Preventing Aspiration Complications: Implementing a Swallow Screening Tool Aims: The aim of this study was to decrease the number of patients with acquired aspiration mortality. Design: This was an evaluation research study. Data were collected on acutely ill hospitalized patients from January 2013 to December 2017. Methods: In 2016, a 1100-bed Midwestern quaternary care facility found an increasing trend in mortality rates of patients with acquired aspiration from 2013 to 2015. A need for improved detection of patients at risk of aspiration was identified. A multidisciplinary team analyzed this need and developed a screening process found on the American College of Chest Physicians practice guidelines and the Massey Bedside Swallowing Screen to reduce these rates. Nurses implemented the aspiration risk screening process on all hospitalized patients. Data were collected through nursing responses and chart reviews. Results: Initial implementation of the aspiration risk screening process yielded procedural concerns that were ameliorated through increased education and refinement of the screen. After refinement and reimplementation, mortality data from 2016 to 2017 revealed a decrease to zero aspiration-related events. Conclusion: Our findings suggest implementation of a nursing-led aspiration risk screening process with acutely ill patients is a factor in decreasing patient mortality from acquired aspiration. These clinical practice changes of identifying patients at risk of aspirating and involving dysphagia therapists prior to oral intake increase patient safety while decreasing acquired aspiration mortality. Impact: This study addressed upward trends in patient mortality with acquired aspiration. Mortality rates declined after implementation of the aspiration risk screening process on hospitalized patients. These findings have potential to impact healthcare personnel and all acutely ill hospitalized patients. NACNS Newsletter: President’s Message No abstract available

Nursology?! No abstract available

Reliability and Validity Measurement Issues: Nothing New to Clinical Nurse Specialists; But Liability Issues, Too? No abstract available

Pilot or Feasibility Studies: An Option for the Clinical Nurse Specialist to Consider No abstract available

Think Tramadol Is a Safer Option? Think Again!: Prescribing Considerations for the Clinical Nurse Specialist No abstract available

Early Enteral Nutrition Within 24 Hours of Lower Gastrointestinal Surgery Versus Later Commencement for Length of Hospital Stay and Postoperative Complications No abstract available

Creating a Nonprofit Organization in Response to a Clinical Need No abstract available

Instrument Development for Evaluation of Gerontological Nurse Specialists Core Competencies in China Purpose: This study aimed to determine the core competencies of Chinese gerontological nurse specialists and test the psychometric properties of a core competency self-evaluation instrument. Methods: This study consisted of 2 stages. A literature review, theoretical analysis, and the Delphi methods involving 28 experts were performed to identify the core competencies required of gerontological nurse specialists in China. Then, a self-evaluation instrument developed based on the results of stage I was tested among 225 certified gerontological nurse specialists. An exploratory factor analysis was applied to test the construct validity, and the content validity and reliability were also evaluated. Results: The core competencies of gerontological nurse specialists comprised 3 first-level domains, 9 second-level dimensions, and 69 third-level items. The average scale-level content validity, overall instrument’s Cronbach’s α, and test-retest reliability were 0.963, 0.983, and 0.834, respectively. The results of the exploratory factor analysis indicated that the factors in the 3 first-level domains (attitude, skill, and knowledge) explained 68.579%, 69.599%, and 75.872% of the variance, respectively. Conclusion: The results showed that the core competencies of Chinese gerontological nurse specialists were reliable and that gerontological nurse specialists could use this self-evaluation instrument to assess their core competencies.

Clinical Nurse Specialist Preceptor Protocol Purpose: Develop an evidence-based clinical nurse specialist (CNS) preceptor protocol to enhance preceptor’s skills and effectiveness and strengthen the preceptor-preceptee relationship and outcomes. Description: An effective CNS preceptor is a key variable to quality, timely, and fiscally responsible CNS transition and retention. Most preceptors receive no formal education or skill development. Literature searched from the previous 10 years explored CNS preceptor, preceptee, and preceptorship process. Outcomes: Protocol key components are development of the mutual collaborative relationship, shared meaning, understanding, goal setting, timelines, and evaluations. The planning phase of the protocol includes face-to-face meeting to identify overarching goals and establish a trusting collaborative relationship. The mutual iterative learning and growing phase includes identification of learning needs, goals, and strategies such as debriefing, reflective journaling, and mutual ongoing evaluation. The concluding phase includes formal evaluation. The outcome phase includes safe autonomous CNS practice, along with mutual growth and satisfaction. Conclusions: The literature informed the CNS preceptor protocol development. The protocol may be evaluated within a preceptor-preceptee relationship across multiple settings. Higher levels of CNS research are vital to identify evidence-based CNS preceptorship strategies. As CNSs are integrated into advanced practice roles, a structured preceptor protocol and education program is critical to provide quality outcomes.