Clinical Nurse Specialist Role and Practice: An International Perspective (Advanced Practice in Nursing)

Preface Contents Part I: General Considerations 1: Global View of the Clinical Nurse Specialist Role 1.1 Introduction 1.2 History of the CNS Role and Practice 1.3 Definitions of Advanced Practice Nurse and Clinical Nurse Specialist 1.4 Substantive Areas of CNS Practice 1.5 Expanded Nursing Practice to Meet Patient Needs 1.6 Regulatory Protection for the CNS Role 1.7 Future of CNS Practice Globally 1.8 Conclusion References 2: Conceptual Models for Clinical Nurse Specialist Role and Practice 2.1 Introduction 2.2 Purpose of Conceptual Models 2.3 Definition of Clinical Nurse Specialist 2.4 Building Blocks of Models and Frameworks 2.5 Critiquing APRN Models: Two Exemplars 2.6 Conceptual Models and Frameworks for CNS Role and Practice 2.7 Differentiating CNS Practice 2.8 Challenges and Opportunities References 3: Core Clinical Nurse Specialist Practice Competencies 3.1 Introduction 3.2 Definitions 3.3 Evolution of CNS Competencies 3.4 Clinical Nurse Specialists and Advanced Practice Nursing 3.5 Clinical Nurse Specialist Competencies 3.6 Discussion 3.7 Future Directions 3.8 Conclusions References 4: Educational Considerations 4.1 Introduction 4.2 Education Standards 4.3 Graduate Nursing Education Standards 4.4 Advanced Practice Nursing Standards 4.5 Clinical Nurse Specialist Core Education Standards 4.6 CNS Specialty Practice Education Standards 4.7 Specialty-Specific Example of a Curriculum 4.8 Accreditation and Evaluation of Programs 4.9 Designing a Curriculum 4.10 Conclusion References Part II: North America 5: Clinical Nurse Specialist Role and Practice in the United States of America 5.1 History of CNS Role and Practice 5.2 Definition of Clinical Nurse Specialist 5.3 A Model of CNS Practice 5.4 Practice Competencies 5.5 Outcome Measures and Evaluation 5.6 CNS Education 5.7 Credentialing 5.8 Moving Forward: Challenges and Opportunities 5.9 Exemplar of Clinical Nurse Specialist Practice: Critical Care CNS References 6: Clinical Nurse Specialist Role and Practice in Canada 6.1 Definition of the CNS 6.2 Current Status and Deployment 6.3 Models of CNS Practice 6.4 Outcome Measures and Evaluation 6.5 CNS Competencies 6.6 CNS Education 6.7 Credentialing: Regulatory, Legal, and Certification Requirements 6.8 Moving Forward: Challenges and Opportunities 6.9 Exemplar of CNS Practice in Oncology Palliative Care References Part III: Europe 7: The Role and Practice of Clinical Nurse Specialists in the UK 7.1 A Historical Perspective 7.2 Defining Clinical Nurse Specialists in the UK 7.3 Models of CNS Practice 7.4 CNS Practice Competencies 7.5 Outcome Measures and Evaluation 7.6 Credentialing, Regulatory and Legal Requirements 7.7 Moving Forward 7.8 Exemplars of Clinical Nurse Specialist Practice 7.8.1 Description of Specialty Area of Practice (Patient Population, Nature of Care, Etc.) 7.8.2 Describe a Case or Project that Is Exemplary of Practice in the Specialty 7.8.3 Describe Practice Competencies Used in the Specialty Practice 7.8.4 Identify Typical Outcomes of Practice in the Specialty 7.8.5 Description of Specialty Area of Practice (Patient Population, Nature of Care, Etc.) 7.8.6 Describe a Case or Project that Is Exemplary of Practice in the Specialty 7.8.7 Describe Practice Competencies Used in the Specialty Practice 7.8.8 Identify Typical Outcomes of Practice in the Specialty 7.8.9 Description of Specialty Area of Practice (Patient Population, Nature of Care, Etc.) 7.8.10 Describe a Case or Project that Is Exemplary of Practice in the Specialty 7.8.11 Identify Typical Outcomes of Practice in the Specialty References 8: CNS Role and Practice in Ireland 8.1 Brief History of CNS Role and Practice 8.2 Definition of CNS 8.3 Conceptualizations/Model(s) of CNS Practice 8.4 CNS Practice Competencies 8.5 Outcome Measures and Evaluation 8.6 CNS Education 8.7 Credentialing: Regulatory, Legal and Certification Requirements 8.8 Moving Forward: Challenges and Opportunities 8.9 Exemplar of Clinical Nurse Specialist Practice: The MS CNS References 9: Clinical Nurse Specialist Role and Practice in Finland 9.1 Brief History of CNS Role and Practice 9.2 Definition