Clinical nurse specialist CNS
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Describe nurses' ability to recognize delirium on both intensive care unit and medical-surgical units. ⋯ Tremendous opportunity exists in nursing education for learning about negative outcomes associated with delirium and the importance of routine assessment. Clarification of negative sequelae related to delirium will lead nurses to value and understand the importance of early detection. Appropriate use of a standard cognitive assessment and an instrument designed to detect delirium is vital in a successful delirium prevention program. Providing nurses with educational resources and opportunities to apply knowledge will increase confidence in identification and management of delirium.
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This study compared outcomes of a fast-track postoperative program implemented for patients undergoing laparoscopic colorectal surgery on 2 surgical units to patients receiving traditional postoperative care following laparoscopic colorectal surgery prior to implementation of the fast-track program. ⋯ Fast-track programs in colorectal surgery reduce length of stay and could be considered for other surgical populations.
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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 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.