health care challenges we face today in terms of nursing shortage, abbreviated plan of care, and facility operation efficiency. Thus, the need for critical care nursing skills is invaluable to the success of an acuity-adaptable care delivery system.

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