Clinical Nurse Specialist: A Critical Member of the ICU Team

Abstract

Objectives To describe the role of the clinical nurse specialist, an advanced practice registered nurse in the intensive care setting. The value and impact of the clinical nurse specialist role as a member of the ICU is presented along with a review of clinical nurse specialist education, licensure, and certification requirements as well as a description of the clinical nurse specialist role, scope of practice, and competencies. In addition, a selected review of clinical nurse specialist–led quality improvement and research that resulted in improved patient outcomes is provided. Data sources Review of published medical and nursing literature and expert opinion guidance from a collaborative effort between the Society of Critical Care Medicine, American Association of Critical-Care Nurses, and National Association of Clinical Nurse Specialists. Study selection Not applicable. Data extraction Not applicable. Data synthesis Not applicable. Conclusions The utilization of a clinical nurse specialist, an advanced practice role, in the ICU is a unique and valuable approach for organizations who strive to move evidence into sustainable practice and drive quality through an interprofessional approach. The valuable contributions made by the clinical nurse specialist efficiently and effectively meet the needs of patients, clinicians, and organizations while improving patient outcomes and optimizing cost avoidance strategies, which further lower economic demands on the healthcare system.

Difficult Times Without Easy Solutions: Nurses Want to Be Heard!

“…5 Strong consideration should be given to other supportive roles such as clinical nurse specialists, whose engagement in patient care has been associated with improved patient outcomes and decreased cost. 6…”

The implementation of physicians assistant in a surgical ward improves continuity in daily clinical work and increases comprehensibility of nurses and physicians

“…The positive effect of PAs on routine clinical work has been reported in numerous studies [4]. The role of PAs in the ICU has been described as a valuable approach to improve interprofessionality [5]. There still is mixed evidence regarding the cost-effectiveness of PAs, however, the improvement of resource management following the implementation of PAs has been demonstrated before [6].…”

Clinical Ladders for Clinical Nurse Specialists

“…The clinical nurse specialist (CNS) role is embedded deeply into clinical practice teams in hospitals and ambulatory settings 1 . When the team achieves great outcomes, hopefully all members have access to a mechanism to highlight their successful contributions.…”

“…T he clinical nurse specialist (CNS) role is embedded deeply into clinical practice teams in hospitals and ambulatory settings. 1 When the team achieves great outcomes, hopefully all members have access to a mechanism to highlight their successful contributions. In many settings, the CNS is the coach for a team of bedside nurses, works with multiple departments to streamline a patient care workflow, or collaborates with interdisciplinary colleagues to change practice.…”