ARDS/ALI: Bundling Care to Impact Outcomes
Content Description
What ventilator techniques, pharmacological agents or routine care practices have made the difference between life and death for the patient with Acute Respiratory Distress Syndrome? What role does the critical care nurse play in the supportive management of the ARDS patient?
This session will review the pathophysiologic processes seen in ARDS. A discussion of assessment cues for early diagnosis and continued evaluation of the progression of acute lung injury and the systemic response will be explored. The session will emphasize an in-depth critical analysis of the multidisciplinary approach to supportive modalities key to improved survival rates in ARDS. Focus will be placed on new ventilator strategies to minimize lung injury and research based interventions such as positioning to optimize patient outcomes and reduce the risk of infection. The session will conclude with a review of experimental therapies currently being tested.
Nurses who attend this session should possess basic knowledge of pulmonary physiology and mechanical ventilation. Participants should express an interest in learning pathophysiologic concepts and research regarding the care of patients with severe lung injury.
(1 hour and 15 min, 2 one hour presentations or 3 hour)
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Surviving Sepsis Campaign: Impacting Patient Outcomes
Program Description
Many consider severe sepsis & multiple organ system failure (MODS) to be the final common pathway to death in the ICU and the leading cause of mortality. With repeated exposure to a "turned on" inflammatory & coagulation system, our organs experience fluctuating states of dysfunction before failure occurs. What role does the nurse play in recognition and early management of the patient with severe sepsis?
This session begins by defining the sepsis continuum and the three phases to the surviving sepsis campaign. A look at the proposed pathogenesis and pathophysiologic mechanisms of injury will be presented to enable the nurse to recognize and minimize the impact of uncontrolled inflammation, coagulation and reduced fibrinolysis on the critically ill patient. An in-depth review of the category A and B evidence e of the sepsis guidelines will be covered. The session will conclude with strategies for moving the campaign outside the walls of the ICU to improve on recognition and early resuscitation.
The session is intended for critical care nurses, educators and clinical specialists. Nurses who attend this session should possess basic knowledge of inflammation, coagulation and stress response. Participants should express an interest in learning advanced pathophysiologic concepts and research regarding the bedside care of patients with severe sepsis.
(1 hour and 15 min or 4 hour when combined with ARDS)
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Sepsis: Early Management Saves Lives
Program Description
Many consider severe sepsis & multiple organ system failure (MODS) to be the final common pathway to death in the ICU and the leading cause of mortality. However, organs systems just don't quit or cease to function. With repeated exposure to a "turned on" inflammatory & coagulation system, our organs experience fluctuating states of dysfunction before failure occurs. What role does the critical care nurse play in management of the patient with severe sepsis & MODS?
This session begins by defining the sepsis continuum and the path to multiple organ dysfunction syndrome (MODS). An examination of risk factors for the development and progression of severe sepsis will be discussed. A look at the proposed pathogenesis and pathophysiologic mechanisms of injury will be presented to enable the nurse to recognize and minimize the impact of uncontrolled inflammation, coagulation and reduced fibrinolysis on the critically ill patient. The session will conclude with an in-depth examination of the multidisciplinary approach to prevention and management of severe sepsis. Emphasis will be placed on presenting research-based interventions to optimize patient outcomes.
The session is intended for critical care nurses, educators and clinical specialists. Nurses who attend this session should possess basic knowledge of inflammation, coagulation and stress response. Participants should express an interest in learning advanced pathophysiologic concepts and research regarding the bedside care of patients with severe sepsis & multiple organ dysfunctions.
(1 hour and 15 min, can be expanded to 2 hours)
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The Right Position at the Right Time: Mobility Makes A Difference
CONTENT DESCRIPTION:
What effect does positioning have on a critically ill patient's musculoskeletal, cardiovascular and pulmonary status? For a number of years, nurses have recognized that positioning prevents skin breakdown, mobilizes secretions and provides comfort without identifying the impact different types of positioning strategies have on pulmonary gas exchange, ventilator weaning outcomes and the prevention of de-conditioning in survivors of ICU care. The importance of positioning as a priority of practice is challenged in a high technology based environment. In a study looking at positioning of critically ill patients over an eight-hour time period only 2.70% achieved every 2-hour position change and 49.5% never moved during an eight-hour period. Critical care nursing has a problem and the solution rest in increasing awareness of the importance of positioning on short and long term patient outcomes. If we do not pay attention to this care activity it does not get done.
