1. Hujcs, Marianne MSN, RN, CCRN, CNRN
  2. Dubendorff, Phyllis MSN, CRNP, CNRN
  3. Lee, Kimberly RN, MSN, CRNP, CPAN
  4. Davidson, Vonda RN, BSN, CPAN

Article Content


The aim of this study was to describe clinical nurse specialists' (CNSs') collaboration in implementing a competency-based educational program. This program was designed to standardize the clinical skills needed to care for neurosurgical intensive care unit patients in the postanesthesia care unit (PACU) while waiting for critical care transfer.



Clinical nurse specialists are essential in establishing collaborative relationships directed to patient care and nurse competence.



Because of increased frequency of critically ill neurosurgical patients admitted postoperatively to the PACU, clinical nurses and physicians mutually requested that the same standard of care in the NTSICU be provided in the PACU.



An interdepartmental meeting with nursing leadership, CNSs, PACU educator, and clinical nurses from both areas outlined educational needs, patient flow and census issues, and other systemic alternatives. Competencies already identified as standards of care for this population in NTSICU were evaluated for use in PACU. Neuroscience CNSs and NTSICU clinical nurses provided didactic presentations, hands-on skill laboratories, and competency validation for the PACU clinical nurses, resulting in the same competency validation.



The collaborative process facilitated resolution of several processes and patient care issues. During the educational process, clinical issues were identified, including team communication with neurosurgery, clarification of physician coverage, and transfer of care after the postanesthesia period. As a result of sharing clinical knowledge and expertise, PACU clinical nurses were able to confidently and safely meet the needs of their complex neurosurgical patients as well as the standards of care. Professional and collaborative relationships developed between the nurses and physicians. Continuous OR flow improved patient progression. The PACU CNS and educator became clinical resources for their team.



Sharing clinical expertise and developing a comprehensive program improved the overall quality of care given to the neurosurgical patient in a separate clinical area. PACU clinical nurses' knowledge increased, as well as their confidence in caring for these complex patients.


Implications for Practice:

Establishing collaborative relationships, validating a consistent competency, and engaging clinical nurses in this process improved patient care.


Section Description

The 2009 NACNS National Conference will be held in St Louis, Missouri, on March 5 to 7. More than 350 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are registered. This year's theme, "Clinical Nurse Specialists: Vision, Value, Voice," demonstrates the essential leadership skills of the CNS as well as the CNS role in implementing evidence-based practice.


Seventy abstracts were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session. The abstracts addressed CNS practice in 3 practice domains (spheres of influence), emphasizing patient safety and quality care outcomes, leadership, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into 3 spheres of influence-patients, nursing practice, organization/system-including the development of clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, CNS practice in end-of-life care decisions, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNSs' contribution to the well-being of individuals, families, communities, as well as to the advancement of the nursing profession.


The conference abstracts were published here to facilitate sharing this emerging new knowledge with those who were unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics. Watch out for next year's call for abstracts and consider submitting for presentation at NACNS' next annual conference in Portland, Oregon, on March 4 to 6, 2010.