Current Practice and Practice Competencies of Clinical Nurse Specialists Working in US Emergency Care Settings: A Survey Study.

PURPOSE/AIMS: The aim of this study was to investigate the current practice of clinical nurse specialists working in US emergency care settings to (1) explicate the application of the Emergency Nurses Association core competencies and define the specialized clinical nurse specialist role in emergency care and (2) align current clinical nurse specialist practice in emergency settings with the National Association of Clinical Nurse Specialists core competencies and the identified substantive areas of clinical nurse specialist practice. DESIGN: This study used a quantitative exploratory descriptive approach using survey data. METHODS: A purposive convenience sample was recruited from the Emergency Nurses Association and the National Association of Clinical Nurse Specialists. Participants completed a 39-item survey based on a consensus process to develop competencies for emergency department (ED)-situated clinical nurse specialists. RESULTS: Respondents (n = 285) reported spending more than 50% of their work time in a primary clinical nurse specialist role. Significant differences in practice were found between geographic location, setting, educational preparation, title protection status, and type of institution. CONCLUSIONS: Our findings suggest that that the competencies ascribed to ED-situated clinical nurse specialists are valid in both frequency and importance. However, ED-situated clinical nurse specialists are not fully credentialed or practicing to the full extent of their education and licenses, because of professional, legislative, and environmental limitations.

Code Carnivals: resuscitating Code Blue training with accelerated learning.

Nurses in the hospital setting must be knowledgeable about resuscitation procedures and proficient in the delivery of care during an emergency. They must be ready to implement their knowledge and skills at a moment's notice. A common dilemma for many nurses is that cardiopulmonary emergencies (Code Blues) are infrequent occurrences. Therefore, how do nurses remain competent and confident in their implementation of emergency skills while having limited exposure to the equipment and minimal experience in emergency situations? A team of nurse educators at a regional medical center in Washington State applied adult learning theory and accelerated learning techniques to develop and present a series of learning activities to enhance the staff's familiarity with emergency equipment and procedures. The series began with a carnival venue that provided hands-on practice and review of emergency skills and was reinforced with subsequent random unannounced code drills led by both educators and charge nurses.

Lessons learned while conducting a clinical trial to facilitate evidence-based practice: the neophyte researcher experience.

Health care is incredibly complex. Now, more than ever, health care providers are being called on to deliver care that is based on evidence and is consistent with current professional knowledge. Educators often struggle to find time when staff are available to participate in scheduled education. The work of nursing staff is to provide patient care. This article describes the journey of neophyte researchers who conducted a clinical trial as a strategy to implement evidence-based practice. Although educational opportunities for the staff were included as part of the trial, there were also many challenges applicable to the neophyte researcher role. Those challenges included the participants' neophyte knowledge and perception of the research process, vendor relationships, data collection methods, staff perceptions, and the culture of the institution itself.

A descriptive analysis of the non-urgent use of emergency departments.

This study by Carla Brim from the United States analyses why people seek non-urgent care in emergency departments during hours when community providers are available. Results indicate that lack of healthcare insurance and having public insurance are the factors most closely associated with such use of emergency departments. This information can be used to bring about change in policymaking decisions about healthcare assessments.