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. 2024 Nov-Dec;38(6):280-291.
doi: 10.1097/NUR.0000000000000856.

Describing Clinical Nurse Specialist Practice: A Mixed-Methods Study

Kelley Kilpatrick  1 , Ruth Tewah, Eric Tchouaket, Krista Jokiniemi, Naima Bouabdillah, Alain Biron, Jessica Emed, Brigitte Martel, Renée Atallah, Mira Jabbour, Denise Bryant-Lukosius
Affiliations

Describing Clinical Nurse Specialist Practice: A Mixed-Methods Study

Kelley Kilpatrick et al. Clin Nurse Spec. 2024 Nov-Dec.

Abstract

Purpose/aims: To describe clinical nurse specialist practice in Québec, Canada, and propose a dashboard to track role dimensions and outcomes.

Design: Sequential mixed-methods study across 6 sites in Québec (June 2021 to May 2022).

Methods: Phase 1: Focus groups (n = 8) and individual interviews (n = 3) were conducted to adapt a time and motion tool. Phase 2: Time and motion studies (n = 25; 203 hours 5 minutes) described clinical nurse specialist practice. Phase 3: A rapid literature review and study participants' feedback informed the dashboard's development. Analysis: Descriptive statistics, with content analysis for qualitative data.

Results: The proportion of time clinical nurse specialists spent in role dimensions included clinical (22.8%), education (11.2%), administrative/leadership (48.6%), research (9.6%), and personal (7.7%). On average, they spent 17% of work time with patients, but this varied across specialties and locations. Key dashboard characteristics and uses were identified.

Conclusions: Important differences were noted in clinical nurse specialist time spent in activities across specialties and regions in Québec. Approximately one-fifth of work time was spent in direct patient care. Additional research is needed to examine the link between clinical nurse specialist practice and outcomes in other jurisdictions and test the implementation of a dashboard to make their practice more visible.

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Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Kilpatrick K, Geese F, Zhou W, Bryant-Lukosius D. Advanced practice nurses and engagement in research, quality improvement, and evidence-informed decision-making. In: Rogers M, Lehwaldt D, Roussel J, Acorn M, eds. Advanced Practice Nurse Networking to Enhance Global Health. 1st ed. Cham, Switzerland: Springer; 2024:143–161.
    1. Bryant-Lukosius D, Wong S, Zhu XJ. Advanced nursing practice research. In: Wong KY, Xia HO, eds. Advanced Nursing Practice. Beijing: People’s Health Publishing House; 2018.
    1. Bryant-Lukosius D, Ziegler E, Kilpatrick K, Martin-Misener R. Advanced practice nursing in Canada. In: Hassmiller S, Pulcini J, eds. Advanced Practice Nursing Leadership: A Global Perspective. 1st ed. Cham, Switzerland: Springer; 2020:77–92.
    1. Sanchez K, Winnie K, de Haas-Rowland N. Establishing the clinical nurse specialist identity by transforming structures, processes, and outcomes. Clin Nurse Spec. 2019;33(3):117–122.
    1. Jokiniemi K, Bryant-Lukosius D, Roussel J, et al. Differentiating specialized and advanced nursing roles: the pathway to role optimization. Nurs Leadersh. 2023;36(1):57–74.

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