of CNS 9.3 Conceptualizations/Model(s) of CNS Practice 9.4 CNS Practice Competencies 9.5 Outcome Measures and Evaluation 9.6 CNS Education 9.7 Credentialing: Regulatory, Legal, and Certification Requirements 9.8 Moving Forward: Challenges and Opportunities 9.9 Exemplar of Clinical Nurse Specialist Practice 9.9.1 Description of Neuroscience Specialty Practice 9.9.2 Exemplary CNS Project in the Specialty of Neuroscience 9.9.3 Practice Competencies Used in the Projects 9.9.4 Outcomes of CNS Practice Within the Projects References 10: From the Nurse Specialist in Clinical Nursing to the Advanced Practice Nurse with Prescribing Rights: The French Case 10.1 Introduction 10.2 Health in France 10.2.1 Organization of the Health System and Healthcare Provision in France 10.2.2 Structure of the Health Professions 10.3 The Development of Clinical Nursing: The Roots of Advanced Nursing Practice 10.3.1 The Origins of a Project 10.3.2 Shaping a Profile 10.3.3 Characteristics of the Curriculum 10.3.4 A Formal Recognition of the Role That Was Narrowly Missed 10.3.5 Difficult Census of Certified Clinical Nurse Specialists 10.3.6 Reinvestment of Clinical Competencies in Healthcare Environments 10.4 From Clinical Nursing to Advanced Practice in Nursing 10.5 Experimentations and Lengthy Negotiations 10.6 A Lengthy Process of Developing Legislation and Regulations for Advanced Nursing Practice 10.7 Summary of the Texts Published in July 2018 and August 2019 Defining the Advanced Practice Nursing Practice 10.7.1 Clinical Activities 10.7.2 Activities Focused on Team/Organisation 10.8 Curriculum 10.8.1 Selection of Students 10.8.2 Programme Structure 10.8.3 Clinical Internships 10.8.4 The Master’s Thesis 10.9 Stakeholder Reactions After the Publication of the Texts 10.10 Perspectives 10.10.1 Effective Implementation of the National Curriculum 10.10.2 Successful Deployment of Advanced Practice Nurses in Clinical Environments 10.10.3 Assessing the Added Value of Advanced Practice Nurse 10.10.4 Propose an Economic Model That Is Commensurate with the Contribution Made 10.10.5 Changing Profile and Creating New Areas of Intervention 10.11 Conclusion References 11: CNS Role and Practice in Germany 11.1 Utilised ANP Models in Germany 11.2 Evaluation of ANP in Germany 11.3 Education of APNs in Germany 11.4 An Example of APNs in the Hospital Setting 11.5 Professional Issues Regarding ANP 11.6 Outlook References Part IV: Asia 12: CNS Role and Practice in Japan 12.1 Introduction 12.2 Brief History of the CNS Role 12.3 Definition and Practice of the Certified Nurse Specialist 12.4 Conceptualizations/Models of CNS Practice 12.5 CNS Practice Competencies 12.6 Outcome Measures and Evaluation 12.7 Education of CNSs 12.8 Credentialing: Regulatory, Legal, and Certification Requirements 12.9 Moving Forward: Challenges and Opportunities 12.10 Envision the Future APN 12.11 Conclusion References 13: Clinical Nurse Specialist Role and Practice in Mainland, China 13.1 Brief History of CNS Role and Practice 13.1.1 Definition of CNS 13.2 CNS Practice Competencies 13.3 Outcome Measures and Evaluation 13.4 CNS Education 13.5 On-the-Job Training Program for SN 13.6 Master of Nursing Specialist 13.7 Credentialing: Regulatory, Legal, and Certification Requirements 13.8 Moving Forward: Challenges and Opportunities 13.9 Exemplar of Clinical Nurse Specialist Practice 13.9.1 Nurse-Led Clinics for Diabetic Patient References 14: The Role and Practice of Clinical Nurse Specialist in Taiwan 14.1 Brief History of Clinical Nursing Specialists’ Roles and Practice in Taiwan 14.2 Definition of APN 14.3 Conceptualization and Model of APN 14.4 APN Competencies 14.5 Outcome Measures and Evaluation 14.6 APN Education 14.7 Moving Forward: Challenges and Opportunities 14.7.1 Challenges 14.7.2 Opportunities 14.8 APN Case Example References Part V: Africa and Middle East 15: The Role and Practice of Clinical Nurse Specialist in Turkey 15.1 Brief History of the Role and Practice of CNS in Turkey 15.2 Definition of CNS 15.3 CNS Practice Competencies 15.4 CNS Education 15.5 Credentialing: Regulatory, Legal, and Certification Requirements 15.6 Moving Forward: Challenges and Opportunities 15.7 Future of Specialist Nursing