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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

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Expanding Prescriptive Privileges for Clinical Nurse Specialists: Evidence From Practice.

Brandon Tatar¹, Mitzi M Saunders

¹Henry Ford Warren Hospital, Warren, MI (Tatar); McAuley School of Nursing, University of Detroit Mercy, Detroit, MI (Saunders).

Clinical Nurse Specialist CNS

|April 15, 2026

Summary

Clinical nurse specialists (CNS) with prescribing authority can improve patient care and health outcomes. Granting CNSs this authority enhances their ability to meet immediate patient needs and drive quality improvement initiatives.

Keywords:

Advanced Practice Nursing Evidence-Based Practice Leadership Nurse Clinicians Patient Care Prescription Scope of Practice

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Area of Science:

Nursing Practice
Healthcare Policy
Clinical Nurse Specialist Role

Background:

Current legislation in 41 states supports clinical nurse specialist (CNS) prescribing.
Barriers to CNS prescribing implementation exist despite legislative support.
Enhancing CNS practice through prescriptive authority can improve patient, nurse, and system outcomes.

Purpose of the Study:

To demonstrate how a critical care CNS with prescriptive authority can meet immediate patient needs.
To illustrate the potential for CNSs to drive quality improvement initiatives.
To highlight the impact of CNS prescriptive authority on population health outcomes.

Main Methods:

Review of the current legislative landscape regarding CNS prescriptive authority.
Examination of the value of a CNS with prescribing authority through real-time scenarios.
Analysis of potential benefits for direct patient care, healthcare delays, and nurse engagement.

Main Results:

A CNS with prescriptive authority can enhance direct patient care delivery.
Prescriptive authority for CNSs can lead to reduced healthcare delays.
Empowering CNSs with prescribing privileges can foster increased nurse engagement.

Conclusions:

Clinical nurse specialists (CNSs) obtaining prescriptive privileges present opportunities to enhance patient services.
CNSs with prescribing authority can positively impact patient outcomes.
Expanding CNS scope of practice through prescribing authority is a valuable strategy for healthcare improvement.