Building a Professional Practice of Critical Care Nursing Excellence: The CCNS Role

1
Building a Professional Practice of Critical Care
Nursing Excellence The CCNS Role

• Georgetown University
• School of Nursing Health Studies
• Karen Kesten, MSN, APRN, CCRN, PCCN, CCNS
• Assistant Professor and Program Director, ACNP
  and CCNS Programs
• Linda Briggs MSN, APRN, BC-ACNP, ANP, CCRN
• Clinical Assistant Professor ACNP Clinical
  Coordinator
• Helen Brown MS, APRN, BC-ACNP, FNP
• Clinical Faculty

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Why Graduate School??

• New challenge
• Professional growth
• Increased new exciting opportunities for health
  care delivery
• Expansion of personal nursing network
• Positioning in the 21st Century

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What is a CCNS?

• The Acute and Critical Care Clinical Nurse
  Specialist (CCNS) is a masters prepared
  advanced practice nurse who provides expert care
  and improves the outcomes of acutely and
  critically ill patients through the 3 spheres of
  influence the patient/family, nursing personnel,
  and organizational systems. The CCNS care is
  collaborative, continuous and comprehensive and
  may be provided in a variety of settings.
• Scope of Practice and Standards of Professional
  Performance for the Acute and Critical Care
  Clinical Nurse Specialist (AACN 2002)

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The CCNS The 5 Roles That ALL
Patients/Families Deserve and Organizations Need

• The Clinical Expert
• The Educator
• The Consultant
• The Researcher
• The Leader

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CCNS Models of Practice

• Joint Professional Practice Model
• RE CCNS reports to Nursing Administration
  Physician
• Nursing Based Practice Model
• RE CCNS assigned to CVICU
• Physician Based Practice Model
• RE CCNS in practice with private group

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Role Differentiation for the CCNS

• CCNS and ACNP
• CCNS more systems focus
• ACNP more patient focus
• Both 3 spheres of influence
• Patients families, Staff and System
• CCNS and other CNSs
• CCNS more acute and critical care settings
• Other CNSs more med-surg or psych-mental health
  settings

• CCNS and Physician Assistants
• CCNS practices under own license
• PA practices under MD license
• CCNS and Physicians
• CCNS more systems focus
• MD more patient focus

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CCNS Characteristics

• Excellence in clinical judgment
• Excellence in advocacy/moral agency
• Excellence in caring practices
• Excellence in collaboration

• Curley, MA.. Patient-nurse synergyoptimizing
  patients outcomes. Am J Crit Care. 1998764-72.
• Maloney, PA. The synergy model Contemporary
  practice of the CNS. Crit Care Nurse.
  19992101-104.

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CCNS Characteristics

• Excellence in systems thinking
• Excellence in diversity
• Excellence in clinical inquiry or
  innovator/evaluator
• Excellence in facilitating staff/patient/family
  education

• Curley, MA.. Patient-nurse synergyoptimizing
  patients outcomes. Am J Crit Care. 1998764-72.
  
• Maloney, PA. The synergy model Contemporary
  practice of the CNS. Crit Care Nurse.
  19992101-104.

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CCNS Educational Preparation

• Masters / Post Masters Program with 500 hours in
  direct clinical CNS practice
• Certification through the American Association of
  Critical Care Nurses (AACN)
• AACN re-certification requirements
• Minimum of 500 clinical hours as a CCNS in the
  care of acutely-and/or critically ill pts within
  last four years PLUS
• Performed a minimum number of activities within
  the last four years associated with the following
  eight nurse characteristics clinical judgment,
  clinical inquiry, facilitator of learning,
  collaboration, systems thinking, advocacy/moral
  agency, caring practices and response to
  diversity
• Vignette of 300-500 words to describe activities
  performed during the four year period that
  contributed to optimal outcomes for pts/families,
  nurses, or organization
• OR retaking and passing the CCNS certification
  exam

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Why Georgetown CCNS Track The Strengths

• Top ranking by US News World Report
• Established history of critical care nursing
  excellence
• Top Quality Acute Critical Care CNS Program in
  the Washington DC and Baltimore, MD area
• 100 success rate on CCNS exam past several years
• Georgetown University Simulator (GUS)
• Cadaver laboratory

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Why Georgetown CCNS Program The Strengths

• Mentoring by faculty who walk and talk the role
  through practice, research, publications,
  presentations
• Leadership by faculty who are recognized for
  nursing contributions with the American
  Association of Critical Care Nurses (AACN) and
  the American Nurses Association (ANA)

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Why Georgetown CCNS Program The Strengths

• Based in the nations capital for legislative and
  policy making activities
• Recognized as leading institute in bioethics and
  cura personalis

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Georgetown CCNS Tract Description

• Strong scientific and values based education
• Clinical experience with CNSs range from SICUs to
  MICUs to Emergency Departments to Sub-Acute
  Facilities

• 40 credit hours
• 500 clinical hours
• FULL Time (one year option) or PART Time (2-3
  year option)
• Post Masters Track Option

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CCNS Curriculum _at_ Georgetown

• Analytical Tools Biostatistics
• Bioethics
• Scholarly Inquiry in Health Care
• Health Systems Policies in Transition
• Professional Aspects of Advanced Practice Nursing
• Advanced Health Assessment
• Advanced Pathophysiology
• Advanced Pharmacology
• Instructional Methodologies and Design
• CCNS I, CCNS II, CCNS III
• Scholarly Project

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A Day in the Life of our CCNS Faculty

• Karen Kesten
• CCNS and ACNP Program Director
• Critical Care experience for gt 24 years, to
  include extensive experience in cardiovascular
  and trauma as a CNS, educator and staff nurse.
  Most recent CNS positions at Washington Adventist
  Hospital , and Shock Trauma at Washington
  Hospital Center. Recently coordinating critical
  care nursing education in the Northern GWAC-AACN
  Critical Care Consortium.
• Accomplished speaker active American
  Association of Critical Care Nurses (AACN)
  member Chapter Advisor for Region 4 of AACN
  former President of the Greater Washington DC
  Area Chapter (GWAC)

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A Day in the Life of our CCNS Faculty

• Linda Briggs
• CCNS ACNP Faculty
• Critical Care experience for gt 20 years, to
  include extensive experience in the
  cardiovascular field as a CNS and ACNP. Previous
  CNS experience at Alexandria Hospital and Prince
  Georges Hospital. Current ACNP position at
  Interventional Cardiology at Georgetown
  University Medical Center.
• Accomplished speaker in the Washington/Baltimore
  metropolitan area past President for AACNs
  Greater Washington DC Area Chapter (GWAC).

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DECIDING CRITERIA TO BE A CCNS The 5 Cs

• Clinical competence
• Confidence in self
• Consistent tough BUT flexible skin
• Collaborative approach for patient care
• Commitment for professional growth and nursing
  excellence

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Are You Ready To Take That Professional Step for
Critical Care Nursing Excellence???

• Call Georgetown University School of Nursing
  Health Studies
• Karen S. Kesten, MSN, APRN,CCRN,PCCN,CCNS
• Assistant Professor and CCNS ACNP Program
  Director
• 202-687-2116
• Or Visit Our Webpage For More Information
• http//snhs.georgetown.edu