title: The clinical nurse specialist role in Canada.
abstract: The clinical nurse specialist (CNS) provides an important clinical leadership role for the nursing profession and broader healthcare system; yet the prominence and deployment of this role have fluctuated in Canada over the past 40 years. This paper draws on the results of a decision support synthesis examining advanced practice nursing roles in Canada. The synthesis included a scoping review of the Canadian and international literature and in-depth interviews with key informants including CNSs, nurse practitioners, other health providers, educators, healthcare administrators, nursing regulators and government policy makers. Key challenges to the full integration of CNSs in the Canadian healthcare system include the paucity of Canadian research to inform CNS role implementation, absence of a common vision for the CNS role in Canada, lack of a CNS credentialing mechanism and limited access to CNS-specific graduate education. Recommendations for maximizing the potential and long-term sustainability of the CNS role to achieve important patient, provider and health system outcomes in Canada are provided.
authors.affiliation: School of Nursing and Department of Oncology, McMaster University, CHSRF/CIHR Program in Advanced Practice Nursing, Canadian Centre of Excellence in Oncology Advanced Practice Nursing at the Juravinski Cancer Centre, Hamilton, ON.
authors.forename: Denise
authors.initials: D
authors.lastname: Bryant-Lukosius
authors.forename: Nancy
authors.initials: N
authors.lastname: Carter
authors.forename: Kelley
authors.initials: K
authors.lastname: Kilpatrick
authors.forename: Ruth
authors.initials: R
authors.lastname: Martin-Misener
authors.forename: Faith
authors.initials: F
authors.lastname: Donald
authors.forename: Sharon
authors.initials: S
authors.lastname: Kaasalainen
authors.forename: Patricia
authors.initials: P
authors.lastname: Harbman
authors.forename: Ivy
authors.initials: I
authors.lastname: Bourgeault
authors.forename: Alba
authors.initials: A
authors.lastname: DiCenso
mesh_terms: D057179:Advanced Practice Nursing / Q000193:education / Q000458:organization & administration* / Q000592:standards; D002170:Canada; D002983:Clinical Competence; D003406:Credentialing; D003661:Decision Support Techniques; D003695:Delivery of Health Care; D004521:Educational Measurement; D004522:Educational Status; D017144:Focus Groups; D006801:Humans; D007857:Leadership; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration* / Q000592:standards; D024802:Nurse's Role