PERCEPTIONS OF DIRECTORS OF NURSING SERVICE REGARDING THE VIABILITY OF THE CLINICAL NURSE SPECIALIST POSITION IN MAJOR HOSPITAL SETTINGS.
Contributors: University of Alabama.
Published: 1985
Number of pages: 188
Subjects: Health Sciences, Nursing.; Health Sciences, Health Care Management.
Description: Current pressures for cost containment in health care provoke speculation as to decisions regarding budget items warranting scrutiny. The clinical nurse specialist (CNS) position stands vulnerable by reason of lesser involvement than staff nurses in providing direct nursing care. The purpose of this study was to ascertain the perceptions of directors of nursing regarding the viability of the CNS position in large hospitals.

Questionnaires were sent to 150 directors of nursing (DON) randomly sampled from hospitals with at least 400 beds in the geographic area governed by the Southern Regional Educational Board. Of this number, 106 were usable for inclusion in the study.

The DON were asked to indicate their agreement or disagreement with statements related to cost effectiveness, utilization, and contribution of CNS in providing nursing care. They were asked to respond to statements relative to role behavior and factors enhancing or detracting from the implementation of the position. Other statements pertained to evaluating the effect of the CNS on the quality of patient care, cost accounting systems, and estimates of need for additional CNS positions.

Data were analyzed by descriptive statistics and Pearson r. Findings of the study indicated that the CNS contributed to improve the quality of patient care but that evaluation methodologies did not accurately reflect that contribution. Most respondents agreed that the position should not be eliminated because of budgetary constraints.

Fifty percent perceived a need for additional CNS positions, but only 26.4% believed the number of CNSs employed would increase within five years. The majority agreed that indirect patient care assignments were appropriate and cost effective. Cost accounting systems were maintained by 27.1%; only 9.6% differentiated costs according to skill level of the care provider. There was strong agreement with factors which enhanced or detracted from the implementation of the position.

The findings support the view that the CNS contributes to improving patient care. In times of severe budgetary constraints this position is even more vital, because the CNS can maximize the contribution of less skilled personnel.

Recommendations were made for further study. Implications were cited for nursing administrators, educators, and clinical specialists.
Notes: Source: Dissertation Abstracts International, Volume: 46-09, Section: B, page: 3004.

Thesis (ED.D.)--THE UNIVERSITY OF ALABAMA, 1985.

School code: 0004.