Core Practice Outcomes for Clinical Nurse Specialists: A Revalidation Study

• Measuring outcomes of clinical nurse specialist (CNS) practice is essential for demonstrating accountability and effectiveness.
• This descriptive study was carried out to assess CNSs' perceptions of the ongoing validity of outcomes published by the National Association of Clinical Nurse Specialists (NACNS).
• Findings demonstrated concordance between identified outcomes and actual CNS practice.
• Being accountable for an outcome and recognizing the outcome as important predicted whether the outcome was monitored.
• Outcomes published by NACNS have potential for use as a conceptual framework for guiding future CNS outcome investigations and ongoing monitoring systems.

Measuring outcomes of clinical nurse specialist (CNS) practice is essential for demonstrating accountability. Literature is limited with respect to the scope of reported CNS outcomes. The National Association of Clinical Nurse Specialists' (NACNS) published listing of CNS outcomes could serve as an outcome measurement framework. Revalidation of these outcomes is an important step in creating a structured outcome measurement approach. The purpose of this descriptive study was to assess CNSs' perceptions of the ongoing validity of NACNS published outcomes. A Web-based survey asked participants to describe, for each of 42 outcomes, the frequency of outcome accountability, importance to practice, and frequency of monitoring. Of the 427 surveys returned, 347 (81%) were included in analysis. Findings demonstrated concordance between identified outcomes and actual CNS practice. When job descriptions included the CNS outcomes, more CNSs reported using the outcomes in practice. Both accountability and importance predicted the monitoring of outcomes (p < .001). This study demonstrated the ongoing validity of NACNS outcomes. Nurse educators must ensure that CNS program curricula are based on the NACNS framework and that successful achievement of program outcomes are congruent with the framework. These outcomes have potential for use as a conceptual framework for guiding future CNS outcome investigations and ongoing monitoring systems. Finally, the findings of this study give voice to CNS practice and provide knowledge about expectations for practice outcomes.