Collaborative practice: a successful model.

Recognizing the need for better collaboration, nursing personnel from two nonrelated health care facilities, acute care and rehabilitation hospitals, came together to establish a methodology to improve outcomes for patients with spinal cord injury (SCI). Focus areas were to facilitate communication and transition between hospitals. A collaborative practice model evolved for the patient with tetraplegia who is ventilator-dependent. This model has been successfully instituted in both institutions. This article describes the processes used in developing this model. It also includes recommendations for the reader to create a workable process in his or her respective institution.

Acute care management of severe traumatic brain injuries.

Preservation or restoration of optimal neurologic function following traumatic brain injury (TBI) requires timely and aggressive therapeutic interventions. Effective diagnostic tools, together with an armamentarium of treatment modalities, have augmented the treatment strategies utilized today. In addition, the Guidelinesfor the Management of Severe Head Injury have established a standardized approach for the TBI patient. This article will provide current information regarding the resuscitation priorities, appropriate interventions, and pharmacological agents used in the treatment required by the complex nature of TBI. Also, a review of the occurrences associated with TBI will be discussed.

Acute care management of spinal cord injuries.

Meeting the health care needs of the spinal cord-injured patient is an immense challenge for the acute care multidisciplinary team. The critical care nurse clinician, as well as other members of the team, needs to maintain a comprehensive knowledge base to provide the care management that is essential to the care of the spinal cord-injured patient. With the active participation of the patient and family in care delivery decisions, the health care professionals can help to meet the psychosocial and physical needs of the patient/family unit. This article provides an evidence-based, comprehensive review of the needs of the spinal cord-injured patient in the acute care setting including optimal patient outcomes, methods to prevent complications, and a plan that provides an expeditious transition to rehabilitation.

Broadening the educator's role. The use of support staff in implementing staff empowerment.

The move to empowerment is on. Healthcare organizations are beginning to recognize the benefits of staff empowerment to both the organization and the staff members. The question for educators is how can skills be best used to support the organization throughout the change. In this article, the role of the educator in the implementation of staff empowerment at a large tertiary care center is described.

The clinical nurse specialist role in shared governance.

In the current health care environment, changes in organizational structure and care delivery systems are occurring in an effort to improve quality, efficiency, and customer satisfaction while decreasing cost. Shared governance empowers the staff to help facilitate these changes. The clinical nurse specialist (CNS) is a key person in facilitating and maintaining the shared governance environment. This new facet of the role makes the CNS a valuable resource and is instrumental in helping the organization achieve its goals. This article addresses the CNS's role in the initiation and continuation of shared governance within the nursing department.