Perioperative Clinical Nurse Specialist Role Delineation: A Systematic Review

Abstract

Public reporting burden tor this collection ot intormation is estimated to average 1 hour per response, including the time Tor reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington. DC 20503. Purpose: The purpose of this study was to provide recommendations for a delineated role of the PCNS that will provide role clarity and practice guidance. AGENCY USE ONLY (Leave blank)Methods: A systematic review of the literature was conducted utilizing an adaptation of Rheiner's "Role Theory Framework for Change". The initial search yielded 6374 articles.Thirteen percent (859) of the articles met inclusion criteria. In order to ensure consistency and confirmability, two members read each article and entered a synopsis into a review summary table. Synopses were analyzed using both deductive and inductive techniques.Results: There was no uniform role for the CNS identified through the literature, Conclusions: Competencies and educational preparation of the CNS are well defined by professional organizations however many nurses use the title without the credentials.Versatility of CNS practice, the lack of core or specialty certification, and the variance of state recognition all contribute to role confusion. Future research should evaluate the merging of the CNS and NP titles; the presence of PCNSs, their functions, spheres of influence, and patient outcomes. All authors are military members and are in transit at the time this manuscript is being submitted. Current addresses and duty assignments will be forwarded to AORN as soon as the members secure housing at their new duty stations. As we previously discussed, I will keep in contact with you during my travel. Tables Table 1 Keyword Phrases Table 2 The purpose of this study was to utilize an evidence-based approach to provide recommendations for a delineated role of the PCNS that would provide role clarity and practice guidance. Using a systematic review of the literature, the researchers analyzed the defined roles of the CNS in perioperative and non-perioperative practice and compared these roles to those of the Registered Nurse (RN) and Nurse Practitioner (NP) within the perioperative environment to answer the research question: What is a Perioperative Clinical Nurse Specialist? The specific study objectives are to compare and contrast the roles, competencies, and educational preparation of the previously stated specialties. As well as to identify and describe organizations/systems that influence their utilization and professional organizations that develop/recommend c...

Advanced nursing roles: A systematic review

“…It has been argued that the vague definition of the APN role is facilitative in the role implementation of self‐directed individuals, allowing for the definition of the individual's own priorities in different domains (McFadden & Miller, 1994). The current variety in titles, definitions, scope of practice, as well as preparation for, and expectations of, these roles, appears to have caused confusion among nursing and other professions, as well as the consumers to such an extent that it suggests the need for some level of standardization (Ketefian et al ., 2001; Daly & Carnwell, 2003; Glover et al ., 2006; Humphreys et al ., 2007; Mantzoukas & Watkinson, 2007; Lewandowski & Adamle, 2009). According to our opinion, a certain level of universal consensus of APN roles is needed, thus we agree with Ruel & Motyka's (2009) claim that a cohesive vision of APN in nursing is imperative to achieving the external legitimacy needed to reinforce the need of APN roles for society, legislators, and stakeholders.…”

“…Education is at the master's or doctoral level” (Lewandowski & Adamle, 2009). For many years, the scope of the CNS practice has been described in terms of its domains, including expert practitioner, educator, consultant, researcher, administrator or leader, and change agent (Scott, 1999; Glover et al ., 2006). Recently, the National Association of Clinical Nurse Specialists articulated even further the competencies and outcomes of the contemporary CNS practice by introducing a conceptual model of CNS practice, in which the three spheres of CNS influence are the patient/client sphere, the nurses and nursing practice sphere, and the organization sphere (Lewandowski & Adamle, 2009).…”

Evaluating psychiatric nursing competencies applied to emergency settings: A pilot role delineation study

“…Competencies were selected a priori from existing psychiatric nursing competencies recommended for generalist entry-level RNs caring for patients with psychiatric disorders based on expert opinion that these competencies would reflect work expected of ED nurses. Following existing role delineation studies (Brown et al, 2012;Glover et al, 2006;McMillan et al, 2002;Thompson and Lulham, 2007), the selected competencies were organized into three performance domains (Assessment, Tasks and Knowledge Application), with five competencies included in each domain. In total, the survey included fifteen competencies and ranking options, using 5-point Likert scales for: (a) the frequency with which the competency is conducted in the ED setting; (b) the importance of the competency to the ED setting; and (c) perceived self-efficacy in performing the competency.…”

“…In total, the survey included fifteen competencies and ranking options, using 5-point Likert scales for: (a) the frequency with which the competency is conducted in the ED setting; (b) the importance of the competency to the ED setting; and (c) perceived self-efficacy in performing the competency. While frequency and importance are standard measures in an RDS (Brown et al, 2012;Glover et al, 2006;McMillan et al, 2002;Thompson and Lulham, 2007), self-efficacy (i.e., belief in one's own ability to complete tasks and reach goals) was added to this pilot study in order to better understand emergency nurses' confidence regarding the psychiatric competencies.…”

The Clinical Nurse Specialist Role

“…In the results and findings, the authors stated that

the perioperative CNS was shown to affect the surgical environment through activities such as advocating for patients, collaborating with surgeons, consulting for nursing staff members, precepting, assessing patients both physically and culturally, and offering clinical insight 2 . (p1022)

…”