CNS Practice Outcomes Management

Research about Clinical Nurse Specialist practice demonstrates outcomes such as:

Reduced Hospital Costs and Length of Stay

Ahrens T, Yancey V, Kollef M. Improving family communications at the end of life: implications for length of stay in the intensive care unit and resource use. American Journal of Critical Care. 2003;12(4):317-324. (Other outcome included decrease resource utilization.)

Blue L, Lang E, McMurray JJ, Davie AP, McDonagh TA, Murdoch DR, et al. Randomised controlled trial of specialist nurse intervention in heart failure. British Medical Journal. 2001;323:715–718.

Brooten D, Youngblut J M, Brown L, Finkler SA, Neff DF, Madigan E. A randomized trial of nurse specialist home care for women with high-risk pregnancies: outcomes and costs. American Journal of Managed Care. 2001;7(8):793-803. (Other outcomes included decreased infant death rate, and decreased hospitalizations.)

Haddock KS. Collaborative discharge planning: Nursing and social services. Clinical Nurse Specialist. 1994;8;248–252.

Lombness PM. Difference in length of stay with care managed by clinical nurse specialists or physician assistants. Clinical Nurse Specialist. 1994;8(5):253-60.

Neidlinger S, Scroggins K, Kennedy L. Cost evaluation of discharge planning for hospitalized elderly. Nursing Economics. 1997;5:225–230.

Paladichuk A, Brass-Mynderse N, Kaliangara O. Chronic disease management: An outpatient approach. Critical Care Nurse. 1997;17:90-95. (Other outcomes included decreased hospital readmissions and improved quality of life.) 

Patton M., Schaerf R. Thoracotomy critical pathway and clinical outcomes. Cancer Practice. 1995;3:286–294.

Russell LC. Cost containment of modified radical mastectomy: The impact of the clinical nurse specialist. Point View. 1989;2:18–19.

Topp R, Tucker D, Weber C. Effect of a clinical case manager/clinical nurse specialist on patients hospitalized with congestive heart failure. Nursing Case Management. 1998;3(4):140-145.

Venner GH, Steelbinder JS Team management of congestive heart failure across the continuum. Journal of Cardiovascular Nursing. 1996;10:71–84. (Other outcomes included decreased hospital readmissions and decreased mortality.)

York R, Brown LP, Samuels P, Finkler SA, et al.  A randomized trial of discharge and nurse specialist follow-up care of high-risk childbearing women. Nursing Research. 1997;46:254–260.

Reduced Frequency of Emergency Room Visits

Alexander JS, Younger RE, Cohen RM, Crawford LV. Effectiveness of a nurse-managed program for children with chronic asthma. Journal of Pediatric Nursing. 1998;3(5):312–7.

Improved Pain Management Practices

Deisch P, Soukup SM, Adams P, et al. Guided imagery: replication study using coronary artery bypass graft patients. Nursing Clinics of North America. 2000;35:417-425. (Other outcomes include decreased fatigue, anxiety, narcotic use, and increased patient satisfaction.)

Increased Patient Satisfaction with Nursing Care

Forster AJ, Clark HD, Menard A, Dupuis N, Chernish R, Chandok N, , et al. Effect of a nurse team coordinator on outcomes for hospitalized medicine patients. American Journal of Medicine. 2005;118(10):1148-1153.

Reduced Medical Complications in Hospitalized Patients

Barnason S, Zimmerman L, Anderson A, Mohr-Burt S, Nieveen J. Functional status outcomes of patients with a coronary artery bypass graft over time. Heart & Lung. 2000;29:33-46.

Conley DM. The gerontological clinical nurse specialist’s role in prevention, early recognition, and management of delirium in hospitalized older adults. Urologic Nursing. 2011;31(6):337-342.

Custer ML. Outcomes of clinical nurse specialist-initiated system-level standardized glucose management. Clinical Nurse Specialist. 2010;24(3):132-139.

Hanneman SK, Bines AS, Sajtar WS. The indirect patient care effect of a unit-based clinical nurse specialist on preventable pulmonary complications. American Journal of Critical Care. 1993;2(4):331-338.

Jacavone JB, Daniels RD, Tyner I. CNS facilitation of a cardiac surgery clinical pathway program. Clinical Nurse Specialist. 1999;13(3):126-132. (Other outcomes included earlier extubation times, decreased nausea, and earlier ambulation.)

Ley SJ. Quality care outcomes in cardiac surgery: the role of evidence-based practice. AACN Clinical Issues: Advanced Practice in Acute & Critical Care. 2011;12(4):606-617.

McCabe PJ. Spheres of clinical nurse specialist practice influence evidence-based care for patients with atrial fibrillation. Clinical Nurse Specialist. 2005;9(6): 308-317. (Other outcomes included increased patient functioning, increased self-care management, and decreased fragmentation of care.)

Rantz MJ, Popejoy L, Petroski GF, Madsen RW, Mehr DR, Zwygart-Stauffacher M, et al. Randomized clinical trial of a quality improvement intervention in nursing homes. The Gerontologist. 2001;41:525–538. (Other outcomes included decreased falls, behavioral symptoms, and pressure ulcers.)

Wheeler EC. The CNS's impact on process and outcome of patients with total knee replacement. Clinical Nurse Specialist. 2000;14(4):159-172. (Other outcome included decreased length of stay.)

Wheeler EC. The effect of the clinical nurse specialist on patient outcomes. Critical Care Nursing Clinics of North America. 1999;11(2):269-275.

Other Quality Measures/Outcomes

Crimlisk JT, Bernardo J, Blansfield JS, Loughlin M, McGonagle EG, McEachern G, et al. Endotracheal intubation: a closer look at a preventable condition. Clinical Nurse Specialist. 1997;11:145–150.

Damato EG, Dill PZ, Gennaro S, Brown LP, York R, Brooten D. The association between CNS direct care time and total time and very low birth weight infant outcomes. Clinical Nurse Specialist. 1993;7:75–79.

Dobscha SK, Gerrity MS, Ward MF. Effectiveness of an intervention to improve primary care provider recognition of depression. Effective Clinical Care. 2001;4(4):163-171.

Hamilton R, Hawley S. Quality of life outcomes related to anemia management of patients with chronic renal failure. Clinical Nurse Specialist. 2006;20(3):139-143.

Larsen L, Neverett S, Larsen R. Clinical nurse specialist as facilitator of interdisciplinary collaborative program for adult sickle cell population. Clinical Nurse Specialist. 2001;15(1):15-22.

McCauley KM, Bixby MB, Naylor MD. Advanced practice nurse strategies to improve outcomes and reduce cost in elders with heart failure. Disease Management. 2006;9(5):302-310. 

Pozen MW, Stechmiller JA, Harris W, Smith S, Fried DD, Voigt GC. A nurse rehabilitator’s impact on patients with myocardial infarction. Medical Care. 1997;15:830–837.

Sulzbach-Hoke LM, Gift AG. Use of quality management to provide nutrition to intubated patients. Clinical Nurse Specialist. 1995;9(5):248-251.

Tsay SL, Lee UC, Lee YC. Effects of an adaptation training programme for patients with end-stage renal disease. Journal of Advanced Nursing. 2005;50:39-46.

Willoughby D, Burroughs D. A CNS-managed diabetes foot-care clinic: A descriptive survey of characteristics and foot care behaviors of the patient population. Clinical Nurse Specialist. 2001;15:52–57.


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