This survey has been set up to collect public comment on the 2017 revised CNS Core Competencies. 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.  The revision draws from multiple resources and has taken into account the 2004 and 2010 CNS Core Competencies.  These proposed CNS Core Competences will be published as section 2 of the revised NACNS Statement on Clinical Nurse Specialist Practice and Education, 3rd edition.  (CNS Statement) The full CNS Statement document will provide additional guidance on the role of the CNS and the use of these competencies in education as well as in practice.

 The 2017 proposed CNS Core Competencies have 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 believes these proposed CNS Core Competencies cover the same material as the 70+, and in addition, they have been written to 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.

Public Comments on the 2017 CNS Core Competencies will be collected by section. Please go to http://nacns.org/professional-resources/publications/cns-statement/ to review the proposed 2017 CNS Core Competencies document as a whole. Additionally, you will find links to the 2004 and 2010 versions of the CNS Core Competencies and a letter from the chairperson of the  NACNS Task Force for the Revision of the NACNS Statement on Education and Practice.

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 content on the applicability and accuracy of the core competency as it relates to CNS practice.

* 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 2017 CNS Core Competencies

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

* 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 2017 CNS Core Competencies

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

* 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
i We adjusted the number you entered based on the slider’s scale.

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

* 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
i We adjusted the number you entered based on the slider’s scale.

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

* 7. Patient/Direct Care Sphere Competency

P.1. Uses relationship-centered communication to promote health, healing, self-care, comfort, and peaceful end-of-life.  (Direct Care)

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

* 8. Patient/Direct Care Sphere Competency

P.2. Conducts an evidence-based, comprehensive health and psychosocial, functional history and physical assessment considering issues that may affect wellness, health promotion, and illness in the patient/population in diverse care settings. (Direct Care)

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

* 9. Patient/Direct Care Sphere Competency

P.3. Synthesizes assessment data, advanced knowledge, and expertise, using critical thinking and clinical judgment to formulate differential diagnoses for patient/population problems. (Direct Care)

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

* 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/populations. (Direct Care)

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

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

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

* 12. Patient/Direct Care Sphere Competency
P.6. Prescribes nursing therapeutics, pharmacologic and non-pharmacologic interventions, diagnostic measures, equipment, procedures, and treatments to meet the needs of patients. (Direct Care)

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

* 13. Patient/Direct Care Sphere Competency
P.7. Designs theoretical- and evidence-based health education strategies and resources appropriate to the patient and/or family developmental level, health literacy level, learning needs, readiness to learn, and personal preferences. (Coaching and Professional Development)

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

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

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

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

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

* 16. Patient/Direct Care Sphere Competency
P.10. Provides education and coaching to individuals, families, groups, and communities with complex learning needs and unpredictable responses. (Direct Care, Coaching and Professional Development)

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

* 17. Patient/Direct Care Sphere Competency
P.11. Evaluates impact of nursing interventions on patient/population outcomes using a scientific approach. (Direct Care, Evidence-based Practice, Quality, and Safety)

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

* 18. Patient/Direct Care Sphere Competency
P.12. Coordinates care and transitions in collaboration with the patient/population and interprofessional team members. (Direct Care, Collaboration)

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

* 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. (Direct Care)

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

* 20. Patient/Direct Care Sphere Competency
P.14. Facilitates resolution of ethical conflicts in complex patient care situations. (Ethical Decision Making, Moral Agency, and Advocacy)

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

* 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. (Ethical Decision Making, Moral Agency, and Advocacy)

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

* 22. Patient/Direct Care Sphere Competency
P.16. Advocates for patient's preferences and rights. (Ethical Decision Making, Moral Agency, and Advocacy)

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

* 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
i We adjusted the number you entered based on the slider’s scale.

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

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

* 26. The next series of questions section will be related to the Nurse/Nursing Practice Sphere

The definition for Nurse/Nursing Practice- The CNS advances nursing practice and improves patient outcomes by updating and improving norms of care and by using standards of care that direct actions of nurses and nursing personnel.

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

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

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

The Nurse/Nursing Practice Sphere Competencies are designated N.1 - N. 14.

