Establishing the Clinical Nurse Specialist Identity by Transforming Structures, Processes, and Outcomes

Area of Science:

• Nursing Practice
• Healthcare Administration
• Quality Improvement

Background:

• The clinical nurse specialist (CNS) role requires clear definition to distinguish it from other nursing positions within academic medical centers.
• Ensuring alignment between CNS responsibilities and core competencies is crucial for effective role implementation and impact.

Purpose of the Study:

• To delineate the clinical nurse specialist (CNS) role from other nursing roles.
• To align CNS responsibilities with core competencies.
• To categorize CNS role-specific activities and disseminate role-sensitive outcomes.

Main Methods:

• The Donabedian model was employed to evaluate the CNS position against established standards.
• Job descriptions were restructured based on CNS competencies and practice standards.
• A productivity tracking system and outcomes reporting method were developed.

Main Results:

• Job description revisions resulted in 88% alignment with CNS competencies and standards.
• The process increased collective role-specific work from 36% to 95%.
• Outcomes were identified from four frequently performed role-specific activities.

Conclusions:

• Redesigning the job description, documenting activities, and capturing outcomes successfully established and differentiated the CNS role.
• Dissemination of findings through a year-end report garnered positive leadership response.
• The study confirmed the need for current and additional CNS positions.