The session is designed to explore the science supporting the use of various positioning strategies including prone position, rotational therapy, unilateral positioning, head of bed elevation and adaptation to dangling and walking the ventilator patient. Strategies to assess patient adaptation and help facilitate progressive mobility will be outlined. Challenges to achieving the position and the barrier of hemodynamic instability will be brought into question. Mobility is a fundamental nursing activity that requires in-depth knowledge and skill to effectively apply to critically ill patients. When mobility is a core component of care it helps with secretion management, reducing feelings of powerlessness, preventing muscle wasting, improving gas exchanging and decreasing the incidence of atelectasis and ventilator associate pneumonia. Matching the right time of the illness to the right positioning strategy will help to achieve positive patient outcomes.
(1 hour and 15 min, can be expanded to 2 hours)
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Positioning: To Everything, Turn, Turn, Turn............
Content Description:
What effect does positioning have on a critically ill patient's cardiovascular and pulmonary status? For a number of years, nurses have recognized that positioning prevents skin breakdown, mobilizes secretions and provides comfort without identifying the impact position has on pulmonary gas exchange. This session is designed to introduce the concept of safe, practical application of positioning as a collaborative treatment modality for critically patients with pulmonary dysfunction. An integral part of the session will be a review and critique of significant positioning research. Discussion of techniques/apparatuses to facilitate positioning will be incorporated. The session will conclude with application of research findings into practice through the use of a decision tree.
The goal of this session is to bring the body of research surrounding the independent nursing activity of positioning to a level of clinical mastery for the critical care nurse.
The development of critical thinking and decision making skills require comprehensive information on a topic in order to synthesize and devise a plan. This session provides both the negative and positive aspects of positioning critically ill patients enabling the nurse to make these decisions at the bedside.
This session is designed for staff nurses, educators and clinical specialists Nurses who attend this lecture should possess basic knowledge of pulmonary physiology and pathophysiology. Participants should express an interest in learning about a body of research which impacts their independent nursing practice to facilitate positive patient outcomes.
(1 hour and 15 min, can be expanded to 2 hours)
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Prone Positioning for the ARDS Patient
Content Description
The Incidence of ARDS in the United States reported annually ranges from 250,000 to 400,000. Mortality rates remain in the 40 to 60 percentile despite advances in the care of critically ill patients over the past 20 years. A variety of treatments modalities are used in an attempt to support the lung of the ARDS patient and improve gas exchange during the acute injury phase. However, it appears that the simple non-invasive act of prone positioning of the critically ill ARDS patient may improve gas exchange while preventing potential complications of high positive end expiratory pressure(PEEP), volutrauma and oxygen toxicity.
This session will provide the critical care nurse with the physiologic rationale for use of the prone position, indications and contraindications for use, a step-by step procedure for safe prone positioning utilizing a patient prone positioner, methods of assessing effectiveness, and determining positioning schedules based on physiologic variables.
This session is designed for staff nurses, educators and clinical nurse specialists. Nurses who attend this lecture should possess a basic knowledge of pulmonary physiology. Participants should express an interest in learning about a body of research which impacts their independent nursing practice to facilitate positive patient outcomes.
(1 hour and 15 minutes)
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The Power of One: Impacting Outcomes By Returning to the Basics
Content Description:
You can make a difference. The leading medical errors in this country fall within nursing's independent scope of practice. The pooled mean rate for ventilator associated pneumonia ranges between 2.4 to 14.7 with a 10 to 40% crude mortality rate. The incidence for hospital acquired pressure ulcers in the ICU ranges from 15% to 40% with the associated cost of pain, suffering and a financial burden to our health systems. We have the ability to change the fundamentals of our work and significantly impact patient outcomes. The challenge to incorporating new evidence into practice lies in altering our routinized behavior and current unit nursing culture in order to support new care practices.
