This survey is designed to collect public comment on Table 2 - Core Clinical Nurse Specialist Competencies (Document B for Comment), 3rd Edition, Statement on Clinical Nurse Specialist Practice and Education.

These competencies were developed by a panel of CNS experts, the NACNS Task Force for the Revision of the NACNS Statement on Education and Practice and were published for public comment at the end of 2017.  This version reflects the integration of the public comments.  We are asking  for public comment - as part of the larger public comment on the Draft Clinical Nurse Specialist Core Statement.  The CNS Statement included the core competencies as well as a number of other chapters all related to NACNS practice and education. 

If you did not provide public comment on the CNS Competencies in 2017, it is important for you to know that the structure of the competencies has been modified.  The number of competencies has been reduced from over 70 in the previous sets to 44.

The task force was able to reduce the number to 44 by eliminating redundancy and giving attention to the specific core competency topic that was being addressed.  They also were conscientious about ascribing a robust connotation to the terminology of the competencies. The task force strived to develop the CNS Core Competencies so that they covered the same material as the 70+, and in addition, cover more content in accord with the evolution of health care since 2008.  One principal used in their development was an agreement to err on the side of generality in composing a competency to that they are applicable to all specialties.  These same principles were used in integrating the public comments into the first draft of the CNS Competencies. 

As a part of the larger public comment on the 3rd Edition, Statement on Clinical Nurse Specialist Practice and Education, this survey is one of a series of surveys developed to collect comprehensive comment.  The documents and links to all of the surveys related to this public comment period can be found at https://www.surveymonkey.com/r/KSSGJMY.

NACNS plans to publish the NACNS Statement on Clinical Nurse Specialist Practice and Education, 3rd. edition on or before Autumn 2018.

Please Note:  The final NACNS Core CNS Competencies will be copy edited, therefore we are requesting you refrain from providing grammatical or editorial comments.  We are specifically seeking comment on the applicability and accuracy of the core competency as it relates to contemporary CNS practice and education.

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* 1. I agree with using the three spheres of impact. – Patient/Direct Care, Nurses and Nursing Practice,  and Organization/System – as the organizing structure for the draft Core CNS Competencies

0 Neutral 100
i We adjusted the number you entered based on the slider’s scale.

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* 2. I agree with using the three spheres of impact (rather than influence) – to describe the Patient/Direct Care, Nurses and Nursing Practice,  and Organization/System – as the organizing structure for the draft Core CNS Competencies.

0 Neutral 100
i We adjusted the number you entered based on the slider’s scale.

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* 3. The definition for Patient is given as - Patient - Represents patient, family, health care surrogate, community, and population.
Please select the point on the scale below that reflects your approval of this definition.

0 = "Don't accept it at all"
100="Brilliant, I like it"

0 Neutral 100
i We adjusted the number you entered based on the slider’s scale.

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* 4. If you do not like the definition for patient as stated.  Please note briefly how you would edit the definition.

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* 5. The definition for Direct Care is given as - Direct Care:  Direct interaction with patients, families, and groups of patients to promote health or well-being and improve quality of life. Characterized by a holistic perspective in the advanced nursing management of health, illness, and disease states.

Please select the point on the scale below that reflects your approval of this definition.

0 = "Don't accept it at all"
100="Brilliant, I like it"

0 Neutral 100
i We adjusted the number you entered based on the slider’s scale.

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* 6. If you do not like the definition for direct care as stated.  Please note briefly how you would edit the definition.

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* 7. Patient/Direct Care Sphere Competency

P.1. Uses relationship-building communication to promote health, healing, self-care, and peaceful end-of-life.  

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 8. Patient/Direct Care Sphere Competency

P.2. Conducts a comprehensive health assessment in diverse settings including psychosocial, functional, physical and environmental factors. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 9. Patient/Direct Care Sphere Competency

P.3. Synthesizes assessment findings using advanced knowledge, expertise,  critical thinking and clinical judgment to formulate differential diagnoses.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 10. Patient/Direct Care Sphere Competency
P.4. Designs evidence-based, cost-sensitive interventions, including advanced nursing therapies, to meet the multifaceted needs of complex patients. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 11. Patient/Direct Care Sphere Competency
P.5. Implements customized evidence-based advanced nursing interventions, including the provision of direct care. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 12. Patient/Direct Care Sphere Competency
P.6. Prescribes medications, therapeutics, diagnostic studies, equipment, and procedures to manage the health issues of patients. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 13. Patient/Direct Care Sphere Competency
P.7. Designsand employs educational strategies that consider readiness to learn, individual preference and other social determinants of health.  

