Embracing the role of a nurse practitioner with a doctorate in nursing practice (DNP) requires taking on the additional challenge of acting as an effective change agent. A DNP’s primary role is to act as a bridge between research and the bedside nurse. A strong clinical background assists in translating research findings into realistic evidence-based practices that nurses can readily incorporate into their daily routines. Nurses needed to learn what resources were available to meet the specific needs of the dying and how to promote a peaceful death. The CARES tool attempts to give some sense of order and structure to the care of the dying. The CARES tool is based on the immense educational resources provided by experts from the End-of-Life National Education Consortium (ELNEC), the National Consensus Project for Quality Palliative Care, and from evidence-based literature reviews.
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This chapter focuses specifically on nursing research program vertical infrastructure. Vertical infrastructure refers to the pillars of the program: the foundation that provides the support to build other services. Three essential components are used to develop a solid nursing research program foundation that advances the scientific foundation of nursing practice and promotes integration of evidence-based practices. The three components are nurse researchers who coach or mentor clinical nurses in nursing research, intranet website resources, and a research departmental database. A successful nursing research program is contingent on having the right nurse researcher personnel who can move research from project inception to dissemination in peer-reviewed literature and translation into practice. Nurse leadership may benefit from educational programs or a business plan that includes the benefits of a nursing research program and information about how a specific nursing research program aligns with strategic goals.
This chapter provides examples of programs and services beyond the foundational elements and global resources that can be used to overcome traditional nursing research barriers. It is assumed that at least one doctorate-prepared nurse researcher is available to facilitate research opportunities and educate nurses about research and evidence-based practice. Many clinical nurses fully understand their clinical roles but are completely unaware of opportunities and resources in nursing research within their hospital. Since contributions of nursing research are vital to the science and art of nursing and provide foundation for evidence-based practices, it is important to overcome the traditional cluster of barriers that include problems with nursing research visibility/priority, time and money, and research education. Nurses need confirmation that nurse leaders support research; when it is visible, it is valued. Moreover, nurses need time, education, and resources to complete rigorous research that leads to discoveries and answers to important clinical problems.
Nurses with a doctor of nursing practice (DNP) degree possess the specific skills needed to address the issues and achieve the goals related to better access, reduced health disparities, balanced quality and cost, improved health literacy, enhanced practice, and sustainability of health care and health care systems. This chapter explains the DNP abilities and proficiencies on financial and business management, applying evidence-based practice (EBPs) to build systems of care, and evaluating outcomes, with specific concentration on grant writing for health care programs. Generally, contemporary operating budgets in the acute hospital, ambulatory, or community settings are based on historic operating expenses and revenues, or increasingly are zero based. This leaves the DNP with little to no margin for increases related to redesigning care delivery models, implementing quality initiatives, initiating performance improvement strategies, or creating new service lines; except, of course, to become leaner.
Clinical Nurse Specialists (
CNS) play a critical role in ensuring the implementation of high-quality evidence based care, improved patient outcomes, and reduced health care delivery costs. Professional certification is one way we distinguish our unique contributions and advanced practice nursing expertise from other advanced practice roles. This first edition of the book represents a compilation of Clinical Nurse Specialist practice knowledge contributed by respected clinicians from across the nation for certification examination preparation. The book incorporates content from the American Association of Colleges of Nursing Adult-Gerontology Clinical Nurse Specialist ( AGCNS) Population Focused Competencies and the American Association of Critical Care Nurses Scope and Standards for CNSPractice. It begins with an introduction to the current AGCNSexamination options, test plans and processes, as well as test taking strategies for success. The remainder of the book organizes test plan subject matter according to the three spheres of impact of CNSpractice. The book includes twelve chapters presenting the overview, pathophysiology, etiology, assessment, diagnosis, treatment/management, and related pharmacology content according to each body system. It addresses the nurse and nursing practice sphere of impact. Relevant content includes age-related response to illness and adult-gerontology population specific practice standards for care and advocacy of the older adult. Emphasis is placed upon culturally competent care and safe care transitions. Nursing practice content includes consultation, collaboration, education, mentoring and communication skills. Nurse and nursing practice advocacy topics review public policy, professional practice issues, and ethical concerns. The book covers systems and systems leadership competencies of the CNS. Relevant content involves quality improvement principles, safety initiatives, financial stewardship, organizational level program development and systems change. Clinical inquiry subject matter covers evidence- based practice, research methodology, and skills for dissemination of CNSwork.