What are some nursing routine care practices based in tradition versus evidence that need to be updated? Oral care, bathing, and pressure ulcer prevention are just a few of the interventions critical care nurses perform on a daily basis. The positive and negative impact of these activities on ventilator-associated pneumonia, resistant microorganism outbreaks, wasted energy work, pressure ulcers and host defense has been the source of considerable research over the past 10 years. We must utilize the evidence in decisions regarding the type, timing and number of interventions to perform in order to maximize patient's adaptation to routine stressors within the environment. Break the routines and traditions of your current work place. Be the power of one by initiating and measure the changes in care practices that nursing owns.
(1 hour and 15 up to 2 hours)
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Back to the Basics: Getting There With Science
Content Description:
Researched based practice is necessary to achieve cost effective, quality outcomes when caring for the critically ill patient. Which studies do we incorporate into our practice? How do we know whether the research is valid? Knowledge of the research utilization process is key to a successful change in practice at the bedside.
What are some nursing routine care practices based in tradition versus research that need to be updated? Oral care, bathing, invasive line care and incontinence management are just a few of the interventions critical care nurses perform on a daily basis. The positive and negative impact of these activities on ventilator pneumonia, O2 consumption, pressure ulcers and host defense has been the source of considerable research over the past 10 years. We must utilize the evidence in decisions regarding the type, timing and number of interventions to perform in order to maximize patients adaptation to routine stressors within the environment. Break the routines and traditions of your current work place. Be the change agent and bring the latest evidence to the bedside.
(1 hour and 15 up to 2 hours)
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Target Zero: Strategies for Lowering Ventilator-Associated Pneumonias (VAPs) & Blood Stream Infections (BSIs) in Your ICU
Content Description:
Ventilator associated pneumonias & blood stream infections are a considered to be medical errors and currently result in anywhere from zero to forty percent mortality rate. The estimate cost per pneumonia is $21,000.00 & up to $36,000.00 per blood stream infection. How can we prevent these? What evidence do we need to incorporate into our practice? Positioning, oral care, enteral feeding, suctioning, ventilator equipment, and line insertion techniques are just a few of the practices/interventions critical care practitioners perform on a daily basis that may positively or negatively impact whether the patients gets a ventilator associated pneumonia or a blood stream infection. Research over the last decade has focused on a number of care activities that have been shown to reduce the incidence of pneumonia while on a ventilator and blood stream infections related to central line placement in the critically ill patient.
We must utilize evidence-based information in decisions regarding the type, timing and number of interventions to perform in order to maximize the critically ill patients adaptation to routine stressors within the environment. Break the routines and traditions of your current work place. Take ownership of one of the major roles of a professional registered nurse: preventing complications. Be the change agent and bring the latest evidence to the bedside to ensure positive patient outcomes.
(1 hour and 15 minutes up to 2 hours)
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Target Zero: Strategies for Reducing VAP's within Your ICU
Program Description:
Evidence based practice is necessary to achieve cost effective, quality outcomes when caring for the critically ill patient. What are some routine care practices based in tradition versus research that need to be updated to impact VAP? How do you bring the evidence into your current ICU culture and shape the change to reduce the incidence of pneumonia in the critically ill mechanically ventilated patients.
Ventilator associated pneumonias are a considered to be a medical error and currently result in a 10-25% increase in mortality rate. The estimate cost range is from $30,000.00 to $40,000.00 per pneumonia. How can we prevent this? Which studies do we need to incorporate into our practice? Positioning, oral care, enteral feeding, suctioning, and ventilator equipment changes are just a few of the practices/interventions critical care practitioners perform on a daily basis that may positively or negatively impact whether the patients on a ventilator gets pneumonia.
We must utilize evidence-based information in decisions regarding the type, timing and number of interventions to perform in order to maximize the critically ill patients adaptation to routine stressors within the environment. Break the routines and traditions of your current work place. Be the change agent and bring the latest research to the bedside.