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 14. Patient/Direct Care Sphere Competency
P.8. Uses advanced communication skills in complex situations and difficult conversations. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 15. Patient/Direct Care Sphere Competency
P.9. Provides expert consultation based on a broad range of theories and evidence for patients with complex health care needs. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 16. Patient/Direct Care Sphere Competency
P.10. Provides education and coaching to patients with complex learning needs and atypical responses. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 17. Patient/Direct Care Sphere Competency
P.11. Evaluates impact of nursing interventions on patients' aggregate outcomes using scientific approach. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 18. Patient/Direct Care Sphere Competency
P.12. Leads and facilitates coordinates care and transitions in collaboration with the patient and interprofessional team. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 19. Patient/Direct Care Sphere Competency
P.13. Facilitates patient and family understanding of the risks, benefits, and outcomes of proposed health care regimens to promote informed, shared decision-making. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 20. Patient/Direct Care Sphere Competency
P.14. Facilitates resolution of ethical conflicts in complex patient care situations. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 21. Patient/Direct Care Sphere Competency
P.15. Analyzes the ethical impact of scientific advances, cost, clinical effectiveness on patient and family values and preferences.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 22. Patient/Direct Care Sphere Competency
P.16. Advocates for patient's preferences and rights. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 23. This concludes the Patient/Direct Care Sphere Competency Section.  Please complete the following general questions about this section.

“To what extent do the Patient/Direct Care Sphere competencies reflect core CNS practice related to the sphere?”

0 - not at all neutral 100- very closely
i We adjusted the number you entered based on the slider’s scale.

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* 24. Are there any Patient/Direct Care Sphere Competencies missing?

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* 25. Should any of the Patient/Direct Care Sphere Competencies be eliminated?

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* 26. The next series of questions will be related to the Nurses and Nursing Practice Sphere

The definition for Nurses and Nursing Practice- The CNS advances nursing practice to achieve optimal outcomes by assuring nurses and nursing peronnel utilize evidence-based practices to meet the multifaceted needs of patients and/or populations.  

Please select the point on the scale below that reflects your approval of this definition.

0 = "Don't accept it at all"
100="Brilliant, I like it"

0 Neutral 100
i We adjusted the number you entered based on the slider’s scale.

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* 27. If you do not like the definition for nurses and nursing practice as stated.  Please note briefly how you would edit the definition.

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* 28. The next series of questions will be on the Nurses and Nursing Practice Sphere Competencies.

The Nurses and Nursing Practice Sphere Competencies are designated N.1 - N. 14.

N.1. Provides expert specialty consultation to nurses related to complex patient care needs.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 29. Nurses and Nursing Practice Sphere Competency
N.2. Promotes interventions that prevent the impact of implicit bias on relationship building and outcomes. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 30. Nurses and Nursing Pracice Sphere Competency
N.3. Advocates for nurses to practice to the full extent of their role in the delivery of health care.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 31. Nurses and Nursing Practice Sphere Competency
N.4. Leads efforts to resolve ethical conflict and moral distress experienced by nurses and nursing staff. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 32. Nurses and Nursing Practice Sphere Competency
N.5. Fosters a healthy work environment by exhibiting positive regard, conveying mutual respect, and acknowledging the contributions of others. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 33. Nurses and Nursing Practice Sphere Competency
N.6. Employs conflict management and negotiation skills to promote a healthy work environment. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 34. Nurses and Nursing Practice Sphere Competency
N.7. Assesses the nursing practice environment and processes for improvement opportunities. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 35. Nurses and Nursing Practice Sphere Competency
N.8. Uses evidence-based knowledge as a foundation for nursing practice to achieve optimal nurse-sensitive outcomes. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 36. Nurses and Nursing Practice Sphere Competency
N.9. Mentors nurses and nursing staff  in using evidence-based practice principles. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 37. Nurses and Nursing Practice Sphere Competency
N.10. Leads nurses in the process of planning, implementing, and evaluating change considering intended and unintended consequences. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 38. Nurses and Nursing Practice Sphere Competency
N.11. Evaluates the outcomes of nursing practice using methods that provide valid data.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 39. Nurses and Nursing Practice Sphere Competency
N.12. Facilitates opportunities for nurses, students, and other staff to acquire new knowledge and skills to foster professional development.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 40. Nurses and Nursing Practice Sphere Competency
N.13. Engages nurses in reflective practice activities that promote self-awareness and invite peer feedback to improve the practice of nursing.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 41. Nurse and Nursing Practice Sphere Competency
N.14. Mentors nurses to analyze legislative, regulatory, and fiscal policies that impact nursing practice and patient outcomes.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 42. This concludes the Nurses and Nursing Practice Sphere Competency Section.  Please complete the following general questions about this section.

