Abstract

Clinical Nurse Specialists (CNSs) are frequently consulted for their expertise, but formalizing this process via the electronic medical record (EMR) provides new opportunities for direct correlation of utilization of the CNS as a patient intervention to outcomes improvement. This project established a structured CNS consult process in the Cardiovascular Intensive Care Unit (CVICU), enabling multidisciplinary team members to order CNS consults tied to various concerns and access detailed post-consult notes in real time.

This project aimed to formalize CNS consults in the CVICU using EMR integration to enhance interdisciplinary collaboration and improve patient outcomes. By enabling team members to request CNS consultations and access detailed post-consult notes in real time, the intervention bridged gaps in communication and clinical decision-making.

Key interventions included bedside mentoring, targeted education sessions, and a structured process for documenting and tracking CNS consults via the EMR. Pre- and post-intervention data were analyzed to evaluate nurse-sensitive indicators, including central line-associated bloodstream infections (CLABSI), hospital-acquired pressure injuries (HAPI), and delirium identification rates. Additionally, nurse perceptions of the CNS role were measured using a 20 question survey with Likert scale questions.

Results demonstrated a 4% reduction in HAPI rates, attributed to increased CNS presence at the bedside, improved assessment practices, and preventative measures identified through open dialogue and staff education. CLABSI rates decreased by 41%, and delirium identification rates increased 15-fold due to enhanced CNS visibility and guidance. Survey results revealed statistically significant improvements in nursing perceptions of the CNS role, with 2024 nurses more likely to report positive views compared to 2023 (p < 0.05).

This initiative highlights the transformative potential of formalized CNS consults in advancing clinical practice. By leveraging EMR integration and fostering real-time interdisciplinary communication, this model has shown measurable improvements in patient outcomes and staff engagement. The findings offer a scalable approach for high-acuity care settings seeking to enhance nursing excellence and patient-centered care.

Notes

Reference list included in attached slide deck.

Description

Integrating CNS consults into the EMR in the CVICU transformed care delivery, reducing CLABSI by 41%, HAPI by 4%, and improving delirium identification rates 15-fold. This process enhanced interdisciplinary collaboration, education, and nurse perceptions of the CNS role, demonstrating scalable improvements in patient outcomes and staff engagement. Attendees will learn about this innovative, high-impact model for advancing nursing excellence in critical care.

Author Details

Sarah Beldin, MSN, APRN, ACCNS-AG, CCRN; Kristina Boudreau. MSN

Sigma Membership

Zeta Theta at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Acute Care, Interprofessional, Interdisciplinary, Coaching, Clinical Nurse Specialists, CNS, Electronic Medical Record, EMR, Cardiovascular Intensive Care Unit, CVICU

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-11-27

Click on the above link to access the slide deck.

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From Insight to Impact: CNS Consults in the CVICU

Indianapolis, Indiana, USA

Clinical Nurse Specialists (CNSs) are frequently consulted for their expertise, but formalizing this process via the electronic medical record (EMR) provides new opportunities for direct correlation of utilization of the CNS as a patient intervention to outcomes improvement. This project established a structured CNS consult process in the Cardiovascular Intensive Care Unit (CVICU), enabling multidisciplinary team members to order CNS consults tied to various concerns and access detailed post-consult notes in real time.

This project aimed to formalize CNS consults in the CVICU using EMR integration to enhance interdisciplinary collaboration and improve patient outcomes. By enabling team members to request CNS consultations and access detailed post-consult notes in real time, the intervention bridged gaps in communication and clinical decision-making.

Key interventions included bedside mentoring, targeted education sessions, and a structured process for documenting and tracking CNS consults via the EMR. Pre- and post-intervention data were analyzed to evaluate nurse-sensitive indicators, including central line-associated bloodstream infections (CLABSI), hospital-acquired pressure injuries (HAPI), and delirium identification rates. Additionally, nurse perceptions of the CNS role were measured using a 20 question survey with Likert scale questions.

Results demonstrated a 4% reduction in HAPI rates, attributed to increased CNS presence at the bedside, improved assessment practices, and preventative measures identified through open dialogue and staff education. CLABSI rates decreased by 41%, and delirium identification rates increased 15-fold due to enhanced CNS visibility and guidance. Survey results revealed statistically significant improvements in nursing perceptions of the CNS role, with 2024 nurses more likely to report positive views compared to 2023 (p < 0.05).

This initiative highlights the transformative potential of formalized CNS consults in advancing clinical practice. By leveraging EMR integration and fostering real-time interdisciplinary communication, this model has shown measurable improvements in patient outcomes and staff engagement. The findings offer a scalable approach for high-acuity care settings seeking to enhance nursing excellence and patient-centered care.