(1 hour and 15 minutes up to 2 hours)
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The Forgotten Organ: A Team Approach for Skin Care of the Critically Ill Patient
Content Description:
The skin is the first line of defense against invading organisms and the organ we often overlook when caring for our critically ill patients in a high tech environment. The incidence of pressure ulcers in the critical care arena ranges from 15% to 40%. In today's cost conscious environment, this type of preventable injury can no longer be place in a low care priority position. Nursing can have a significant impact on reversing these negative outcomes. Mastery of the clinical knowledge and skills necessary to impact and create change in skin care practices is essential. This session will succeed in providing the critical care nurse with numerous examples, research based techniques and knowledge to make the change happen within his/her own environment.
This session will focus on a team approach to research based prevention and treatment of skin alterations created by pressure and incontinence, the two greatest skin risk factors facing the critically ill patient. A review of pressure ulcer classification and stages of wound healing will form the foundation. The session integrates successful patient and financial outcomes of a unit base model for prevention and treatment of the critically ill patient's skin.
The session is designed for critical care nurses, educators and clinical specialists. Participants recognize that care of the critically ill patient's skin belongs to the nurse and therefore, we are accountable for patient outcomes related to skin care. To attend, prerequisite knowledge is not essential, however, enthusiasm and a willingness to make a difference is a must.
(1 hour and 15 min)
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If Florence Knew…How & When Did We Get So Lost: Examining Nursing's Unique Contributions to HealthCare (Keynote address)
Content Description
To shape the practice we want it is essential to have a clear understanding of what is professional nursing. There has been a lack of consensus & great confusion over the years in how we define our practice and ourselves, making it difficult to articulate who we are & what we bring as professionals to the health care arena. Nightingale's reflection on nursing over 130 years ago clearly articulates some of the same problems we face today. She said "nursing has been limited to signify little more than the administration of medicines and the application of poultices. It ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet and the proper use & selection of diet and this should be at the least expense of vital power to the patient. The goal is to put the patient in the best condition for nature to act upon him.
This session will open with a discussion of three factors that contribute to confusion regarding identity issues in nursing. An emphasis will be placed on defining health from a nursing perspective as well as understanding nursing's autonomous scope of practice. Video segments of bedside nurses & patients articulating nursing's unique contributions to health care will be used to demonstrate principles outlined in the presentation. The session will conclude with an opportunity to celebrate our successes.
This session is designed for nurses who have lost touch with the essence of why they wanted to become a nurse or require the skill & knowledge to better articulate the unique contributions of nursing to the consumers of health care.
(1 hour to 1 hour & 30 minutes)
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Creating an Environment for Change: Tools & Techniques to Impact Patient Outcomes at a Unit Level
Content Description
The Clinical Nurse Specialist, Unit Manager and bedside nurse are in an excellent position to lead and design the necessary changes required in acute care to meet the economic and legislative agendas to reshape health care delivery. The key to successful navigation of change is the ability to draw a map highlighting the barriers and facilitators to achievement of the clearest path to change. Although change is most often an opportunity for growth and expansion, it is frequently looked upon with great fear and uncertainty.
Organizational structure and unit culture will shape clinical practice and often determines the degree of difficulty experienced when change occurs. How do we create a value change and develop an environment that fosters professional growth and enthusiasm towards change and quality improvement? This session will focus on front-line strategies developed and implemented in a MICU to enhance the staffs feelings of personal power, ownership in their own destiny and a solid functioning team proactively changing their environment.
As we move toward the 21st century, the pace of health care reform is rapidly accelerating. The opportunity exists to positively influence change within your unit and organization.
(1 hour and 15 minutes)
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To Err is Human-To Reduce Medical Errors is Divine: Creating an Environment for Change
Content Description
The multidisciplinary unit team is in an excellent position to lead, participate and design the necessary changes required in acute care setting to meet the patient safety agenda healthcare is faced with today. The key to successful error reduction is the ability to change the current culture of blame and fear of punishment to a unit culture that sees mistakes as information that must be analyzed in order to change systems that support the employee. Although cultural change is most often an opportunity for growth and expansion, it is frequently looked upon with great fear and uncertainty.
Clearly, the organizational structure and unit culture will shape clinical practice and often determines how medical errors are reported and managed. How do we create a value change and develop an environment that fosters professional growth and enthusiasm towards change, self-review and continuous quality improvement? This session will focus on front-line strategies developed and implemented in a MICU to enhance the staff's feelings of personal power, ownership in their own destiny and a solid functioning team proactively changing their environment and in the process reducing medical errors.
