《临床护士专家™：国际高级护理实践杂志》的目的是传播临床护士专家实践的成果，促进临床护士专家角色的持续发展，并突出临床护士专家对推进护理实践和卫生政策的贡献全球范围内。该期刊的目标是： 1. 传播有关临床护士专科能力以及实践教育和规范的知识； 2. 就整个护理过程中护理和健康服务的质量、安全和成本交流临床护理专家实践的结果； 3. 推动护理卫生政策转型的循证实践和创新，造福社会； 4. 促进针对不同护理环境和文化中特殊人群的护理和健康服务的专业内和跨学科对话。

The purpose of the Clinical Nurse Specialist™: International Journal of Advanced Nursing Practice is to disseminate the outcomes of clinical nurse specialist practice, promote the ongoing development of the clinical nurse specialist role, and highlight the contributions of clinical nurse specialists to advancing nursing practice and health policy globally. The journal aims to: 1. Disseminate knowledge regarding clinical nurse specialist competencies, as well as practice education and standards; 2. Communicate the results of clinical nurse specialist practice concerning the quality, safety, and cost of nursing and health services throughout the nursing process; 3. Promote evidence-based practice and innovation in transforming nursing health policy for the benefit of society; 4. Facilitate intra- and interdisciplinary dialogue on nursing and health services for special populations in diverse nursing environments and cultures.

《Clinical Nurse Specialist™：国际高级护理实践杂志》旨在传播临床护士专家实践的成果，促进临床护士专家角色的持续发展，并突出临床护士专家在推动护理实践和卫生政策方面的全球贡献。该期刊的目标包括：1. 传播有关临床护士专科能力、实践教育和规范的知识；2. 交流临床护理专家实践在护理和健康服务质量、安全和成本方面的成果；3. 推动护理卫生政策转型的循证实践和创新，以造福社会；4. 促进针对不同护理环境和文化中特殊人群的护理和健康服务的专业内和跨学科对话。

Clinical Nurse Specialist

Objectives: The present study was a feasibility study of a tailored acupuncture intervention in postmenopausal breast cancer survivors (BCSs) reporting sleep disturbances and hot flashes. Objectiveswere (1) to describe patterns of acupuncture point use; (2) evaluate outcome expectancy, credibility, and acceptability relative to the intervention; and (3) evaluate patterns of symptom change over time. Design: This was a single-group, nonrandomized, quasi-experimental 8-week study. Sample/Setting: Ten BCSs with both sleep disturbances and hot flashes were referred to any of 4 Midwestern community acupuncturists. Methods: Assessments were done at baseline (weeks 1, 2), during treatment (weeks 3, 4), and after treatment (weeks 5, 8). Acupuncture treatment was tailored to the individual by community acupuncturists and provided as 3 sessions within a 2-week period (weeks 3, 4). Patients wore a wrist actigraph during weeks 1, 2, 3, 4, 5, and 8 and a sternal skin conductance monitor for 24 consecutive hours during weeks 1, 2, 3, 4, 5, and 8. Subjective data were obtained by questionnaire at weeks 1, 2, 3, 4, 5, and 8. Findings: Women were a mean age of 53 years, with an average 6.75 years since diagnosis. A mean of 10 needles were used per session, with the most common points located in the lung or lung meridian. Breast cancer survivors had high expectancy that acupuncture would decrease their symptoms, believed it was a credible treatment, and felt it an acceptable form of treatment. Three significant patterns of symptom change were noted from baseline: an increase in the number of minutes it took to fall asleep after treatment (from week 5 to 8; P = .04), a decrease in the percentage of time awake after sleep onset from baseline to follow-up 2 (week 8; P = .05), and a decrease in the number of hot flashes from baseline to follow-up 1 (week 5; P = .02). Implications for Nursing: Findings may be used by clinical nurse specialists to consider recommending acupuncture to improve sleep and reduce hot flashes in BCSs. Conclusions: Acupuncture treatment seems to be a feasible treatment option for highly motivated BCSs with sleep disturbances and hot flashes but needs to be further evaluated in a larger, randomized, controlled clinical trial.

Julie L. Otte

Janet S. Carpenter

Xin Zhong

Peter A. S. Johnstone

Feasibility Study of Acupuncture for Reducing Sleep Disturbances and Hot Flashes in Postmenopausal Breast Cancer Survivors

针灸用于减轻绝经后乳腺癌幸存者睡眠障碍和潮热的可行性研究

Serious events within healthcare occur daily exposing the failure of the system to safeguard patient and providers. The complex nature of healthcare contributes to myriad ambiguities affecting quality nursing care and patient outcomes. Leaders in healthcare organizations are looking outside the industry for ways to improve care because of the slow rates of improvement in patient safety and insufficient application of evidenced-based research in practice. Military and aviation industry strategies are recognized by clinicians in high-risk care settings such as the operating room, emergency departments, and intensive care units as having great potential to create safe and effective systems of care. Complexity science forms the basis for high reliability teams to recognize even the most minor variances in expected outcomes and take strong action to prevent serious error from occurring. Cultural and system barriers to achieving high reliability performance within healthcare and implications for team training are discussed.