To what extent do the Nurses and Nurse Sphere competencies reflect core CNS practice related to the sphere?

0 - Not at all Neutral 100- very well
i We adjusted the number you entered based on the slider’s scale.

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* 43. Are there any Nurses and Nursing Practice Sphere Competencies missing?

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* 44. Are there any Nurses and Nurse Practice Sphere Competencies that should be eliminated?

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* 45. The following questions relate to the Organization/System Sphere

Definition - Organization/ and System Sphere -The CNS articulates the value of nursing care at the organizational, decision-making level, and influences system changes that facilitate improvement of quality cost-effective patient outcomes.

0 I don't support at all Neutral 100 It's brillant, I like it
i We adjusted the number you entered based on the slider’s scale.

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* 46. If you do not like the definition for organization/system sphere as stated.  Please note briefly how you would edit the definition.

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* 47. The following questions are related to the Organization/System Sphere Competencies.

The Organization/System Sphere Competencies are designated O.1 - O. 14.

O.1. Cultivates a practice environment in which respect, communication, and collaboration contribute to safe, quality outcomes. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 48. Organization/System Sphere Competency
O.2. Uses leadership, team building, negotiation, collaboration, and conflict resolution to build partnerships within and across systems and/or communities.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 49. Organization/System Sphere Competency
O.3. Consults with health care team members to integrate the needs, preferences, and strengths of a population  into the health care plan to optimize health outcomes and patient experience with a health care system. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 50. Organization/System Sphere Competency
O.4. Leads and participates in systematic quality and safety initiatives based on precise problem/etiology identification, gap analysis, and process evaluation. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 51. Organization/System Sphere Competency
O.5. Provides leadership to the interprofessional team in identifying, development, implementing, and evaluating evidence-based practices and research opportunities. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 52. Organization/System Sphere Competency
O.8. Leads and facilitates change in response to organizational and community needs in a dynamic health care environment.  

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 53. Organization/System Sphere Competency
O.7. Leads and participates in the process of selecting, integration, managing, and evaluating technology and products to promote safety, quality, efficiency, and optimal health outcomes. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 54. Organization/System Sphere Competency
O.6.Partners with research-focused, doctorally prepared (e.g. PhD) colleagues to translate, conduct, and disseminate research that addresses gaps and improves clinical knowledge and practice.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 55. Organization/System Sphere Competency
O.9. Evaluates system level  interventions, programs and outcomes vased on the analysis of information from relevant sources.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 56. Organization/System Sphere Competency
O.10. Demonstrates stewardship of human and fiscal resources in decision-making. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 57. Organization/System Sphere Competency
O.11. Disseminates CNS practice and fiscal outcomes to internal stakeholders and to the public at large. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 58. Organization/System Sphere Competency
O.12. Promotes nursing's unique contributions toward advancing health to stakeholders (e.g. organization, the community, the public, and policymakers.) 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 59. Organization/System Sphere Competency
O.13. Advocates for equitable health care by participating in professional organizations and public policy activities. 

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 60. Organization/System Sphere Competency
O.14. Advocates for ethical principles in safeguarding the dignity, uniqueness and safety of all.

If you have no comments, please leave the comment field blank.  If you have comments, please add them into the comment box.

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* 61. This concludes the Organization/System Sphere Competency Section.  Please complete the following general questions about the revised 2017 CNS Core Competencies.  

“To what extent do the Organization Sphere competencies reflect core CNS practice related to the sphere?”

0 - not at all Neutral 100 - very much
i We adjusted the number you entered based on the slider’s scale.

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* 62. Are there any competencies missing from the Organization/System Sphere Competencies?

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* 63. Are there any competencies that should be eliminated from the Organization/System Sphere Competencies?

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* 64. When considering the draft Core CNS  Competencies as a whole, do you have any additional comments you wish to share about these competencies not addressed in the questions above?

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* 65. Address

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* 66. I am answering this question on behalf of:

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* 67. Thank you for your comments on the 2017 CNS Core Competencies.  

If you have any questions, please email info@nacns.org.

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