Clinical Nurse SpecialistA Copyright B 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins DOI: 10.1097/01.NUR.0000454978.43124.6b
News National Association of Clinical Nurse Specialists
National Association of Clinical Nurse Specialists News President’s Message Les Rodriguez, MSN, MPH, RN, ACNS-BC, APRN
TASK FORCES The National Association of Clinical Nurse Specialists (NACNS) is a volunteer organization representing the clinical nurse specialists (CNSs). A majority of the work is accomplished through the work of different volunteer work performed by members of the association and board liaisons. The organization uses different models of work groups to achieve these outcomes including committees, teams, and particularly task forces. A task force is a group made up of individuals with expertise in a specific area or knowledge or practice working towards the completion of a specific objective.1 Upon completion of the objective, the group generally disbands or may be suspended pending further work. NACNS uses volunteer task forces for much of its work where evidence-based literature and position statements are produced. Some of the excellent work that has been produced as of recent includes but is not limited to (1) Alarm Fatigue (2) Cost and Outcomes, (3) Transitional Care, and (4) DNP. ALARM FATIGUE The Alarm Fatigue task force was charged with looking at alarm fatigue from all different sources. The literature has demonstrated on numerous occasions the effect that alarms have on quality of nursing care. Like the story of The Boy Who Cried Wolf, false alarms lead the nurse to become apathetic toward alarms. This apathy or fatigue has eventually led to untoward events related to real alarms. This task force made up of CNSs from around the country across all disciplines looked at all different types of alarms from bed and intravenous pump to cardiac monitors in the critical care setting. They presented their findings at the March 2014 national conference and are in the process of developing a toolkit for publication. The author reports no conflicts of interest.
Clinical Nurse Specialist
A
COST AND OUTCOMES The Cost and Outcomes task force was charged with assessing and determining the financial impact that the CNS generates through cost avoidance and direct dollars if they were billing. This task force is in the final process of its charge and will soon be releasing its results. TRANSITIONAL CARE The Transitional Care task force was charged with assessing and determining the impact that the CNS has on patient outcomes as he/she relates when patients are transitioned from one level of care to another. This also includes how the CNS impacts transitions. This task force is also finishing up its work, which will soon be released. DNP The Doctorate of Nursing Practice or DNP task force has been charged with determining what recommendation for the organization to adopt related to the DNP. There are multiple issues to consider when taking a position regarding the DNP, and NACNS is not immune to those issues, so a task force was one of the best ways to determine how to deal with this. This task force continues to work with this issue and will continue to work on this until an acceptable outcome is achieved. NACNS continues to await this group’s recommendation. In conclusion, task forces are a great way to achieve work that is required by an organization. I applaud all the current work done and the work completed. Without the expertise of you, the membership, NACNS could not accomplish many of the things we do. As healthcare continues to evolve and become more involved, we will continue to rely on you as the experts in our pool of resources (although limited but very valuable). Thank you to all who have participated, and I look forward to those of you who will www.cns-journal.com
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
305
News participate. Without your assistance, NACNS would not be where it is today. Reference 1. Grigsby RK. Committee, task force, team: what’s the difference? Why does it matter? Acad Phys Sci. 2008:4Y5.