As we move toward the 21st century, the pace of health care reform is rapidly accelerating. The opportunity exists to positively influence change within your unit and organization.
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Mind, Body and Spirit: Making the Connection by Creating A Healing Environment
Content Description:
The critical care area is an extremely stressful environment where anxiety is prevalent, pain frequent, rest difficult and sleep almost impossible. The ICU with its flashing lights, alarms, hectic pace and numerous unfamiliar faces can heighten the pain experience and create agitation. Significant amounts of pharmacological agents are used in critical care to manage patient response to their illness & environment. Clearly, if we were to assess the percentage of time the caregivers spend with the patient versus the time the patient spent interfacing with the environment, we would recognize that the environment must be considered as a therapeutic caregiver.
This session will focus on a review of the literature on environmental factors which impact healing and examine strategies to overcome these barriers. A plan for changing a medical critical care environment to create a more healing atmosphere for patients and families will be introduced. The team believes noise level, color of the walls, type of art, exposure to nature, natural or artificial lights and interaction of the caregiver and family all impact healing and recovery. The team's goal is to provide a caring, comfortable and safe passage to wellness or death while minimizing the stress within the environment. A discussion of a three-phase plan for the introduction of music, complimentary therapies and structural alterations will be reviewed. Initial data regarding outcomes of the planned change will be presented.
This session is intended for all nurses. We have a unique opportunity to influence our patient's road to recovery and significantly impact their level of satisfaction by creating a more healing environment. Healing integrates both science and spirituality and assumes a strong connection between the body, mind and spirit.
(1:15 min)
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Completing the Circle: Grief Management for Families and Staff Through Development of a Unit-Based Bereavement Committee
Content Description
Grief is a normal emotion that accompanies death, not only for the loved ones of patients, but for caregivers as well. When engaged in a care-giving relationship for long periods of time, it is natural to develop a bond with the patient and family. However, if death should occur in the critical care environment, often the family quickly departs & little or no contact is maintained. We recognized an opportunity to impact the grieving process of our patients' families as well as for ourselves through the initiation of a bereavement program within a medical intensive care unit. This session will share strategies for the development and implementation of a unit-based bereavement committee to help facilitate adaptive movement through the stages of grief for families & staff. Information will be discussed regarding the barriers and facilitators to the change process. The session will conclude with a presentation of the impact this program has on the families who have lost a loved one as well as the on the caregivers who provided support during the dying process. This session is intended for all nurses. Death can be a frightening and emotionally draining experience for both the family and caregiver. Through the implementation of a bereavement program we have successfully begun to meet the emotional needs of our families upon the death of their loved one while anchoring a sense of fulfillment & completion of the grief process for the staff.
(1 hour & 15 minutes)
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Igniting the flame: Leaderships Role in Mentoring the Staff Nurse in Research Utilization and Conduct
Content Description:
Conducting and moving research into practice is paramount in ensuring outcome driven patient care. With limited educational preparation and experience in the conduct of research, staff nurses often experience difficulty in conduct or utilization of research to find the answers for clinical questions at the bedside. Formation of a mentoring program between the staff nurse, managers and advance practice nurses provides the necessary support and resources to learn the research process. This session will describe how a staff nurse is able to be involved in the research process through mentoring. Examples will be used to provide a step by step guideline for impacting patient care through the research process. A description of the role of a mentor in the clinical and professional development of the bedside nurse will be outlined. The focus on a team approach to research by balancing the expertise of all those involved will serve as the foundation for this session. Nurses who are willing to take charge of their clinical and professional growth should attend this session. It is time to break down the wall of fear and uncertainty related to participation in the research process.
(1 hour)
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Inventing: From Idea Development to Market
What is your product idea? How is it unique? Who would utilize your product and how large is the potential market? How much money will you need for start up expenses and where might you go to finance your project?
These questions and others will be addressed through examining the process from idea development to market reality of a patient prone positioner. Strategies for protecting your idea, outlining the patent process as well as suggestions for financing the development of a product will be discussed. The session will conclude with reviewing options for getting your product to market through a licensing agreement or self-manufacturing. The avenues for creativity and advancement are limitless. Don't wait to hear yourself say, "I thought about doing that", as you stand by and watch your idea being developed and marketed by someone else. The climate for creativity and change is ripe.
