1. Jeffries, Marian MSN, RN, FNP-C
  2. Gavaghan, Susan MSN, RN

Article Content

Problem and Significance

Respiratory emergencies on the general care units necessitate transferring the patient to an ICU level of care. Staff nurses outside of the ICU often feel unprepared to care for this challenging population.



The purpose of this initiative was to develop, implement, and evaluate a program to increase the nursing staff's knowledge around the effective management of patients with acute respiratory problems.


Description of Project

An educational respiratory program was designed by the CNSs and implemented by a multidisciplinary team that included the CNS, respiratory therapist, and staff from the professional development department. The program began in April 2004 and was presented to new staff working across several general care units in the hospital.



All nurses new to the organization attended a 4-hour class on respiratory care prior to the completion of their 6-week orientation. Following the class, each participant completed an evaluation. These data were used to inform and revise future classes to foster improvements in respiratory care outside of the ICU. In addition, a competency assessment was completed by the participants within 2 weeks and reviewed by their unit-based CNS for follow-up as needed. Data analysis is in the process and includes quantitative and content analysis of different evaluation parameters. In addition, system-wide evidence on occurrence, preparation, and resources related to aspects of respiratory care management provide additional evaluation of the impact the classes have had on staff knowledge related to respiratory care.



Patients experiencing respiratory difficulties are visible on all inpatient areas. CNS practice involving designing, implementing, and evaluating this program will be used as a model for further educational endeavors to increase knowledge and improve safe, effective care. Competency assessments have revealed that nurses are gaining knowledge and leadership has expressed satisfaction with this initiative.


Section Description

This year's annual NACNS conference is planned for Orlando, Fla, March 9-12, 2005. Over 300 clinical nurse specialists (CNSs) are expected to attend, and as with past conferences, attendees will also include graduate faculty from CNS programs, nurse administrators, and nurse researchers. The theme of the conference, CNS Leadership: Navigating the Healthcare Environment Toward Excellence, was selected to showcase the many ways CNSs acquire and disseminate knowledge and innovative practices in their specialty areas. Two preconference sessions are scheduled. One session, sponsored by NACNS Legislative/Regulatory Committee, targets information for CNSs interested in understanding the legislative/regulatory process as it deals with the practice of nursing, and will also help build skills CNSs need to engage in the process. The second session, sponsored by NACNS Education Committee, focuses on CNS education issues, and as with the education preconferences of past years, anticipates informative dialogue and much sharing among CNS educators around curriculum design, teaching strategies, and indicators of quality in the curriculum that link to the NACNS education standards to program review and excellence. The conference planning committee is proud and pleased to have Jeanette Ives Erickson, MS, RN, CNA, Senior Vice President for Patient Care Services and Chief Nurse Executive of Massachusetts General Hospital as the opening keynote speaker. She will begin the conference by highlighting the importance of CNS practice on patient safety. The planning committee is equally proud and pleased to have NACNS past-president Rhonda Scott, PhD, RN, Chief Nursing Officer of Grady Health System as the closing speaker. Dr Scott will challenge attendees to use the information from the conference to shape quality care delivered in a safe environment and to advance the profession of nursing through direct care to clients, influencing standards of care delivered by other nurses, and influencing the healthcare delivery system to be to support innovative, cost-effective, quality nursing care. A total of 64 abstracts for podium and poster presentations were selected in addition to graduate student posters. The abstracts address the 3 spheres of CNS practice with a strong emphasis on clinical practice improvements. As you will note from the abstracts published in this issue of the journal, specialty practice areas represented in the abstracts include children, adults, and gerontological patient groups; hospital, outpatient, and home care settings, and community health. In addition, a wide variety of specialty topics including smoking cessation programs, end-of-life care issues, and protocols outlining nursing approaches to improved diabetes, cardiovascular and ventilator management. A number of the abstracts described hospital and healthcare system level innovations that resulted from CNS practice. Collectively, these abstracts reflect the breadth, depth, and richness of CNS contributions to the well-being of individuals, families, groups, and communities. The following abstracts are from those presenters who elected to have their work published in the journal so those who are unable to attend this year's conference can share in the knowledge of the conference. As you read each abstract, consider the talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to improved outcomes for patients and healthcare organizations. You may want to contact individual presenters to network, collaborate, consult, or share your own ideas about these topics. Watch for next year's call for abstracts and consider submitting an abstract for presentation at NACNS's next conference in Salt Lake City, Utah, March 15-18, 2006.