Comparing and contrasting the clinical nurse specialist and the advanced nurse practitioner roles

There is currently a great deal of ambiguity regarding the difference between the role of clinical nurse specialist and advanced nurse practitioner. In distinguishing one title from another, factors such as the educational requirements of such, what the role involves, who the client is and whether the role encroaches on a doctor's role are discussed. This paper sets out the factors that are seen by some as significant in distinguishing between a clinical nurse specialist and advanced nurse practitioner.     

Supporting preceptors of distance nurse practitioner students

Preceptors play an important role in facilitating clinical competency development of nursing students. Support of preceptors is essential to ensure optimal student learning as well as preceptor satisfaction, recruitment and retention. Distance education programs face a unique barrier in supporting preceptors due to lack of physical proximity to preceptors and students. This quality improvement initiative explored current supports available to preceptors of students in distance nurse practitioner programs and the importance preceptors place on these supports. Findings revealed individual, institutional and external factors must be jointly considered to optimally support preceptorship. The study provides a Canadian perspective to a growing body of global research on nurse practitioner student preceptorship, contributing to development of best practices for supporting preceptors and students in distance health education programs.     

The development of clinical nurse specialist roles in Ireland

While the term specialist in nursing can be traced to the turn of the 20th Century, it is only since 2001 that a framework was developed for a clinical career pathway in Ireland. This framework has promoted the development and expansion of the clinical nurse/midwife specialist (CNS/CMS) throughout Ireland over the past 10 years guided by the National Council for the Professional Development of Nursing and Midwifery (NCNM). To build upon the achievements of the NCNM and advance nursing practice, it is imperative that CNS/CMSs adopt and fulfil the components of their role. Since CNS/CMS practice is relatively new to Ireland, there is the opportunity to learn from experiences of other countries. This article outlines the development and challenges of the CNS role in Ireland.     

Quality and safety education for nurses competencies and the clinical nurse specialist role: implications for preceptors

Quality and Safety Education for Nurses came about through a grant from the Robert Wood Johnson Foundation. Its mission has been to transform nursing education by deliberately changing the focus of nursing's professional identity. The purpose of this article is to discuss the recent adaptation of the Quality and Safety Education for Nurses knowledge, skills, and attitudes, originally developed for undergraduate education, into competencies for advanced practice nursing education. This article discusses the applicability of those competencies for graduate education as it applies to the spheres of influence in the clinical nurse specialist role and the implications for preceptors.     

The perceptions of nurse teachers, student nurses and preceptors of the theory-practice gap in nurse education

The theory-practice gap has been the subject of much debate within nursing. Issues include: where the gap is, whether it is a positive or negative phenomenon and whether attempts should be made to bridge it. This paper describes a research study adopting an innovative approach to exploring the theory-practice gap by investigating it from the perspectives of three different groups: nurse teachers, student nurses and clinical preceptors. Combining the perceptions of these diverse groups has allowed a more complete picture of the theory-practice gap to emerge than is possible when examining it from one group's perspective alone. Twenty-three group interviews were conducted and content analysed to identify common themes. Mutual concerns were identified by all groups: shortness of clinical placements, sequencing of theory and practice, lack of collaboration between clinical areas and educational institutions and the lack of clarity regarding link teacher roles. All interviewees felt a theory-practice gap does exist, and whilst this could be viewed positively as a means of developing students' problem-solving skills, attempts should be made to minimize its impact. Ways to achieve this include: the development of an innovative curriculum allowing closer sequencing of theory and practice, evaluating the effect length of clinical placement has on knowledge and skill acquisition, improving collaboration between clinical areas and educational institutions and developing preceptors' lecturing roles.     

Case management: clinical nurse specialist and nurse practitioner, converging roles.

In nursing there is discussion about the commonalities and differences among nurses in advanced practice. This article compares the roles of the clinical nurse specialist and the nurse practitioner. A case management model integrating the two roles is described.     

专科护士在护理专业中的角色和地位

对“专科护士”(CNS)的概念和执业标准 ,CNS的工作内容、角色作用和在实践中遇到的问题 ,以及CNS在护理专业发展中的意义作了简要的介绍和分析。CNS是在护理专业化进程中产生的 ,是高级临床护理工作者。在一些国家的卫生保健系统中 ,CNS活跃在各种护理服务场所 ,可有其专门的工作岗位和相应的岗位职责 ,为服务对象提供常规的医疗护理工作未能提供或未能系统地提供的专门化护理服务。多年来 ,CNS所做的工作体现了护理工作在卫生保健事业中的独特作用和价值 ,丰富了护理学知识体系 ,对护理学科的发展做出了贡献。我国CNS的培养和使用尚处于起步阶段 ,其发展是符合卫生保健事业的需求的 ,也给临床护士在专业上的发展展示了一个全新的领域     

Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review

BackgroundAdvanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness.ObjectiveTo examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles.MethodsOur methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel.ResultsThe narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles and should be routinely followed. However, seven out of 15 current guideline sections (describing a decision problem, choosing type of economic evaluation, selecting comparators, determining the study perspective, estimating effectiveness, measuring and valuing health, and assessing resource use and costs) may require additional role-specific considerations to capture costs and effects of these roles.ConclusionCurrent guidelines for economic evaluation should form the foundation for economic evaluations of nurse practitioner and clinical nurse specialist roles. The proposed role-specific considerations, which clarify application of standard guidelines sections to economic evaluation of nurse practitioner and clinical nurse specialist roles, may strengthen the quality and comprehensiveness of future economic evaluations of these roles.     

Confusion, concern, or complimentary function: the overlapping roles of the clinical nurse specialist and the clinical nurse leader

Within the practice environment there are many demands to meet and many conflicting perspectives. The most recent example of this conflict is the polarity caused by the confusion and overlap between the established role of the clinical nurse specialist and the emerging role of the clinical nurse leader. The issues surrounding the confusion, concern, and potential for complimentary function are explored. The intent is to inform nursing leaders and provide points to use in making decisions regarding the roles and the focus on patient outcomes.