Illuminating the clinical nurse specialist role of advanced practice nursing: a qualitative study

School of Nursing, University of British Columbia, Vancouver, BC.
Nursing leadership (Toronto, Ont.) 01/2006; 18(4):70-89. DOI: 10.12927/cjnl.2005.17836
Source: PubMed


As the advanced practice nursing initiative in Canada gains momentum, effort is being directed towards clarifying and defining advanced practice roles. A qualitative study was undertaken to increase understanding of the clinical nurse specialist role of advanced practice. Sixteen nurses who worked in advanced practice roles, organizing and providing healthcare for children with complex health needs and their families across the continuum of care, participated in in-depth conversations about the nature of their practice, the knowledge that informs it and the factors that influence it. Findings suggest that clinical nurse specialists have a unique role in the organization and delivery of healthcare for specialized populations with complex health needs in their dual focus on the system level of healthcare and on population health needs. Initiatives directed to children and families within the study participants' specialties included program development, consultation and educational outreach and the development of clinical guidelines and policies. Although the nurses described their practice as focusing both on individual children and families and on the population of children and families within their specialty, it is at the population level that they see their greatest potential for contributing to the delivery of high-quality, cost-effective healthcare.

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    • "Contrary to the wealth of publications about the substantive areas of ANP and an increasing body of research on the impact of nurse-led services on clinical outcomes, there are few studies examining the elements of process of care that constitute good ANP (Bonsall & Cheater 2008). Some related empirical findings on the positive aspects of ANP can be identified, for example, using a holistic approach to client care (Wong & Chung 2006, Bhattacharya et al. 2007, Edward et al. 2008), improving community–hospital interface (Canam 2005, Stephen 2007), involving family in the care (Canam 2005) and initiating innovative interventions (Stephen 2007). While these findings extend our understanding , the available research-based information is fragmented and a systematic empirical exploration of such elements has been lacking. "
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    • "Notable exceptions were in oncology and palliative care, where CNSs had extensive clinical roles in pain and symptom management and care coordination. In contrast, Canadian studies described a number of ways CNSs were involved in direct patient care, including the assessment and management of acute and chronic illnesses, health promotion, discharge planning, care coordination and education (Bryant-Lukosius et al. 2007; Canam 2005; Charchar et al. 2005; Lasby et al. 2004; Schreiber et al. 2003). Interview participants observed that CNSs without a direct clinical role were more vulnerable to funding cutbacks because the loss of the role may not have immediate impact on practice settings. "
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    Full-text · Article · Dec 2010 · Nursing leadership (Toronto, Ont.)
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