tarea

SIMPOSIUM
DEMONSTRATING THE VALUE OF CLINICAL NURSE SPECIALISTS IN ACUTE AND CRITICAL CARE MARY FRAN TRACY , RN, PHD, CCNS MARY FRAN TRACY IS THE EDITOR OF AACN ADVANCED CRITICAL CARE AND CRITICAL CARE CLINICAL NURSE SPECIALIST, UNIVERSITY OF MINNESOTA MEDICAL CENTER, 500 HARVARD ST. SE, MINNEAPOLIS, MN 55455 ( MTRACY1@FAIRVIEW.ORG ). THE AUTHOR DECLARES NO CONFLICTS OF INTEREST.
The idea forthe symposium in this issue of AACN Advanced Critical Care came to me at the National Teaching Institute in Denver, Colorado, May 2014. A colleague, Roberta Fruth, a senior consultant with JCR Consulting, and I were discussing the challenges of the current health care environment. In her role, Dr Fruth consults with health care institutions on how they can create highreliability organizations andimprove patient safety. Dr Fruth commented that the complexity of today’s patient populations, the financial pressures of organizations, and the demands of the regulatory environment present overwhelming challenges to frontline staff. Her comment to me was that organizations need the expertise of clinical nurse specialists (CNSs)—to provide leadership in clinical expertise, quality improvementefforts to optimize patient outcomes, and professional advancement of the nursing staff—but the contributions of CNSs are not well recognized. As a CNS myself, of course I totally agreed! Why don’t all organizations use CNSs? Some senior leaders lack an awareness of the CNS role or the contributions CNSs provide in achieving organizational goals. I have heard some chief nursing officers comment thatCNSs don’t generate revenue; therefore, they are seen as a costly investment to a nursing department. This statement is only partially true—CNSs functioning in the traditional role don’t typically bill or generate revenue, but neither do nurse managers, nursing directors, staff nurses, or educators. Yet all, like CNSs, play valuable roles in the delivery of optimal care to patients and thefunctioning of the health care institution. So how do we increase the visibility of the wonderful outcomes CNSs can and have achieved? I continued to think about our conversation as I attended sessions at the National Teaching Institute and realized how many of the presenters were CNSs highlighting the good work they were doing in cost avoidance, decreasing lengths of stay, optimizing patient safety,improving patient outcomes, and mentoring staff nurses in evidence-based practice and professional presentation opportunities. All these contributions add value and are critical elements in improving health care delivery. It became clear that AACN Advanced Critical Care could highlight some of these success stories.
Therefore, this series provides examples of the work of CNSs. Lisa Soltisdescribes an interdisciplinary quality improvement project she led to improve the care of cardiovascular surgical patients in improving early extubation times Mary Fran Tracy, RN, PhD, CCNS Symposium Editor Copyright © 2015 American Association of Critical-Care Nurses. Unauthorized reproduction of this article is prohibited. NCI-D-14-00055.indd 33 CI-D-14-00055.indd 33 27/12/14 3:58 AM 7/12/14 3:58AMSymposium WWW.AACNADVANCEDCRITICALCARE.COM 34 after surgery. This project resulted in significant decreases in length of stay, decreased intensive care unit readmissions, and impressive cost savings. Stacy Jepsen describes a group effort in her institution to develop a CNS scorecard, clearly documenting to senior leaders the tangible outcomes of CNS-led quality improvement efforts. Dave Hansonhighlights the valuable role CNSs play in the achievement of Magnet recognition. Finally, Paul Thurman describes one state’s efforts to ensure that CNSs are legally recognized as advanced practice nurses, protecting the use of the title and ensuring that CNSs are afforded the opportunity to practice to the full extent of their education and training, as recommended by the Institute of Medicine’s 1 The...