WASHINGTON AFFILIATE NEWS The Washington Affiliate has continued to work with the Nursing Commission Quality Assurance Committee (our State nursing board) to advocate for clinical nurse specialist (CNS) inclusion in the state’s advanced practice rules. The Commission has responded to the Washington Affiliates 2011 petition to the Commission to revise the ARNP (all advanced practice nurses in the State are referred to as ARNP, this definition is in statute and would require legislation to change) and has been conducting rule writing workshops across the state. Proposed rules including CNS as ARNPs will be presented to the Nursing Commission for voting/ approval in September. It is anticipated that the proposed rules will align closely with APRN Consensus, requiring a graduate degree in nursing and national certification for entry into practice. Currently practicing CNSs who meet the requirements will be provided a period of time to apply for the advanced practice designation. Questions regarding the work in progress can be directed to Affiliate Chair Heather Schoonover, MN, RN, PHCNS-BC, athschoonover@ peacehealth.org. CALIFORNIA ASSOCIATION OF CLINICAL NURSE SPECIALISTS I am pleased to acknowledge and congratulate our California Association Of Clinical Nurse Specialists (CACNS) members’ numerous achievements: h CACNS will be holding its annual conference ‘‘Making a Difference: The CNS Contribution to Quality Care’’ on November 15 at Santa Barbara Cottage Hospital, Santa Barbara, California. h Alfie Ignacio, DNP, ACNS-BC, FNP-BC, CEN, CCRN, CFRN, Clinical Nurse Specialist, Emergency Department, Torrance Memorial Medical Center, received his doctor of nursing practice degree (DNP) (August 2014) at Western University of Health Sciences, Pomona, California. Additional achievements include the following presentations: ‘‘Improving Neurologic Function After Cardiac Arrest Through Therapeutic Hypothermia,’’ a poster presentation, and ‘‘The Use of Ultrasound-Guided Peripheral IV Insertion in the Emergency Department,’’ an oral/podium presentation at the 25th International Nursing Research Congress, Hong Kong Sigma Theta Tau International. h Darlene Abe, RN, CNS (student), will be presenting her poster on ‘‘Using Change Management to Implement a Delirium 306
www.cns-journal.com
Assessment Tool in the ICU’’ at the 2014 National Gerontological Nursing Association Convention in San Antonio, Texas. Submitted by: Diane Barkas, MSN, RN, ACNS-BC, CCRN
2014 CLINICAL NURSE SPECIALIST SUMMIT For the last 13 years, NACNS has provided a forum for leaders from our membership and collegial organizations to come together to discuss CNS hot topics and other issues. This year’s summit was well attended with 63 participants. The discussions were wide ranging addressing skills and information needed for the CNS who is interested in advanced professional skills, such as prescriptive privilege, hospital privileges, obtaining their DEA number and PIN, and achieving federal reimbursement status. Discussions brought forth the challenge of DNP education. The participants supported master’s education but were increasingly concerned that DNP programs were not meeting the needs of the CNS. This is particularly important when the need for the development of specialty knowledge is considered. The participants at the summit engaged in an exercise to begin to gather information from members and stakeholders on the revision of the CNS Core Statement. NACNS will be appointing a task force of volunteers to begin work on this important document. Copies of slides from this meeting are available on the NACNS Web site (www/ nacns.org). NACNS Annual Meeting and 20th Anniversary Celebration Yes, it has been 20 years! And the NACNS Board of Directors is planning on recognizing and celebrating our history and success throughout 2015, but specifically at the NACNS 2015 Annual Conference. The theme for this meeting is: ‘‘The Clinical Nurse Specialists: The Essence of Transitional Health Care.’’ This meeting is being held at the Loews Coronado Bay Resort in San Diego, California. This meeting hotel will allow for an excellent educational experience as well as relaxation and exploration of beautiful Southern California. The hotel offers 3 pools, a sand beach, and a spa. So plan now for a 20th anniversary celebration that will allow you to take care of your mind and body! The Loews Coronado Bay Resort caters to relaxation and will allow all of us to learn, network, and relax. Coronado Island is a 10-minute cab ride from downtown San Diego. This will give everyone the best of both worldsV shopping and restaurants in San Diego and pampering and beautiful views on Coronado Island. Do consider extending your trip by a day to appreciate the beauty of this area.
NACNS ADVOCATES FEDERALLY FOR CNS ROLE At the end of July, NACNS submitted comments to a Federal Register Announcement published concerning the Department of Labor’s (DOL’s) Standard Occupational Classification. This work is done every 8 years and provides a national list of occupations. In the previous round, the DOL did not November/December 2014
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
recognize the CNS role as an APRN role. Therefore, NACNS submitted comments in this new round to advocate for the CNS as one of the 4 APRN roles. The document discussed the role of the CNS, proposed a definition for the CNSVbased on the DOL’s formatVand spoke to how the CNS role is different than the RN role. Our comments for this rulemaking can be retrieved from the NACNS homepage, on the right column (www.nacns.org).