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

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

* 29. Nurse/Nursing Practice Sphere Competency
N.2. Promotes interventions that prevent the impact of implicit bias on relationship building and outcomes. (Ethical Decision Making, Moral Agency, and Advocacy)

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

* 30. Nurse/ Nursing Pracice Sphere Competency
N.3. Advocates for nurses' right to practice to the full extent of their role in the delivery of health care. (Ethical Decision Making, Moral Agency, and Advocacy)

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

* 31. Nurse/Nursing Practice Sphere Competency
N.4. Addresses ethical conflict and the potential for moral distress experienced by nurses and the interprofessional team. (Ethical Decision Making, Moral Agency, and Advocacy)

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

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

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

* 33. Nurse/Nursing Practice Sphere Competency
N.6. Employs conflict management and negotiation skills to promote a healthy work environment. (Collaboration)

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

* 34. Nurse/Nursing Practice Sphere Competency
N.7. Assesses the nursing practice environment and processes for improvement opportunities. (Evidence-based Practice, Quality, and Safety)

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

* 35. Nurse/Nursing Practice Sphere Competency
N.8. Uses evidence-based knowledge as a foundation for nursing practice to achieve optimal nurse-sensitive outcomes. (Evidence-based Practice, Quality, and Safety)

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

* 36. Nurse/Nursing Practice Sphere Competency
N.9. Mentors nurse colleagues in using evidence-based practice principles. (Evidence-based Practice, Quality, and Safety)

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

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

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

* 38. Nurse/Nursing Practice Sphere Competency
N.11. Evaluates the outcomes of nursing practice using methods that provide valid data. (Evidence-based Practice, Quality, and Safety)

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

* 39. Nurse/Nursing Practice Sphere Competency
N.12. Facilitates opportunities for clinical nurses, students, and others to acquire new knowledge and skills to foster professional development. (Coaching and Professional Development)

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

* 40. Nurse/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. (Coaching and Professional Development)

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

* 41. Nurse/Nursing Practice Sphere Competency
N.14. Analyzes legislative, regulatory, and fiscal policies as they impact nursing practice and patient/population outcomes. (Leadership)

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

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

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

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

* 43. Are there any Nurse/Nursing Practice Sphere Competencies missing?

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

* 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
i We adjusted the number you entered based on the slider’s scale.

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

* 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. Builds a practice environment in which respect, communication, and collaboration contribute to safe, quality outcomes. (Leadership, Collaboration)

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

* 48. Organization/System Sphere Competency
O.2. Acknowledges one's own role and those of other professions to foster collaboration. (Collaboration)

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

* 49. Organization/System Sphere Competency
O.3. Uses leadership, team building, negotiation, and conflict resolution skills to build partnerships within and across systems, including communities. (Leadership, Collaboration)

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

* 50. Organization/System Sphere Competency
O.4. Consults with health care team members to integrate the needs, preferences, and strengths of the patient and family into the healthcare plan to optimize health outcomes. (Consultation)

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

* 51. Organization/System Sphere Competency
O.5. Leads systematic quality and safety initiatives based on precise problem/etiology identification, gap analysis, and process evaluation. (Evidence-based Practice, Quality, and Safety, Leadership)

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

* 52. Organization/System Sphere Competency
O.6. Provides leadership to the interprofessional team in development, implementation, and evaluation of evidence-based practices. (Leadership, Evidence-based Practice, Quality, and Safety)

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

* 53. Organization/System Sphere Competency
O.7. Leads the integration, management, and evaluation of technology to promote safety, quality, efficiency, and optimal health outcomes. (Evidence-based Practice, Quality, and Safety, Leadership)

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

* 54. Organization/System Sphere Competency
O.8. Leads change in response to organizational and community needs in a dynamic healthcare environment. (Leadership)

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

* 55. Organization/System Sphere Competency
O.9. Evaluates system level programs and outcomes based on the analysis of information from relevant sources. (Evidence-based Practice, Quality, and Safety)

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

* 56. Organization/System Sphere Competency
O.10. Demonstrates stewardship of human and fiscal resources in decision making. (Ethical Decision Making, Moral Agency, and Advocacy)

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

* 57. Organization/System Sphere Competency
O.11. Disseminates CNS practice and fiscal outcomes to internal stakeholders and to the public at large. (Leadership, Evidence-based Practice, Quality, and Safety)

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

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

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

* 59. Organization/System Sphere Competency
O.13. Advocates for equitable health care by participating in professional organizations, or public policy activities. (Ethical Decision Making, Moral Agency, and Advocacy)

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

* 60. Organization/System Sphere Competency
O.14. Advocates for ethical principles in safeguarding the confidentiality, dignity, and safety of all. (Ethical Decision Making, Moral Agency, and Advocacy)

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

* 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
i We adjusted the number you entered based on the slider’s scale.

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

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

* 64. When considering the 2017 CNS Core Competencies as a whole, do you have any additional comments you wish to share about these competencies not addressed in the questions above?

* 65. Address

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

* 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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