This survey is designed to collect public comment on Table 3 - Outcomes of Clinical Nurse Specialist  (Document C for Coment), 3rd Edition, Statement on Clinical Nurse Specialist Practice and Education. (CNS Statement)

These outcomes of clinical nurse specialists were reviewed and revised as part of the work in the revision of the 3rd Edition, CNS Statement.

This survey is part of the constellation of surveys that cover aspects of the draft 3rd Edition, CNS Statement.  This is one of a series of surveys developed to collect comprehensive comment on the draft CNS Statement.  The remainder of the components of this public comment 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 outcomes as they relate to the CNS.

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* 1. There are 16 Outcomes under the Patient Direct Care Sphere. 

The 1st Outcome is:

Phenomena of concern requiring nursing interventions are idenified. 

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* 2. There are 16 Outcomes under the Patient Direct Care Sphere.

The 2nd Outcome is:

Diagnosis are accurately aligned with assessment data and etiologies.  

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* 3. There are 16 Outcomes under the Patient Direct Care Sphere.

The 3rd Outcome is:

Plans of care are appropriate for meeting patient needs with available resources, reflecting patient/family treatment reference and shared decision-making.

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* 4. There are 16 Outcomes under the Patient Direct Care Sphere.

The 4th Outcome is:

Nursing interventions target specified etiologies. 

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* 5. There are 16 Outcomes under the Patient Direct Care Sphere.

The 5th Outcome is:

Programs of care are designed for specific populations (e.g. oncology, specific ethnic groups, end-of-life).

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* 6. There are 16 Outcomes under the Patient Direct Care Sphere.

The 6th Outcome is:

Prevention, alleviation, and/or reduction of symptoms, functional problems or risk behaviors are achieved.

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* 7. There are 16 Outcomes under the Patient Direct Care Sphere.

The 7th Outcome is:
Nursing interventions, in combination with interventions by members of other disciplines, result in synergistic patient outcomes.

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* 8. There are 16 Outcomes under the Patient Direct Care Sphere.

The 8th Outcome is:

Unintended consequences and errors are prevented.

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* 9. There are 16 Outcomes under the Patient Direct Care Sphere.

The 9th Outcome is:

Predicted and measureable nurse-sensitive outcomes are attained through evidence-based practice

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* 10. There are 16 Outcomes under the Patient Direct Care Sphere.

The 10th Outcome is:

Interventions have measureable outcomes that are incorporated into guidance for practice with deletion of inappropriate interventions.

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* 11. There are 16 Outcomes under the Patient Direct Care Sphere.

The 11th Outcome is:

Collaboration with patients/clients, nursing staff, as well as physicians and other health care professionals , occurs as appropriate.

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* 12. There are 16 Outcomes under the Patient Direct Care Sphere.

The 12th Outcome is:

Desirable measurable patient/client outcomes are achieved. Desired outcomes of care may include improved clinical status, quality of life, functional status, alleviation or remediation of symptoms, patient/family satisfaction, and cost effective care. 

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* 13. There are 16 Outcomes under the Patient Direct Care Sphere.

The 113th Outcome is:

Innovative educational programs for patients/clients are fully integrated across the continuum of care to decrease fragmentation.

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* 14. There are 16 Outcomes under the Patient Direct Care Sphere.

The 14th Outcome is:

Transitions of patients/clients are fully integrated across the continuum of care to decrease fragmentation. 

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* 15. There are 16 Outcomes under the Patient Direct Care Sphere.

The 15th Outcome is:

Reports of new clinical phenomena and/or interventions are disseminated through presentations and publications.

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* 16. There are 16 Outcomes under the Patient Direct Care Sphere.

The 16th Outcome is:
Interventions that are effective in achieving nurse sensitive outcomes are incorporated into guidelines and policies.

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* 17. There are 14 Outcomes under the Nurses and Nursing Practice Sphere.

The 1st Outcome is:

Knowledge and skill development.

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* 18. There are 14 Outcomes under the Nurses and Nursing Practice Sphere.

The 2nd Outcome is:

Evidence-based practices are used by nurses.

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* 19. There are 14 Outcomes under the Nurses and Nursing Practice Sphere.

The 3rd Outcome is:

The research and scientific base for innovations is articulated, understandable, and accessible. 

