Evaluation of clinical nurse specialist practice

Evaluation of the impact of clinical nurse specialist (CNS) practice in today's health care environment is currently one of the most important issues facing these advanced practitioners and nursing administrators. The unique contributions of CNS practice can be demonstrated through use of sophisticated evaluation methods. This paper begins with a discussion of types of evaluation (structure, process, and outcome) that have been utilized in the past and then describes the structure, developmental process, and function of an evaluation instrument recently implemented by a group of CNSs. The evaluation instrument is a step towards the ultimate goal of process-outcome evaluation, the most sophisticated method of evaluating the impact of the CNS. The benefits of utilization of this tool are presented from the perspective of CNSs and nurse administrators.