Clinical nurse specialist CNS
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Concerns about acute pain management prompted the development of a pain management program. The program, with assessment, intervention, and evaluation components, was introduced by the clinical nurse specialist (CNS) in collaboration with a multidisciplinary team. The assessment phase included a descriptive study of postoperative pain and a baseline audit of nursing documentation related to pain assessment and management. ⋯ Additionally, at each follow-up evaluation, patients reported decreased postoperative pain. The assessment and management of pain is an important domain of nursing practice. The CNS is in a unique position to influence nursing practice and to impact on patient outcomes in this area of pain management.
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This retrospective study examined the medical records of 100 patients who experienced an in-hospital cardiopulmonary arrest. The purposes of this study were to identify pre-arrest physiologic changes that may have occurred in the patient and to determine whether physician notification time, physiologic variables, patient location, and the presence of an electrocardiogram (ECG) monitor before the arrest affected the resuscitation outcome. The results showed that assessment variances were present in most patients before the arrest and also were recognized by the nursing staff. Implications for practice include formation of quality improvement screening tools to assess the patient's pre-arrest status, development of competency tests that include scenarios involving changes in a patient's physiologic parameters, staff education, and evaluation of current nursing policies for obtaining vital signs and assessments.
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Comparative Study
Comparison of the oral thermometer versus the tympanic thermometer.
After the use of tympanic thermometers replaced the use of oral thermometers at the Veterans Affairs Medical Center in Memphis, the nursing staff initiated a comparison study of the two instruments, monitoring 160 temperature readings. Current studies demonstrate that tympanic thermometers give presumably higher temperature readings than do oral thermometers. ⋯ It may be premature to conclude that the oral thermometer is not as accurate as the tympanic thermometer. Removal of this proven oral system may need to be evaluated, and further comparison studies should be conducted before the tympanic thermometer is unconditionally embraced as the more accurate of the two.
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The aims of this study were to describe and assess nutritionally at-risk patients' energy intake and nurses' knowledge and opinions of patients' need of energy during their hospital stay, before and after training and education. The effects of the intervention were evaluated by using a questionnaire, answered by the nurses before and after the intervention, and indirectly by measuring the patients' nutritional outcome, using a nutritional assessment form. ⋯ Nurses' knowledge about the content of energy in a standard portion of food had increased, and they found it easier to assess patients' need of energy. After the education, more nurses had the opinion that well-educated nurses in nutrition make it easier to motivate patients to reach a sufficient intake of energy.