Observing the work of the Clinical Nurse Specialist: a pilot study.
The Clinical Nurse Specialist (CNS) is an advanced practice nurse (APN) with graduate preparation as a clinical expert within a specialty area of nursing practice. There is a need for information about the work of the CNS in order to link CNS activities to outcomes and costs of care.


OBJECTIVE
To describe the work of the CNS in the acute care setting using the National Association of Clinical Nurse Specialists (NACNS) model as an organizing framework.


METHODS
Descriptive pilot study of the work of the CNS in acute care.


METHODS
A 500-bed academic medical center located in the Midwestern United States.


METHODS
Five masters-prepared APNs in a unit-based CNS role.


METHODS
Direct observation and time study were used to record activities and time for 4 hours with each CNS (n = 5) for a total of 20 hours of observation.


RESULTS
CNS activity and time within each practice domain included patient/client (30%), nursing (44%), organization/system (10%), and other activities (16%). Specific activities observed were linked to possible outcomes in the NACNS framework.


CONCLUSIONS
The NACNS model provided a useful framework for developing a data collection tool that can be used in a larger study that analyzes the work of the acute care CNS.


CONCLUSIONS
Describing the work of the CNS is an important preliminary step to measuring outcomes and costs of care.
Darmody
Julie V
JV
School of Nursing, Clinical Science Center, University of Wisconsin-Madison, Madison, WI 53792-2455, USA. jvdarmody@wisc.edu
D000046:Academic Medical Centers; D000208:Acute Disease / Q000451:nursing; D002983:Clinical Competence; D003142:Communication; D003253:Consultants; D003625:Data Collection; D004509:Education, Nursing, Continuing; D004511:Education, Nursing, Graduate; D004650:Employee Performance Appraisal; D006801:Humans; D007400:Interprofessional Relations; D007587:Job Description; D008008:Licensure, Nursing; D015146:Midwestern United States; D016294:Models, Nursing; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration* / Q000523:psychology; D024802:Nurse's Role / Q000523:psychology; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D010865:Pilot Projects; D017009:Professional Autonomy; D013996:Time and Motion Studies