References 16: The Role and Practice of Clinical Nurse Specialists: An International Focus on Saudi Arabia 16.1 Brief History of the Role and Practice of CNS 16.2 Definition of CNS 16.3 Conceptualizations/Model(s) of CNS Practice 16.4 CNS Practice Competencies 16.5 Outcome Measures and Evaluation 16.6 CNS Education 16.7 Credentialing: Regulatory, Legal, and Certification Requirements 16.8 Moving Forward 16.9 Exemplar of Clinical Nurse Specialist Practice 16.10 Summary References 17: The Role and Practice of Clinical Nurse Specialist in Nigeria 17.1 The Clinical Nurse Specialist 17.2 Brief History of Nursing Education and Training in Nigeria 17.3 Pathways to the Role and Practice of CNS in Nigeria 17.3.1 Hospital-Based Pathway 17.3.2 University-Based Pathway 17.3.3 Task-Shifting Pathway 17.4 Moving Forward: Challenges and Opportunities 17.5 Conclusion References Part VI: Oceania 18: The Role and Practice of CNS in Australia 18.1 Brief History of the Role and Practice of CNS 18.1.1 Introduction 18.1.2 Nursing in Australia 18.1.3 History of the Role of CNS 18.2 Definition of CNS 18.2.1 Advanced Practice Nursing 18.2.2 Clinical Nurse Specialist 18.3 Conceptualisations/Model(s) of CNS Practice 18.3.1 Key Responsibilities and Scope of Duties 18.3.2 Direct Versus Non-direct Care 18.3.3 Areas of Practice 18.4 CNS Practice Competencies 18.5 Outcome Measures and Evaluation 18.6 CNS Education 18.7 Endorsement and Professional Recognition 18.8 Moving Forward: Challenges and Opportunities 18.9 Exemplar of CNS Practice 18.9.1 Specialist Breast Nurse in Australia 18.9.2 Prostate Cancer Specialist Nurse in Australia 18.10 Conclusion References 19: Clinical Nurse Specialist Role and Practice in New Zealand 19.1 Clinical Nurse Specialist: New Zealand 19.1.1 Clinical Nurse Specialist Role: New Zealand History 19.1.2 NZ Definition of a Clinical Nurse Specialist Role 19.1.3 Conceptualized Models of Clinical Nurse Specialist Practice 19.1.4 Clinical Nurse Specialist Practice Competencies 19.1.5 Clinical Nurse Specialist Education and Credentialing 19.1.5.1 Nurse Prescribing 19.1.6 Outcome Measures and Evaluation 19.1.7 Moving Forward: Challenges and Opportunities 19.1.7.1 Development of a National CNS Group 19.1.8 Exemplar of Clinical Nurse Specialist Practice 19.1.8.1 Quality Initiative: CNS Exemplar 19.1.9 Conclusion References 20: Challenges and Opportunities for CNS Practice Globally 20.1 Introduction 20.2 Role Definition, Practice Competencies, Outcomes 20.3 Educational Standards 20.4 Credentialing and Scope of Practice 20.5 Research and Evaluation 20.6 Organizational Support and Advocacy 20.7 Final Thoughts References Developed under the direction of the International Council of Nurses (ICN), this book is part of a series exploring advanced practice globally. It is the first known volume to provide an international view of the advanced practice role of clinical nurse specialist (CNS). It features an in-depth examination of advanced speciality practice in nursing, and the advanced practice role of the clinical CNS. Content includes models of practice, core practice competencies, curricular recommendations, practice outcomes, and regulatory requirements related to scope of practice. The CNS role and practice as implemented in North America, Europe, Asia and Oceania are examined in the context of the country’s healthcare system, educational traditions and regulatory requirements. Exemplars describe role implementation in various specialty practices and discuss how the role is implemented to advance nursing and improve clinical and fiscal outcomes. Measurement and evaluation of CNS practice in the context of countries and health care systems are examined. For practicing CNSs, this book provides an in-depth examination of the role from the global perspective; for administrators it provides a foundational understanding of the CNS role and practice and performance expectations. Educators will use the book as a resource for curriculum development, whereas students will offers an expanded global view of the role. Advanced practice roles, including the CNS, are continuing to evolve. This book makes important contributions to a global understanding of the CNS role.