This chapter describes the relevance of critical thinking and the related process and philosophy of evidence-based practice (EBP) to cognitive behavior therapy and suggests choices that lie ahead in integrating these areas. Critical thinking in the helping professions involves the careful appraisal of beliefs and actions to arrive at well-reasoned ones that maximize the likelihood of helping clients and avoiding harm. Critical-thinking values, skills and knowledge, and evidence-based practice are suggested as guides to making ethical, professional decisions. Sources such as the Cochrane and Campbell Collaborations and other avenues for diffusion, together with helping practitioners and clients to acquire critical appraisal skills, will make it increasingly difficult to mislead people about “what we know”. Values, skills, and knowledge related to both critical thinking and EBP such as valuing honest brokering of knowledge, ignorance and uncertainty is and will be reflected in literature describing cognitive behavior methods to different degrees.
Research is a foundation of correctional nursing practice. Correctional nurses can apply general nursing research to the correctional patient population and environment to improve care outcomes. In addition, research specific to correctional nursing practice can provide a basis for nursing care delivery in the specialty setting. Evidence-based practice (EBP) expands upon research utilization to include clinical expertise and patient preference. EBP and best practice guidelines apply external sources of information to local clinical practice. By using research principles in practice, correctional nurses can have greater confidence when changing clinical practice to improve patient outcomes. Involvement in a clinical trial should be of benefit to the inmate and a possible treatment for a known condition. Common therapeutic clinical trial involvement includes treatments for cancer, human immunodeficiency virus (HIV), and Hepatitis C. Clinical issues specific to the specialty practice can be investigated to expand the knowledge base and improve patient outcomes.
- Go to chapter: Integrating Theories of Developmental Psychology Into the Enactment of Child Psychotherapy
Child psychotherapy requires case conceptualization through the lens of developmental psychology in a multimodal approach to assessment, diagnosis, treatment planning, and clinical interventions. This chapter outlines a blueprint for therapists to provide treatment for children by integrating these fundamental principles while collaborating with the other people in the child’s life. The chapter guides the therapist through case conceptualization that integrates the most efficacious treatment interventions into the eight-phase template of eye movement desensitization and reprocessing (EMDR). Adaptive information processing (AIP) theory drives treatment with EMDR throughout the eight phases of that protocol and provides a template for case conceptualization and treatment planning. The use of the EMDR approach to psychotherapy is well documented and approved as evidence-based practice in Substance Abuse and Mental Health Administration (SAMHSA) and California Evidence-Based Clearinghouse for Child Welfare (CEBC).
This book provides the foundations and training that social workers need to master cognitive behavior therapy (CBT). CBT is based on several principles namely cognitions affect behavior and emotion; certain experiences can evoke cognitions, explanation, and attributions about that situation; cognitions may be made aware, monitored, and altered; desired emotional and behavioral change can be achieved through cognitive change. CBT employs a number of distinct and unique therapeutic strategies in its practice. As the human services increasingly develop robust evidence regarding the effectiveness of various psychosocial treatments for various clinical disorders and life problems, it becomes increasingly incumbent upon individual practitioners to become proficient in, and to provide, as first choice treatments, these various forms of evidence-based practice. It is also increasingly evident that CBT and practice represents a strongly supported approach to social work education and practice. The book covers the most common disorders encountered when working with adults, children, families, and couples including: anxiety disorders, depression, personality disorder, sexual and physical abuse, substance misuse, grief and bereavement, and eating disorders. Clinical social workers have an opportunity to position themselves at the forefront of historic, philosophical change in 21st-century medicine. While studies using the most advanced medical technology show the impact of emotional suffering on physical disease, other studies using the same technology are demonstrating CBT’s effectiveness in relieving not just emotional suffering but physical suffering among medically ill patients.
There is abundant evidence of the importance of sleep and sleep disorders in nursing practice. This chapter provides a perspective on future directions in nursing research, practice, and education relative to sleep promotion and prevention and treatment of sleep disorders. It also provides an opportunity to examine some of the exciting possibilities and challenges for advancing sleep science and the implementation of this evidence in the discipline of nursing. While the contributions of nurses to sleep science are growing, the application of science to practice and pedagogy lags behind scientific progress. The chapter presents an overview of opportunities and possible directions for nursing scholarship related to sleep, and also presents an overview of current trends that intersect with the need for evidence-based practice in sleep promotion, and suggest implications for nursing curricula. The effort will require creativity, dedication, strategic planning and successful interdisciplinary collaboration, as well as collaborations within nursing.