TASK FORCE UPDATES The NACNS Task Forces are in full swing! The Alarm Fatigue Task Force recently received approval from the NACNS Board on their work to develop an online toolkit with resources the CNS can use to make change in patient outcomes related to reduction of alarm fatigue. Look for an e-mail announcing its availability. Also, NACNS will be appointing 2 new task forcesVMalnutrition in the Hospitalized Patient and Chronic Care and the CNS. A blast e-mail will be sent soon to request NACNS members to volunteer for these opportunities. Make sure you let your affiliate members know! WOMEN’S HEALTH COMPETENICES SOON TO BE PUBLISHED NACNS has been working with the Association of Women’s Health, Obstetric and Neonatal Nurses on the publication of the Women’s Health/Gender-Related CNS Competencies. These competencies are currently in the final stages of development and should be available to NACNS and AWHONN members no later than early fall 2015. ABBOTT NUTRITIONALS SPONSORS NACNS NACNS is pleased to acknowledge the support provided by Abbott Nutritionals to NACNS. They have again agreed to support the 2015 NACNS Annual Meeting. In addition, they have provided an educational grant for the establishment and operation of the task forceVMalnutrition and the
Clinical Nurse Specialist
A
Hospitalized Patient. Our thanks go out to Abbott Nutritionals for their support of the CNS role!
NACNS WEBINARS You asked for webinars in our membership survey, so we have developed a webinar series just for the CNSs! All webinars are offered at a great deal for NACNS members! Registration Fees: Single Webinar: Member $45 Non Member $60 Student $30. Topics November 12, 2014: The Cutting Edge of Diabetes ManagementVPharmacology CE offered December 10, 2014: CNS Competencies: Positioning Yourself to Close the Clinical Alarm Gap Times for all sessions: 3:00 PM eastern/2:00 PM central/ 1:00 PM mountain/12:00 PM west coast
2014 INSTITUTIONAL MEMBERS Institution Aurora Health Care
Membership Category Diamond
Cedars-Sinai Medical Center
Silver
Duke University Hospital
Bronze
Lakeland Regional Medical Center
Bronze
Texas Christian University Harris School of Nursing
Bronze
Wheaton FranciscanVSt. Joseph
Bronze
Children’s Hospital of Wisconsin
Copper
Nebraska Methodist Hospital and Women’s Hospital
Copper
Purdue University Calumet
Copper
St John Fisher College
Copper
www.cns-journal.com
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
307
News National Association of Clinical Nurse Specialists
National Association of Clinical Nurse Specialists News President’s Message Les Rodriguez, MSN, MPH, RN, ACNS-BC, APRN
TASK FORCES The National Association of Clinical Nurse Specialists (NACNS) is a volunteer organization representing the clinical nurse specialists (CNSs). A majority of the work is accomplished through the work of different volunteer work performed by members of the association and board liaisons. The organization uses different models of work groups to achieve these outcomes including committees, teams, and particularly task forces. A task force is a group made up of individuals with expertise in a specific area or knowledge or practice working towards the completion of a specific objective.1 Upon completion of the objective, the group generally disbands or may be suspended pending further work. NACNS uses volunteer task forces for much of its work where evidence-based literature and position statements are produced. Some of the excellent work that has been produced as of recent includes but is not limited to (1) Alarm Fatigue (2) Cost and Outcomes, (3) Transitional Care, and (4) DNP. ALARM FATIGUE The Alarm Fatigue task force was charged with looking at alarm fatigue from all different sources. The literature has demonstrated on numerous occasions the effect that alarms have on quality of nursing care. Like the story of The Boy Who Cried Wolf, false alarms lead the nurse to become apathetic toward alarms. This apathy or fatigue has eventually led to untoward events related to real alarms. This task force made up of CNSs from around the country across all disciplines looked at all different types of alarms from bed and intravenous pump to cardiac monitors in the critical care setting. They presented their findings at the March 2014 national conference and are in the process of developing a toolkit for publication. The author reports no conflicts of interest.
