NACNS Statement on Clinical Nurse Specialist Practice and Education Revision Task Force. Annual Meeting Forum March 10, 2017

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2 NACNS Statement on Clinical Nurse Specialist Practice and Education Revision Task Force Annual Meeting Forum March 10, 2017

3 Task Force Members Sherri L. Atherton, MS, RN, CNS-BC, CIC; Oregon Kathy A. Baker, PhD, RN, ACNS-BC, FAAN; Texas Niloufar Niakosari Hadidi, PhD, APRN, CNS-BC, FAHA; Minnesota Carol Manchester, MSN, APRN, ACNS-BC, BC-ADM, CDE; Minnesota Mary Beth Modic, DNP, RN, CNS, CDE, FAAN, Ohio Mary Fran Tracy, PhD, APRN, CCNS, FAAN, Minnesota Jane Walker, PhD, RN, Indiana

4 Objectives Discuss the key priorities for the task force in revising the Statement on Clinical Nurse Specialist Practice and Education. Discuss the top 5 revisions in the new Statement. Outline the next steps for public comment on the task force draft of the revised Statement.

5 Statement on Clinical Nurse Specialist Education and Practice NACNS formed-1995 First Edition of statement-1998 Second Edition of statement-2004 Now 13 years later

6 Since last statement AACN The Essentials of Doctoral Education for Advanced Practice Nursing (2006) Consensus Model for APRN Regulation (2008) NACNS/National CNS Doctoral Competency Task Force Core Practice Doctorate Clinical Nurse Specialist Competencies (2009) NACNS/National CNS Competency Task Force Clinical Nurse Specialist Core Competencies Executive Summary (2010) AACN/NACNS Adult Gerontology Clinical Nurse Specialist Competencies (2010) NACNS Criteria for the Evaluation of Clinical Nurse Specialist Master s, Practice Doctorate, and Post-Graduate Certificate Educational Programs (2012) ANA Nursing: Scope and Standards of Practice (2010) NACNS Statement on the APRN Consensus Model Implementation (2012) NACNS and AWHONN Women s Health CNS Competencies (2014)

7 Additional Documents Reviewed International Council of Nurses Fact Sheet: Nurse Practitioner/Advanced Practice Nurse: Definition and Characteristics (2009) Adult-Gerontology Acute Care Nurse Practitioner Competencies (Hartford Institute of Gerontology Nursing, AACN, NONPF, 2012) Nurse Practitioner Core Competencies, (NONPH, 2012)

8 Additional Documents Reviewed Canadian Nurses Association Pan-Canadian Core Competencies for the Clinical Nurse Specialist (2014) Nurse Practitioner Competency Content, (NONPH, 2014) Core Competencies for Basic Midwifery Practice (AWHONN, 2014) Competencies for Master s Level Midwifery Education (AWHONN, 2014)

9 Key Priorities Document must: Be updated and relevant Look at current practice and healthcare demands as well as to the future Resonate with current consumers-faculty, CNSs in practice, students, and employers Retain CNS core competencies, outcomes and education standards to continue as a stand-alone document Include implications related to DNP education

10 Goals of Statement Make explicit the contributions of CNSs in meeting societal health care needs; Articulate competencies for CNS practice and associated outcomes; Provide a standardized framework for CNS education at the graduate level. Removed as covered elsewhere in document: Provide a foundation for core CNS credentialing, including certification examination, portfolio, or other mechanisms

11 Statement Section 1-Introduction and Clinical Nurse Specialist Practice Section 2-Clinical Nurse Specialist Competencies Section 3-Clinical Nurse Specialist Outcomes Section 4-Recommendations for Graduate Preparation of Clinical Nurse Specialists

12 Three Spheres Influence the act or power of producing an effect without apparent exertion of force or direct exercise of command the power or capacity of causing an effect in indirect or intangible ways the power to produce desired effects or outcomes by moving others to action

13 Three Spheres Impact to have a direct effect or impact on to have a strong effect on someone or something a powerful or major influence or effect

14 Three Spheres-Conceptual Model Patient /Client Direct Care Nurses/Nursing Practice Organization/System

15 Figure 1 CNS practice conceptualized as core competencies in three interacting spheres actualized in specialty practice, and guided by specialty knowledge and specialty standards within the context of the ever-changing healthcare environment, healthcare policy, interprofessional collaboration, and societal needs.

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17 Specialty per APRN Consensus APRN SPECIALTIES Model Focus of practice beyond role and population focus linked to health care needs Examples include but are not limited to: Oncology, Older Adults, Orthopedics, Nephrology, Palliative Care

18 Direct Care Core Competencies 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. Consultation Interprofessional Patient/Nurse/System Systems Leadership Collaboration Coaching/Professional Development

19 Core Competencies Research Evidence Based Practice Ethical Decision Making, Moral Agency and Advocacy Expand advocacy across spheres Patients, populations, nurses Ethical decision making and moral agency are skills/characteristics

20 Core Competencies Quality Improvement Safety Economics of healthcare Cultural Diversity Gender/LGBT Ethnic and Racial Religion

21 Transitions of Care Core Competencies

22 Clinical Nurse Specialist Outcomes Section of its own Validity of outcomes Expand

23 Recommendations for Graduate Preparation of CNSs Evolution of CNS education Essential core content Outcome evaluation methods

24 Next Steps Finalizing draft to send to NACNS Board of Directors, April, 2017 Public Comment Period for members and all key stakeholders May/June, 2017 Stakeholder feedback at Educator s Forum and NACNS Summit, July, 2017 Finalization of document August/September, 2017

25 Questions and Comments can be sent to: