The purpose of this presentation is to describe CNS perceived influence on patient and family outcomes, as well as, system outcomes. How these outcomes are related to organizational and CNS characteristics will also be addressed.
SAMPLE/METHODS: The sample consisted of 547 practicing CNS certified by the California BRN. Data were collected via the CNS Specialists Outcomes/Barrier Analysis (CNS-SOBA). Subscales measured perceived influence on: Education, Clinical Practice, Advocacy, Leadership, Interdisciplinary Consultation, Utilization, Product Evaluation, Research, and Support Group outcomes. Data analysis: Descriptive and inferential statistics.
FINDINGS: Top three outcomes were multidisciplinary cooperation (M = 3.21, SD 0.873), staff knowledge (M = 3.18, SD 0.840), and patient satisfaction (M=3.18, SD 0.876). The top three outcome categories were Educational (M=63, SD 26), Clinical Practice (M=62, SD=24), and Advocacy (M=60, SD=29). CNSs working in moderately sized hospitals (100-250 beds) had less perceived influence on clinical practice (F=3.914, P=0.02) and advocacy (F=3.593, p=0.02) outcomes than those working in smaller hospitals (<100 beds), and less perceived influence on support-group outcomes (F=3.445, p=0.3) than CNSs in larger hospitals (>100beds). Home health CNSs had statistically significant higher scores (M = 67.04; SD 27.10) than all other CNSs (M = 44.82; SD 28.17) for utilization outcomes (t=3.285, p=0.001). In addition, more experienced CNSs had statistically significant differences when compared with CNSs in practice two years or less in perceived influence on clinical practice, advocacy, utilization, interdisciplinary consultation, and research outcomes.
CONCLUSIONS: CNSs perceive they influence a variety of outcomes, with more experienced CNSs perceiving they influence outcomes to a greater degree. CNSs working in smaller hospitals perceived greater influence.
APPLICATION: Nursing leaders should understand that outcomes influenced vary with type of CNS, years of experience and facility bed size. CNS job descriptions/evaluations should be re-evaluated in terms of personal/organizational characteristics and the impact to advanced practice outcomes.
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