Clinical Nurse Specialist
A
COST AND OUTCOMES The Cost and Outcomes task force was charged with assessing and determining the financial impact that the CNS generates through cost avoidance and direct dollars if they were billing. This task force is in the final process of its charge and will soon be releasing its results. TRANSITIONAL CARE The Transitional Care task force was charged with assessing and determining the impact that the CNS has on patient outcomes as he/she relates when patients are transitioned from one level of care to another. This also includes how the CNS impacts transitions. This task force is also finishing up its work, which will soon be released. DNP The Doctorate of Nursing Practice or DNP task force has been charged with determining what recommendation for the organization to adopt related to the DNP. There are multiple issues to consider when taking a position regarding the DNP, and NACNS is not immune to those issues, so a task force was one of the best ways to determine how to deal with this. This task force continues to work with this issue and will continue to work on this until an acceptable outcome is achieved. NACNS continues to await this group’s recommendation. In conclusion, task forces are a great way to achieve work that is required by an organization. I applaud all the current work done and the work completed. Without the expertise of you, the membership, NACNS could not accomplish many of the things we do. As healthcare continues to evolve and become more involved, we will continue to rely on you as the experts in our pool of resources (although limited but very valuable). Thank you to all who have participated, and I look forward to those of you who will www.cns-journal.com
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
305
News participate. Without your assistance, NACNS would not be where it is today. Reference 1. Grigsby RK. Committee, task force, team: what’s the difference? Why does it matter? Acad Phys Sci. 2008:4Y5.
WASHINGTON AFFILIATE NEWS The Washington Affiliate has continued to work with the Nursing Commission Quality Assurance Committee (our State nursing board) to advocate for clinical nurse specialist (CNS) inclusion in the state’s advanced practice rules. The Commission has responded to the Washington Affiliates 2011 petition to the Commission to revise the ARNP (all advanced practice nurses in the State are referred to as ARNP, this definition is in statute and would require legislation to change) and has been conducting rule writing workshops across the state. Proposed rules including CNS as ARNPs will be presented to the Nursing Commission for voting/ approval in September. It is anticipated that the proposed rules will align closely with APRN Consensus, requiring a graduate degree in nursing and national certification for entry into practice. Currently practicing CNSs who meet the requirements will be provided a period of time to apply for the advanced practice designation. Questions regarding the work in progress can be directed to Affiliate Chair Heather Schoonover, MN, RN, PHCNS-BC, athschoonover@ peacehealth.org. CALIFORNIA ASSOCIATION OF CLINICAL NURSE SPECIALISTS I am pleased to acknowledge and congratulate our California Association Of Clinical Nurse Specialists (CACNS) members’ numerous achievements: h CACNS will be holding its annual conference ‘‘Making a Difference: The CNS Contribution to Quality Care’’ on November 15 at Santa Barbara Cottage Hospital, Santa Barbara, California. h Alfie Ignacio, DNP, ACNS-BC, FNP-BC, CEN, CCRN, CFRN, Clinical Nurse Specialist, Emergency Department, Torrance Memorial Medical Center, received his doctor of nursing practice degree (DNP) (August 2014) at Western University of Health Sciences, Pomona, California. Additional achievements include the following presentations: ‘‘Improving Neurologic Function After Cardiac Arrest Through Therapeutic Hypothermia,’’ a poster presentation, and ‘‘The Use of Ultrasound-Guided Peripheral IV Insertion in the Emergency Department,’’ an oral/podium presentation at the 25th International Nursing Research Congress, Hong Kong Sigma Theta Tau International. h Darlene Abe, RN, CNS (student), will be presenting her poster on ‘‘Using Change Management to Implement a Delirium 306
www.cns-journal.com
Assessment Tool in the ICU’’ at the 2014 National Gerontological Nursing Association Convention in San Antonio, Texas. Submitted by: Diane Barkas, MSN, RN, ACNS-BC, CCRN
2014 CLINICAL NURSE SPECIALIST SUMMIT For the last 13 years, NACNS has provided a forum for leaders from our membership and collegial organizations to come together to discuss CNS hot topics and other issues. This year’s summit was well attended with 63 participants. The discussions were wide ranging addressing skills and information needed for the CNS who is interested in advanced professional skills, such as prescriptive privilege, hospital privileges, obtaining their DEA number and PIN, and achieving federal reimbursement status. Discussions brought forth the challenge of DNP education. The participants supported master’s education but were increasingly concerned that DNP programs were not meeting the needs of the CNS. This is particularly important when the need for the development of specialty knowledge is considered. The participants at the summit engaged in an exercise to begin to gather information from members and stakeholders on the revision of the CNS Core Statement. NACNS will be appointing a task force of volunteers to begin work on this important document. Copies of slides from this meeting are available on the NACNS Web site (www/ nacns.org). NACNS Annual Meeting and 20th Anniversary Celebration Yes, it has been 20 years! And the NACNS Board of Directors is planning on recognizing and celebrating our history and success throughout 2015, but specifically at the NACNS 2015 Annual Conference. The theme for this meeting is: ‘‘The Clinical Nurse Specialists: The Essence of Transitional Health Care.’’ This meeting is being held at the Loews Coronado Bay Resort in San Diego, California. This meeting hotel will allow for an excellent educational experience as well as relaxation and exploration of beautiful Southern California. The hotel offers 3 pools, a sand beach, and a spa. So plan now for a 20th anniversary celebration that will allow you to take care of your mind and body! The Loews Coronado Bay Resort caters to relaxation and will allow all of us to learn, network, and relax. Coronado Island is a 10-minute cab ride from downtown San Diego. This will give everyone the best of both worldsV shopping and restaurants in San Diego and pampering and beautiful views on Coronado Island. Do consider extending your trip by a day to appreciate the beauty of this area.
