Clinical nurse specialists leading research to improve practice in the use of ankle blood pressure readings.

PURPOSE: The purpose of this article is to describe Clinical Nurse Specialist (CNS) practice as it relates to leadership in clinical research through the presentation of a study on ankle blood pressure (BP) measurements led by the CNS. BACKGROUND: Under the direction of the CNS, staff nurses engaged in the EBP process to explore the association between arm and ankle BP measurements. This EBP project led to a research study which was directed and led by the CNS. RATIONALE: CNS practice requires leadership in the areas of evidence-based practice and research. CNS leadership was critical to the success of the research project. DESCRIPTION: A descriptive study was undertaken which examined the agreement between upper extremity BP readings and ankle BP readings by comparing a series of three simultaneous ankle and arm BP readings on 174 subjects. CONCLUSION: Leading the research project elevated the CNS's visibility and influence within the organization by clearly demonstrating the value of the CNS in the research process and the impact nursing research has on nursing practice and patient outcomes.

The effect of high-fidelity patient simulation on the critical thinking and clinical decision-making skills of new graduate nurses.

This study was conducted to determine whether the addition of high-fidelity patient simulation to new nurse orientation enhanced critical thinking and clinical decision-making skills. A pretest-posttest design was used to assess critical thinking and clinical decision-making skills in two groups of graduate nurses. Compared with the control group, the high-fidelity patient simulation group did not show significant improvement in mean critical thinking or clinical decision-making scores. When mean scores were analyzed, both groups showed an increase in critical thinking scores from pretest to posttest, with the high-fidelity patient simulation group showing greater gains in overall scores. However, neither group showed a statistically significant increase in mean test scores. The effect of high-fidelity patient simulation on critical thinking and clinical decision-making skills remains unclear.

Improving hand hygiene adherence among nursing staff.

This quasi-experimental study explored initial and sustained effects of educational and behavioral interventions on hand hygiene adherence and the relationships between hand hygiene adherence and health care-associated infections. Education paired with positive reinforcement behavioral interventions significantly improved hand hygiene adherence after the first month (χ² = 4.27; P = .039); however, the improvement was not sustained over 6 months. There were no significant differences in infection rates between the treatment and control groups.