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* 20. There are 14 Outcomes under the Nurses and Nursing Practice Sphere.

The 4th Outcome is:

Nurses are able to articulate their unique contributions to patient care and nurse-sensitive outcomes.

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* 21. There are 14 Outcomes under the Nurses and Nursing Practice Sphere.

The 5th Outcome is:

Nurses are empowered to solve patient care problems at the point of service.

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* 22. There are 14 Outcomes under the Nurses and Nursing Practice Sphere.

The 6th Outcome is:

Desired patient outcomes are achieved through the synergistic effects of collaborative practice.

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* 23. There are 14 Outcomes under the Nurses and Nursing Practice Sphere.

The 7th Outcome is:

Nurses career enhancement programs are ongoing, accessible, innovative, and effective.

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* 24. There are 14 Outcomes under the Nurses and Nursing Practice Sphere.

The 8th Outcome is:

Nurses experience job satisfaction.

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* 25. There are 14 Outcomes under the Nurses and Nursing Practice Sphere.

The 9th Outcome is:

Nurses engage in learning experiences to advance or maintain competence.

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* 26. There are 13 Outcomes - Organization/System Sphere

The 10th Outcome is:

Clinical problems are articulated within the context of the organization/system structure, mission, culture, policies, and resources.

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* 27. There are 14 Outcomes under the Nurses and Nursing Practice Sphere.

The 13th Outcome is:

Educational programs that  advance the practice of nursing  are developed, implemented, evaluated, and linked to evidence-based practice and effects on clinical and fiscal outcomes.

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* 28. There are 14 Outcomes under the Nurses and Nursing Practice Sphere.

The 14th Outcome is:

Nurses have an effective voice in decision-making about patient care.

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* 29. There are 13 Outcomes - Organization/System Sphere

The 1st Outcome is:

Clinical problems are articulated within the context of the organization/system structure, mission, culture, policies, and resources.



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* 30. There are 13 Outcomes - Organization/System Sphere

The 2nd Outcome is:

Patient care processes reflect continuous improvements that benefit the system.

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* 31. There are 13 Outcomes - Organization/System Sphere

The 3rd Outcome is:

Change strategies are  integrated throughout the system.

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* 32. There are 13 Outcomes - Organization/System Sphere

The 4th Outcome is:

Policies enhance the practice of nurses individually as members of multidisciplinary teams.

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* 33. There are 13 Outcomes - Organization/System Sphere

The 6th Outcome is:

Evidence-based, best practice models are developed and implemented.

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* 34. There are 13 Outcomes - Organization/System Sphere

The 7th Outcome is:

Nursing care and outcomes are articulated at organizational/system decision-making levels.

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* 35. There are 13 Outcomes - Organization/System Sphere

The 8th Outcome is:

Stakeholders (nurses, other health care professionals, and management) share a common vision of practice outcomes. 

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* 36. There are 13 Outcomes - Organization/System Sphere

The 9th Outcome is:

Decision makers within the institution are informed about practice problems, factors contributing to the problems, and the significance of those problems with respect to outcomes and costs.

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* 37. There are 13 Outcomes - Organization/System Sphere

The 10th Outcome is:

Patient care initiatives reflect knowledge of cost management and revenue enhancement strategies.

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* 38. There are 13 Outcomes - Organization/System Sphere

The 11th Outcome is:

Patient care programs are aligned  with the organization's strategic imperatives, mission, vision, philosophy and values

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* 39. There are 13 Outcomes - Organization/System Sphere

The 12th Outcome is:

Staff comply with policies, protocols and standards of care that reflect regulatory requirements and standards.

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* 40. There are 13 Outcomes - Organization/System Sphere

The 13th Outcome is:

Policy-making bodies are influenced to develop regulations/procedures to improve patient care and health services

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* 41.   Please complete the following general questions about the Outcomes of Clinical Nurse Specialists, Table 3

“To what extent do these Outcomes reflect CNS practice in the three spheres - Patient Direct Care; Nurses and Nursing Practice; and Organization/Systems 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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* 42. Are there any outcomes missing from the document?

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* 43. Are there any outcomes that should be eliminated from the document?

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* 44. When considering the Outcomes of Clinical Nurse Specialists, Table 3, document C - do you have any additional comments you wish to share about these coutcomes not addressed in the questions above?

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* 45. Address

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

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* 47. 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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