NACNS ADVOCATES FEDERALLY FOR CNS ROLE At the end of July, NACNS submitted comments to a Federal Register Announcement published concerning the Department of Labor’s (DOL’s) Standard Occupational Classification. This work is done every 8 years and provides a national list of occupations. In the previous round, the DOL did not November/December 2014
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
recognize the CNS role as an APRN role. Therefore, NACNS submitted comments in this new round to advocate for the CNS as one of the 4 APRN roles. The document discussed the role of the CNS, proposed a definition for the CNSVbased on the DOL’s formatVand spoke to how the CNS role is different than the RN role. Our comments for this rulemaking can be retrieved from the NACNS homepage, on the right column (www.nacns.org).
TASK FORCE UPDATES The NACNS Task Forces are in full swing! The Alarm Fatigue Task Force recently received approval from the NACNS Board on their work to develop an online toolkit with resources the CNS can use to make change in patient outcomes related to reduction of alarm fatigue. Look for an e-mail announcing its availability. Also, NACNS will be appointing 2 new task forcesVMalnutrition in the Hospitalized Patient and Chronic Care and the CNS. A blast e-mail will be sent soon to request NACNS members to volunteer for these opportunities. Make sure you let your affiliate members know! WOMEN’S HEALTH COMPETENICES SOON TO BE PUBLISHED NACNS has been working with the Association of Women’s Health, Obstetric and Neonatal Nurses on the publication of the Women’s Health/Gender-Related CNS Competencies. These competencies are currently in the final stages of development and should be available to NACNS and AWHONN members no later than early fall 2015. ABBOTT NUTRITIONALS SPONSORS NACNS NACNS is pleased to acknowledge the support provided by Abbott Nutritionals to NACNS. They have again agreed to support the 2015 NACNS Annual Meeting. In addition, they have provided an educational grant for the establishment and operation of the task forceVMalnutrition and the
Clinical Nurse Specialist
A
Hospitalized Patient. Our thanks go out to Abbott Nutritionals for their support of the CNS role!
NACNS WEBINARS You asked for webinars in our membership survey, so we have developed a webinar series just for the CNSs! All webinars are offered at a great deal for NACNS members! Registration Fees: Single Webinar: Member $45 Non Member $60 Student $30. Topics November 12, 2014: The Cutting Edge of Diabetes ManagementVPharmacology CE offered December 10, 2014: CNS Competencies: Positioning Yourself to Close the Clinical Alarm Gap Times for all sessions: 3:00 PM eastern/2:00 PM central/ 1:00 PM mountain/12:00 PM west coast
2014 INSTITUTIONAL MEMBERS Institution Aurora Health Care
Membership Category Diamond
Cedars-Sinai Medical Center
Silver
Duke University Hospital
Bronze
Lakeland Regional Medical Center
Bronze
Texas Christian University Harris School of Nursing
Bronze
Wheaton FranciscanVSt. Joseph
Bronze
Children’s Hospital of Wisconsin
Copper
Nebraska Methodist Hospital and Women’s Hospital
Copper
Purdue University Calumet
Copper
St John Fisher College
Copper
www.cns-journal.com
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
307
