title: Clinical nurse specialist practice in evidence-informed multidisciplinary cardiac care.
abstract: Care gaps exist in the management of cardiac patients throughout the care continuum. The clinical nurse specialist (CNS) is paramount in the development, implementation, and evaluation of tools to assist care providers in the use of evidence-informed therapies to maximize patient outcomes. The purpose of this article was to describe the CNS practice in terms of these evidence-informed initiatives for defined cardiac populations. Putting evidence into practice is one of the primary responsibilities for the CNS practice. Evidence-informed tools such as clinical pathways have been implemented throughout the healthcare region to reduce care gaps for the acute myocardial infarction and cardiac surgery populations. These tools equip care providers with a standards document, physician order sets, cardiac rehabilitation referral process, care guide, depression screening tool, and patient education material. By incorporating interventions known to reduce avoidable adverse events in the cardiac population into the clinical pathways, patient outcomes have been impacted. Ongoing evaluation of the evidence-informed tools through regular tracking of key indicators has enabled refinement of existing processes and care. It is the CNS practice that ensures not only patient care standards, but also daily routine care are underpinned by scientific evidence. Bridging research with clinical practice remains the stronghold for CNS practice.
authors.affiliation: Winnipeg Regional Health Authority Cardiac Sciences Program, Winnipeg, Canada. lavery@sbgh.mb.ca
authors.forename: Lorraine J
authors.initials: LJ
authors.lastname: Avery
authors.forename: Karen N
authors.initials: KN
authors.lastname: Schnell-Hoehn
mesh_terms: D002318:Cardiovascular Diseases / Q000451:nursing*; D055318:Evidence-Based Nursing; D006801:Humans; D013041:Specialties, Nursing; D016896:Treatment Outcome; D000078329:Workforce