This session is designed for nurses who are tired of giving away their ideas and seek information and a plan to make their idea turn into a reality. To attend, prerequisite knowledge is not essential, but an entrepreneurial spirit is a must. The outcome of participating will be to stretch your comfort zone and provide the learner with new knowledge & skills to help engineer a dream.
(1 hour or 1 ½ hours)
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Seize the Opportunity: Nurse Entrepreneurship
Content Description:
Nurses... seize the opportunity!!!
With the current environment for significant health care reform, the nurse is presented with many unique opportunities for entrepreneurship. What is your business idea? How is it unique? Who would utilize your product and how extensive is the market? How much money will you need for start up expenses and where might you go to finance your project. Do I have what it takes to succeed? These questions and others will be addressed through examining the step-by-step process from idea development to market reality of a patient prone positioner. This session is designed for the nurse who has entrepreneurial thoughts and is looking for guidance on how to get started.
Strategies for protecting your ideas will be discussed, along with suggestions for financing the development of a product. The components of the business plan will be reviewed and a market analysis for the patient prone positioner will be presented. Suggestions for marketing yourself and the product will be provided through real life examples. Decisions regarding the organizational structure of your business will be reviewed as well as opportunities for linking business ventures.
The avenues for creativity and advancement are limitless. Don't wait to hear yourself say, "I thought about doing that", as you stand by and watch your idea being developed and marketed by someone else. Seize the moment... the climate for creativity and change is ripe.
(1 hour and 15 min)
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Taking the First Step: Discovering the Path to Success
What does it take to make a major change in life? How will I get myself ready? What are the skills and abilities I need to eliminate my fears and forge out into the unknown? This session will focus on highlights from the day of successful business and personal development strategies that will help lift us out of our routine. Audience interaction will be essential to help produce an outcome for each participant of at least one new direction to their career and a solid method to begin the journey.
(1 hour workshop)
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Nursing Intrapreneurship and Entrepreneurship: Creating Opportunities for a Life Adventure
With the current environment engaged in significant health care reform, the advanced practice nurse is presented with many unique opportunities for intrapreneurship and entrepreneurship adventures. What is your business idea? How is it unique? Who would utilize your product and how extensive is the market? How will it be funded or how much money will be needed for start up expenses? Where might you find internal or external funding sources for your project? Do I have what it takes to succeed? These questions and others will be addressed through examining one Clinical Nurse Specialist's parallel career path in developing intrapreneurial and entrepreneurial businesses.
Ideas for successful businesses usually arise from solution development surrounding problems that exist in our everyday work and personal life. Learn how to recognize the opportunity and seize on the potential business development. This session will outline the skills necessary to succeed in the business world as well as strategies for creating internal or external businesses out of projects you may be currently working on. Methods for protecting your idea will be outlined as well as components of a business plan. Suggestions for marketing yourself and your product will be provided through real life examples as well as opportunities for linking business ventures.
The avenues for creativity and advancement are limitless. Don't wait to hear yourself say, "I thought about doing that", as you stand by and watch your idea being developed and marketed by someone else. Seize the moment... the climate for creativity and change is ripe.
(1 hour to 1 hour & 30 minutes)
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Stretch Your Comfort Zone: Strategies to Succeed at the Podium
Content Description:
The skills to communicate effectively to one person or an audience of one hundred provide the critical care nurse with the essential tools for success at the bedside, in an auditorium or in the corporate boardroom. Public speaking skills, a professional image and improved communication can facilitate advancement along any career ladder. The greater your fear, the more self-confidence you will gain by stepping out of your comfort zone and conquering it. This session will describe techniques to manage the anxiety produced when attempting to articulate your thoughts. Identifying mechanism for enhancing your professional image in order to score during the initial impression period and strategies for organizing and presenting your message in a clear and concise format will be outlined. The session will conclude with a formula for thriving during any question and answer period. This session is designed for any nurse who wishes to expand the boundaries of their practice.
