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Differentiating Specialized and Advanced Nursing Roles: The Pathway to Role Optimization
Krista Jokiniemi1, Denise Bryant-Lukosius2, Josette Roussel3
1University Lecturer, Department of Nursing Science, University of Eastern Finland, Kuopio, Finland, Canadian Centre for Advanced Practice Nursing Research, School of Nursing, McMaster University, Hamilton, ON.
Nursing Leadership (Toronto, Ont.)
|August 8, 2023
Summary
Canadian nurses in specialized and advanced roles show distinct practice patterns. Nurse practitioners focus on direct care, while clinical nurse specialists lead in systems support, education, research, and leadership.
Area of Science:
- Nursing Practice
- Healthcare Policy
- Advanced Practice Nursing
Background:
- Specialized and advanced nursing roles are integral to modern healthcare systems.
- Understanding the unique contributions of different advanced nursing roles is crucial for optimizing healthcare delivery.
- Previous research has not fully delineated the practice patterns across various specialized nursing roles.
Purpose of the Study:
- To differentiate the practice patterns of nurses in specialized and advanced roles.
- To compare the time spent in five domains of advanced practice across different nursing groups.
- To identify factors influencing domain involvement in advanced nursing practice.
Main Methods:
- A cross-sectional study involving Canadian nurses.
- Self-report questionnaires were administered from June to September 2017.
- Demographic data and time allocation across five advanced practice domains were analyzed using regression analysis for specialized nurses (SNs), clinical nurse specialists (CNSs), and nurse practitioners (NPs).
Main Results:
- A total of 1,107 nurses participated, representing all Canadian provinces/territories.
- Nurses across all groups dedicated the most time to direct comprehensive care and the least to research.
- Nurse practitioners (NPs) showed higher involvement in direct comprehensive care compared to CNSs and SNs (p < 0.001).
- Clinical nurse specialists (CNSs) demonstrated greater involvement than SNs and NPs in systems support, education, research, and professional leadership (p < 0.001).
- Role type, years as an advanced practice nurse, and specialist certification were identified as modest predictors of domain involvement.
Conclusions:
- Distinct practice patterns exist among specialized and advanced nursing roles in Canada.
- Nurse practitioners primarily engage in direct patient care, while clinical nurse specialists focus on broader system-level activities.
- Differentiating these roles can inform healthcare policies for their optimal utilization and support within healthcare systems.
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