LESLIE M. McKEON

JILL D. OSWAKS

PATRICIA D. CUNNINGHAM

Safeguarding Patients

保护患者

Purpose: The purpose of this study was to assess the effects of the injection duration (30 seconds) and local dry cold application (5 minutes before and after injection) on pain intensity and bruising at the injection site in subcutaneous heparin injections. Design This was a randomized controlled, prospective, experimental study. Setting: This study was performed between February 2011 and February 2012 in the orthopedic wards of 1 university hospital. Sample: The sample consisted of 60 patients receiving subcutaneous injections of heparin once a day and hospitalized in the orthopedic and trauma wards. Methods: A computerized randomization program was used to allocate the patients to 3 experimental groups: group A (30-second injection duration), group B (30-second injection duration and 5-minute dry cold application applied locally), and group C (injection administered for 10 seconds and no dry cold application applied locally). Results: This study observed statistically significant differences in pain intensity and bruising occurrence and formation measured over time among groups A and B (30-second injection duration or 30-second injection duration and 5-minute local dry cold application) and group C (10-second injection duration). Conclusion: It was determined that a subcutaneous injection duration of 30 seconds and 5-minute local dry cold application (before and after injection) can be effective in decreasing the intensity of pain and in reducing the occurrence of bruising.

Merdiye Şendir

Funda Büyükyilmaz

Zuhal Çelik

İlknur Taşköprü

Comparison of 3 Methods to Prevent Pain and Bruising After Subcutaneous Heparin Administration

3种方法预防皮下注射肝素后疼痛和瘀伤的比较

Buhagiar, Teresa M. MS, RN, GCNS-BC, ACHPN, CEN; Schoenlein, Malcolm H.; Smith, Deborah S. MS, RN, CNS Author Information

Teresa M. Buhagiar

Malcolm H. Schoenlein

Deborah S. Smith

Ethical Decision Making in Critical Care

重症监护中的伦理决策

Christie M. Lang

Martina Taylor-Campbell

Matthew Kenney

Ashley Yano

Brian Cahill

Drew Baird

Kenneth Romito

Addressing the Risk of Postpartum Hemorrhage in African American or Black Patients at a Military Treatment Facility

解决非洲裔或黑人患者在军事治疗机构中产后出血风险的问题

Kristen Hill

Reflections From an Intrapreneurial Podcaster

内部创业者播客的反思

Kim Reina Failla

Jennifer Hinson

Melodie Daniels

Leah Brown

Dawn Harrell

Julie-Kathryn Graham

An Electrocardiogram Taskforce to Lean System Competency in Rhythm Recognition in a High-Reliability Organization

高可靠性组织中识别节律能力的动态心电图特别工作组

Abstract Life satisfaction is a multidimensional construct impacted by many variables and needs to be explored within that context. A correlational design was used to survey community-dwelling older adults to determine perceptions of life satisfaction and its association with physical, social, psychological, and environmental factors. The sample was primarily White (n = 474 [93%]) but balanced between male (n = 253 [50%]) and female (n = 258 [50%]). The mean age was 73.1 (SD, 4.8) years. Associations with life satisfaction were evaluated using linear regression models. In multivariable modeling, social isolation, living alone, depression, sleep disturbance, social vulnerability, and physical ability predicted life satisfaction. Physical ability was the only predictor of high life satisfaction. Findings underscore the importance of helping older adults with improvements in physical ability and addressing social, psychological, and environmental influences that may lead to low life satisfaction.

Lee Anne Siegmund

Sandra L. Siedlecki

James F. Bena

Physical, Social, Psychological, and Environmental Predictors of Life Satisfaction Among Older Adults

老年人生活满意度的生理、社会、心理和环境预测因素

Jeanine Young-Mason

The Power of Music and Dance to Heal and Transform

音乐与舞蹈治愈与蜕变的力量

Abbreviation	Clin Nurse Spec
Journal Impact	0.91
Quartiles(Global)	NURSING(Q3)

ISSN	0887-6274, 1538-9782
h-index	37

Publication Information	Publisher: Lippincott Williams and Wilkins Ltd.，Publishing cycle: Bimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1987，Proportion of original research papers: 97.30%，Self Citation Rate:9.10%， Gold OA Rate: 1.85%
Average review cycle	网友分享经验：>12周，或约稿
Average recruitment ratio	网友分享经验：容易

Clinical Nurse Specialist

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Feasibility Study of Acupuncture for Reducing Sleep Disturbances and Hot Flashes in Postmenopausal Breast Cancer Survivors

Safeguarding Patients

Comparison of 3 Methods to Prevent Pain and Bruising After Subcutaneous Heparin Administration

Ethical Decision Making in Critical Care

Addressing the Risk of Postpartum Hemorrhage in African American or Black Patients at a Military Treatment Facility

Addressing the Risk of Postpartum Hemorrhage in African American or Black Patients at a Military Treatment Facility

Reflections From an Intrapreneurial Podcaster

An Electrocardiogram Taskforce to Lean System Competency in Rhythm Recognition in a High-Reliability Organization

Physical, Social, Psychological, and Environmental Predictors of Life Satisfaction Among Older Adults

The Power of Music and Dance to Heal and Transform