Negley Kristin D, Cordes Mary E, Evenson Laura K, Schad Shauna P
Author Affiliations: Clinical Nurse Specialist, Department of Nursing, Mayo Clinic, Rochester, Minnesota.
Clin Nurse Spec. 2016 Sep-Oct;30(5):271-6. doi: 10.1097/NUR.0000000000000231.
PURPOSE/OBJECTIVES: This article describes how a large healthcare organization expanded the practice of clinical nurse specialists from the hospital to the ambulatory setting.
Clinical nurse specialist practice traditionally focused on actualizing the 3 spheres of influence (patient, nurse, and organization) in the hospital setting.
Changes in the healthcare system shifting patient care to the ambulatory setting created opportunities for clinical nurse specialists to improve patient outcomes in this setting.
An innovation framework from the Mayo Clinic Center for Innovation based on inspiration, generation of ideas, experimenting, and diffusion was used to assess and prioritize the work of clinical nurse specialists in the ambulatory setting.
Clinical nurse specialists became integral members of hospital and ambulatory nursing leadership. In the ambulatory setting, they are partnering to standardize patient care, providing tools for nurses to practice to full scope, and identifying and providing solutions for patient safety issues.
Aligning clinical nurse specialists in the hospital and ambulatory care settings allows partnership with multidisciplinary teams to ensure that evidence-based practices and standardized care are infused across the continuum of care.
Evidence-based practices and standardized care encourage nurses to practice to full scope and focus on improved patient outcomes.
目的/目标：本文描述了一个大型医疗保健机构如何将临床护理专家的业务范围从医院扩展到门诊环境。
传统上，临床护理专家的业务重点是在医院环境中实现三个影响领域（患者、护士和组织）。
医疗保健系统的变化将患者护理转移到门诊环境，为临床护理专家改善该环境中的患者结局创造了机会。
采用了梅奥诊所创新中心基于灵感、创意产生、试验和传播的创新框架，对门诊环境中临床护理专家的工作进行评估并确定优先次序。
临床护理专家成为医院和门诊护理领导层不可或缺的成员。在门诊环境中，他们合作使患者护理标准化，为护士提供充分发挥专业能力的工具，并识别和解决患者安全问题。
使医院和门诊护理环境中的临床护理专家保持一致，能够与多学科团队合作，确保循证实践和标准化护理贯穿整个护理过程。
循证实践和标准化护理鼓励护士充分发挥专业能力，并专注于改善患者结局。