(1 hour to 1 hour & 30 minutes)
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From Bedside Care To Entrepreneurship: Self Development
Content Description:
Will you be prepared for nursing in the 21st century? What skills and attributes are required to care for critically ill patients in the future? Nurses must develop themselves to be experts at the bedside as well as articulate savvy business minded experts. It is time to take advantage of the many opportunities for growth that exist in the current health care environment. Break the routines and traditions of your current work place. Be the change agent and bring the latest research to the bedside. Utilize the knowledge and skills of communication and idea development to shape your career. The first half of the day will focus on application to practice of current research in the areas of positioning, hemodynamic monitoring, activity/oxygen consumption, and pressure ulcer management. The second half of the workshop will concentrate on self development in the art of public speaking and starting a business.
The avenues for creativity and advancement are limitless. Don't wait to hear yourself say, "I thought about doing that", or "we need to do this a different way". Be the change agent by preparing yourself with the necessary knowledge and skills to be successful. Seize the moment... the climate for creativity and change is ripe.
(all day workshop or can be broken up into different segments)
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Implementation of Guidelines: Invasive Lines & Handwashing
Content Description:
How do we help ensure practitioners are "doing the right thing" for their patients? There is growing evidence within the healthcare profession that moving research into practice is the most difficult piece of the evidence based practice movement. The CNS is position well to be the designer & driver of the implementation process. In this session, practical approaches to the implementation of multidisciplinary evidence based guidelines for Invasive Catheters and Handwashing will be discussed. Strategies to overcome the barriers of routinization as well as methods to measure success will be outlined.
(1 hour)
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Measuring Outcomes Through CNS competencies: A Productivity Model
Content Description:
How do you justify a Clinical Nurse Specialist's existence within an organization in troubled economic times? As we move toward the 21st century, the pace of health care reform is rapidly accelerating. The opportunity exists to positively influence changes within your organization, but only if the CNS role remains viable. Therefore, it is essential that every CNS have a mechanism in which to document the outcomes of his/her practice.
The presentation will cover the development of a competency based CNS practice model and evaluation tools for outcome measurement. A CNS committee assumed the responsibility for defining the five roles of a CNS practice; expert practitioner, educator, consultant, researcher and leader. After operational definitions were formulated, brainstorming techniques were utilized to develop competency statements and critical behaviors for the five roles.
Upon completion of the model, a system for productivity documentation and outcome measurement was developed. The tools will be presented with case examples for clarification of the process. Outcome measures for CNS directed improvements will include patient, nursing staff, and organizational components.
Now is the time to take charge of your practice. The use of advance practice nurses within an organization is changing. The role of the CNS as a part of the organizational team may be in jeopardy unless we prove the impact of our actions in dollars and cents.
(1 hour and 15 min)
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Wishes Really Do Come True: Seamless Managed Care of Wounds in a Large Urban Health System
Content Description:
As population's age and advances in medicine result in improved survival from trauma, surgery, cancer and chronic illness, the health care practitioner is faced with treating an increased number of patients with complex wounds. Currently, the care of patients with chronic wounds is often fragmented; time consuming, costly and frustrating for the patient/customer and the caregiver(s). An opportunity for improvement existed in the management of chronic/problematic wounds within our large urban integrated health system.
A CNS led multidisciplinary quality improvement team was created. A one-month system evaluation was conducted to quantify process variation and supply usage in the management of one type of chronic wound, the pressure ulcer. The results demonstrated that significant process variation existed in the care of chronic wounds and that the wound patient volume numbers were sufficient for a wound care service. A five year business plan presented to administration received funding for two full time advance practice nurse positions.. The team completed design and pilot testing of a consultative process, protocols for treatment and a documentation system and launched the inpatient service. Part of the teams ongoing financial impact is the standardization of wound care products among the various business units within the health system with estimates of a 5 to 10% cost reductions derived from volume adjusted pricing.
The achievement of continuous care by linking hospital to home or extended care facility in the management of chronic wounds will result in cost reductions by improved healing rates and a potential decrease in readmissions. The future holds expansion of the model to our sister hospitals, to home care, the clinics and to the skilled nursing facilities within the Henry Ford Health System.
(1 hour and 15 min)
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