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clinical nurse specialist
A clinical nurse specialist (CNS) is a healthcare worker who can provide expert advice related to specific conditions or treatment pathways.
==United States==
In the United States a CNS is an advanced practice registered nurse (APRN), with graduate preparation (earned master's or doctorate) from a program that prepares CNSs. The National Association of Clinical Nurse Specialists (NACNS) announced in July 2015 its endorsement of proposals for the Doctor of Nursing Practice (DNP) as the required degree for CNS entry into practice by 2030.〔()〕 According to the Consensus Model for APRN Regulation (2008), "The CNS has a unique APRN role to integrate care across the continuum and through three spheres of influence: patient, nurse, system. The three spheres are overlapping and interrelated but each sphere possesses a distinctive focus. In each of the spheres of influence, the primary goal of the CNS is continuous improvement of patient outcomes and nursing care. Key elements of CNS practice are to create environments through mentoring and (p. 8) system changes that empower nurses to develop caring, evidence-based practices to alleviate patient distress, facilitate ethical decision-making, and respond to diversity. The CNS is responsible and accountable for diagnosis and treatment of health/illness states, disease management, health promotion, and prevention of illness and risk behaviors among individuals, families, groups, and communities." (p. 9). CNSs are clinical experts in a specialized area of nursing practice and in the delivery of evidence-based nursing interventions.
A systematic review published in 2011 identified 11 studies from the US (four RCTs and seven observational) that had looked at the possible effect of having CNS as part of the healthcare team. The reviewers found some evidence of reduced length of stay and costs of care for teams which included a CNS.
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