Catania Kimberly, Askew Taletha, Birkhimer Danette, Courtney Laurel, Hanes Deborah, Lamprecht Misty, Rettig Amy, Vendlinski Susanne
James Cancer Hospital and Solove Research Institute, the Ohio State University-Comprehensive Cancer Center, Columbus, OH 43210, USA.
Clin Nurse Spec. 2012 Mar-Apr;26(2):103-6. doi: 10.1097/NUR.0b013e31824590d0.
PURPOSE/OBJECTIVES: The aim of this study was to describe how the clinical nurse specialist (CNS) role can be positioned to proactively plan and facilitate evidenced-based best practices in collaboration with a transdisciplinary, population-focused team that manages the patient across the cancer care continuum. This model capitalizes on the spheres of CNS practice (patient, nurse, and organization) through the functional roles of the CNS (clinical expert, researcher, educator, and consultant) to maximize quality care.
BACKGROUND/RATIONALE: The CNS practice in a Midwest comprehensive cancer center has been unit based, focused on nursing staff education, skills, and competencies. Practice varied based on the needs of the unit. With the aging population, rapid growth in research accrual, increasing referrals, and expansion of facilities and programs, a reexamination of CNS practice was undertaken.
DESCRIPTION OF THE PROJECT/INNOVATION: Nursing administration and CNSs evaluated the efficacy of transitioning to a population-focused model. Some responsibilities transitioned to other roles, the reporting structure was changed, and the role was realigned to a specific disease focus that encompassed care across the entire cancer continuum.
There was significant improvement in the areas of physician collaboration, autonomy, administrative support, teamwork, and contribution to the mission of the cancer program.
INTERPRETATION/CONCLUSION: In this model, CNSs proactively plan and facilitate evidenced-based best practices in collaboration with a transdisciplinary team that manages the patient from diagnosis through the cancer trajectory, maximizing quality care and nursing-sensitive patient outcomes.
Healthcare organizations need to examine various roles for opportunities to focus on incorporating evidenced-based practices that will result in improved patient care and satisfaction.
目的/目标：本研究的目的是描述临床护理专家（CNS）的角色如何定位，以便与跨学科、以人群为中心的团队合作，积极主动地规划并促进循证最佳实践，该团队负责在癌症护理连续过程中管理患者。此模式通过CNS的功能角色（临床专家、研究者、教育者和顾问），利用CNS实践的各个领域（患者、护士和组织），以实现优质护理的最大化。
背景/理论依据：中西部一家综合癌症中心的CNS实践一直以科室为基础，侧重于护理人员的教育、技能和能力。实践因科室需求而异。随着人口老龄化、研究入组的快速增长、转诊量的增加以及设施和项目的扩展，对CNS实践进行了重新审视。
项目/创新描述：护理管理层和CNS评估了向以人群为中心模式转变的效果。一些职责转移到了其他角色，报告结构发生了变化，该角色重新定位到特定疾病重点，涵盖整个癌症连续过程中的护理。
在医生协作、自主性、行政支持、团队合作以及对癌症项目使命的贡献等方面有显著改善。
解读/结论：在此模式中，CNS与跨学科团队合作，积极主动地规划并促进循证最佳实践，该团队负责管理从诊断到癌症病程的患者，实现优质护理和护理敏感型患者结局的最大化。
医疗保健组织需要审视各种角色，寻找机会专注于纳入循证实践，以改善患者护理和满意度。
