Core competencies of different-level clinical nurse specialists: A comparative study between two years

Abstract

Background: To promote the collaborative development of CNSs at different levels, it is necessary to have a targeted understanding of the current core capabilities of CNSs at different levels. The study aims to describe and compare the core competencies of clinical nurse specialist (CNS) between two years in China and investigate the differences among three levels of expertise of CNSs: primary, intermediate, and advanced. Methods: This is a cross-sectional study. An online survey was conducted in 5 November, 2021 and 7 November, 2023. The study was conducted in a grade 3A hospital in China. A population sample of clinical nurse specialists from China was recruited. Core competency was assessed through a self-evaluation strategy, and the assessment instrument included five first-level domains and 35 items. The data were analysed based on their level and survey year. Results: A total of 483 clinical nurse specialists, classified into primary, intermediate, and advanced levels of expertise, participated in the study. The average CNS competency scores increased after two years (P=.002). Among the primary-level CNSs, the scores for all five core competencies significantly differed from 2021 to 2023 (P= .032, .009, .031, .006, .047). The competency of intermediate-level CNSs improved throughout the two years, and their scores for ‘consulting and teaching’ and ‘management and leadership’ were significantly different (P< .001). For advanced-level CNSs, self-assessment scores all increased but were not significantly different. Conclusion: After two years of working at the clinic and receiving further education, the overall core abilities of specialized nurses improved. The performance improvement of intermediate specialized nurses is particularly outstanding, and they are the most popular among colleagues in clinical practice and can provide effective care for patients. The core abilities of primary and intermediate clinical nurse specialists need to be further improved to meet the more urgent needs of hospitals and patients in difficult clinical problems, team management, and professional development.