《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

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

Purpose Advanced medical therapies enable people to live longer with multiple comorbidities, increasing the acuity and complexity of care required upon admission into the intensive care unit. This, coupled with the shift toward a less experienced nursing workforce as skilled nurses retire or leave the critical care environment, prompted the need to re-envision how critical care is delivered. The purpose of this quality improvement project was to embed the values of staff and patient partners in a re-envisioned critical care model, which aligns the provision of high-quality care with staff skill mix and patient needs. Methods Through a series of clinical nurse specialist–led engagement sessions with patients, families, and the members of the healthcare team who work in this environment every day, we talked about what is important in critical care. We used their words and thoughts to inform and shape a new sustainable model of critical care. Outcome The 4 components identified as essential to achieving this vision include an acuity-complexity–based approach to care, a transition from separate high-acuity and intensive care areas to integrated units, development of a career pathway to advance practice, and exploration of opportunities to optimize the scope of the interprofessional team. Conclusion Embedding the values and experience of the people directly connected with providing and/or experiencing critical care increases the likelihood of success in developing, implementing, and sustaining a new model of care. This multifaceted approach resulted in 4 distinct components with achievable outcomes that support this re-envisioned patient-centered sustainable model of critical care.

Sharon Hickin

Heather Hudniuk

Sarah Gyorfi

Improving Patient Care Through Collaborative Re-envisioning of the Model of Critical Care

通过协作重新构想重症监护模式以改善患者护理

Abstract External urine management devices were introduced into healthcare as a novel solution to avoid indwelling urinary catheter placement and the associated urinary tract infection risk for adult patients. These devices are favored among healthcare workers and patients. However, the downstream impacts of this device can be detrimental to patient outcomes when immobility is promoted through their use. Clinical nurse specialists are the ideal team member to evaluate the introduction of new technology to promote patient-focused care over task-focused care.

Lauren Crosby

Lydia Booher

Misuse of External Urine Management Devices in Hospitalized Patients

住院患者对外用尿管管理装置的误用

Adarsh Singh Sidhu

Maria Galletto

Clin Nurse Spec

Incorporating Sikh Culture Into Palliative Care of Critically Ill Children

将锡克文化融入危重儿童的临终关怀

Purpose/Objectives To present evidence-based elements supporting the synergistic relationship between nurse scientists and clinical nurse specialists to improve the translation of evidence into practice. Description of the Project/Program Using best-practice elements to support the improvement of evidence-based translation, we define the roles and synergies between nurse scientists and clinical nurse specialists within clinical environments. Outcome Five themes were identified in the literature review: ● Although clinical nurse specialists and nurse scientists differ in focus and competencies, they are in key positions to collaborate to meet healthcare demands. ● Clinical nurse specialists are well-equipped to implement the science developed by nurse scientists. ● To meet the increased demands and complexity of the healthcare system and patient needs, organizational leadership must lend support to clinical nurse specialists and nurse scientist collaboration. ● Clinical nurse specialists are well-positioned to foster interprofessional partnerships and generate opportunities for evidence-based project initiatives across healthcare disciplines. ● Clinical nurse specialists should utilize professional models to inform practice to improve the review, translation, and implementation of research into practice. Conclusion Projects conducted using a collaborative structure had a system-level impact and long-term sustainability capabilities. Additionally, projects were more likely to be disseminated by clinical nurse specialists within a formal structure.

Joshua D Smith

Gina L Eberhardt

Bethany I Atwood

Kenneth J Romito

David F Bradley

Patricia M Schmidt

Elements Supporting Translation of Evidence Into Practice

支持将证据转化为实践的要素

Chelsea Passwater

Erica A Fischer-Cartlidge

Julie M Linder

Kathleen Wiley

Piloting an Innovative Collaboration Between a Clinical Nurse Specialist Program and a Professional Organization

临床护理专家项目与专业组织之间创新合作的试点

短名	Clin Nurse Spec
Journal Impact	0.91
国际分区	NURSING(Q3)
期刊索引	SCI Q4中科院 4 区

ISSN	0887-6274, 1538-9782
h-index	37
国内分区	医学(4区)医学护理(4区)

涉及主题	医学心理学政治学护理部法学生物计算机科学病理化学经济生物化学家庭医学梅德林
出版信息	出版商: Lippincott Williams and Wilkins Ltd.，出版周期: Bimonthly，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 1987，原创研究文献占比: 97.30%，自引率:9.10%， Gold OA占比: 1.85%
平均审稿周期	网友分享经验：>12周，或约稿
平均录用比例	网友分享经验：容易

Clinical Nurse Specialist

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Safeguarding Patients

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

Improving Patient Care Through Collaborative Re-envisioning of the Model of Critical Care

Misuse of External Urine Management Devices in Hospitalized Patients

Incorporating Sikh Culture Into Palliative Care of Critically Ill Children

Improving Patient Care Through Collaborative Re-envisioning of the Model of Critical Care

Misuse of External Urine Management Devices in Hospitalized Patients

Incorporating Sikh Culture Into Palliative Care of Critically Ill Children

Elements Supporting Translation of Evidence Into Practice

Piloting an Innovative Collaboration Between a Clinical Nurse Specialist Program and a Professional Organization