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Using Learning Outcome Measures to assess Doctoral Nursing Education

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Published on: June 21, 2010

Structural and Process Factors That Influence Clinical Nurse Specialist Role Implementation.

Kelley Kilpatrick¹, Eric Tchouaket, Nancy Carter

¹Author Affiliations: Assistant Professor, Faculty of Nursing, Université de Montreal, Affiliate Faculty, Canadian Centre for Advanced Practice Nursing Research, and Researcher, Hôpital Maisonneuve-Rosemont Research Centre, Montréal, Quebec (Dr Kilpatrick); Assistant Professor, Department of Nursing, Université du Québec en Outaouais, Saint-Jérôme, Québec (Dr Tchouaket); Assistant Professor, School of Nursing, McMaster University, and Affiliate Faculty, Canadian Centre for Advanced Practice Nursing Research, Hamilton, Ontario (Dr Carter); Associate Professor, School of Nursing and Department of Oncology, McMaster University, and Codirector, Canadian Centre for Advanced Practice Nursing Research, Hamilton, Ontario (Dr Bryant-Lukosius); and Professor Emeritus, School of Nursing and Department of Clinical Epidemiology & Biostatistics, McMaster University, and Senior Advisor, Canadian Centre for Advanced Practice Nursing Research, Hamilton, Ontario (Dr DiCenso), Canada.

Clinical Nurse Specialist CNS

|February 6, 2016

Summary

Structures and processes significantly influence clinical nurse specialist (CNS) roles. Understanding these factors can optimize CNS practice and improve healthcare quality.

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Last Updated: Mar 26, 2026

Using Learning Outcome Measures to assess Doctoral Nursing Education

Using Learning Outcome Measures to assess Doctoral Nursing Education

Published on: June 21, 2010

Area of Science:

Nursing Science
Healthcare Management
Organizational Behavior

Background:

Clinical Nurse Specialist (CNS) roles are crucial for healthcare quality.
Understanding the factors influencing CNS role implementation is essential for optimizing their impact.
Existing research has not fully elucidated the structural and process elements affecting CNS practice.

Purpose of the Study:

To examine the influence of structure and process on the implementation of the Clinical Nurse Specialist (CNS) role.
To identify key determinants that facilitate or hinder effective CNS role enactment.

Main Methods:

Secondary analysis of cross-sectional survey data from 445 graduate-prepared CNSs in Canada.
Utilized hierarchical regression analysis based on Donabedian's framework.
Assessed the internal consistency of CNS role dimensions and team dynamics subscales, finding excellent reliability.

Main Results:

Framework utilization positively influenced all CNS role dimensions.
Employer understanding, urban setting, specialty certification, and experience positively impacted team dynamics.
Factors like accountability to nurse managers and seeing patients influenced specific dimensions (e.g., organizational leadership, consultation).
Negative influences were observed with non-nurse manager accountability and unionization on certain dimensions.

Conclusions:

Specific structures and processes directly and indirectly influence CNS role implementation across various dimensions.
Identifying these factors can inform strategies for healthcare providers and decision-makers.
Optimizing CNS roles through informed strategies can enhance the delivery of high-quality patient care.