1. O'Brien, Denise MSN, RN, ACNS-BC, CPAN, CAPA, FAAN
  2. Dickinson, Sharon MSN, RN, ACNS-BC, CCRN

Article Content


The objectives of this study were to review the current evidence supporting the need for implementation of a multidrug resistant organism (MDRO) policy in the critical care setting. To objectively quantify the impact a comprehensive MDRO policy has on nursing workload and finances in our units.



Multidrug resistant organisms incidence is on the rise. These infections not only increase morbidity and mortality but also increase hospital and intensive care unit lengths of stay, amplify demands on staff, consume resources, and tax the healthcare system.



The SICU and PACU at the University of Michigan Medical Center are not immune to the impact of MDROs. We follow the CDC recommendations for preventing, identifying, treating, and isolating infectious pathogens. The role of the clinical nurse specialist (CNS) in designing and implementing this type of policy requires knowledge and skill in change process, evidence-based practice, cost-benefit analysis, and staff development.



This session will describe the why's, how's, and what-if's of implementing MDRO policy in a SICU and a PACU setting of a major academic medical center. Other institutions may benefit from the lessons learned and issues presented in this session. A cost-benefit analysis will be presented defining the variables to consider when implementing such a policy. This will include patient cohorting, issues of patient safety, environmental challenges, and multidisciplinary provider compliance.



The goal is to describe the challenges faced by CNSs in busy critical care units when implementing policies that have significant financial and nursing workload implications.



The CNS must be able to use evidence to support the implementation of policies that are costly to an institution and require staff compliance and buy-in. Minimizing the spread and development of MDROs should be at the forefront of our units' cost-containment strategies.


Implications for Practice:

This session will provide the CNS with the necessary information to identify and analyze the costs and nursing practice implications of new policies.


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.