1. Edinger, Germaine M. MS, APRN,BC, CNS
  2. Finch-Guthrie, Patty PhD, APRN,BC, CNS

Article Content


Describe the evolution of one CNS group practice's experience with measuring outcomes using the 3 spheres of influence.



Through the described efforts, CNSs at one institution were able to articulate their value to an organization.



Healthcare institutions need to be fiscally responsible. As advanced practice nurses, the CNSs need to be able to describe their value to the organization. They need to be able to articulate their value within all 3 spheres of influence. The description that follows is an example of how 13 CNSs described their group practice and individually used the data to improve their individual practices.



The group initially began with focus on the "patient" sphere. The group utilized NIC and NOC standardized language to describe the patient/family focus of the CNS practice. Simultaneously, a subgroup of the CNSs formed a task force to identify a process for collecting outcomes related to organizational and nursing spheres of influence.



Identifying the most commonly used NIC for a diverse group of CNSs has been challenging. Through the collection of data related to the organizational sphere, the CNS group was able to articulate their contribution to broader organization.



Using the 3 spheres of influence was a good framework for beginning to describe a group CNS practice.