1. Moore, Stephanie R. MS, ACNS-BC
  2. Stewart, Carol MS, RN,GCNS-BC

Article Content


The aim of this study was to improve quality patient outcomes through the development of coaching competency in the clinical nurse specialist (CNS) student.



Through development of the coaching skill, the CNS student learns how to strengthen staff nurse performance, leading to improved patient outcomes and understanding of how to guide the patient and family.



Coaching is a personal relationship technique that uses teaching, directing, and development of critical thinking. Coaching occurs at the point of delivery of patient care. The CNS coaches by observing behavior and by working with the staff, patient, and/or families in areas of need.



Clinical nurse specialist students are taught to use system-level assessment techniques when evaluating and working with stakeholders to resolve an issue. Identification of opportunities for improvement in the system can be linked to undesired patient outcomes and nursing practices. An example of a poor clinical outcome would be a patient with a chronic pain issue being discharged to the nursing home from the hospital without pain medication or non-pharmacologic therapies. The CNS gathers data, works in collaboration with team members to implement strategies, and uses coaching strategies when working with the discharge team to evaluate the steps of the discharge process.



The following are the outcomes of this study:


* increase in patient and family satisfaction,


* identification of specific nursing practices and the impact on patient outcomes, and


* development and articilation of interdisciplinary team-building skills through process improvement.




The focus on coaching skills has enhanced the process for addressing the learning needs of the student related to each sphere of influence. Coaching interdisciplinary team members increases critical thinking skills and improves the team's ability to proactively address individual patient's needs. Being able to coach experienced nursing staff in the area of practice develops relationships that yield enhanced orientation for the novice nurse. Coaching through a systems approach ensures common vision among stakeholders and alignment with leadership. The organizational environment becomes conducive for learning.


Implications for Practice:

Articulation and practice of core competencies in the CNS education process provide for an enhanced learning experience. Development of the coaching skill provides the students the ability to guide staff, patients, and families in resolving of system needs. This then provides for the avenue to increased patient quality outcomes.


Section Description

The 2009 NACNS National Conference will be held in St Louis, Missouri, on March 5 to 7. More than 350 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are registered. This year's theme, "Clinical Nurse Specialists: Vision, Value, Voice," demonstrates the essential leadership skills of the CNS as well as the CNS role in implementing evidence-based practice.


Seventy abstracts were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session. The abstracts addressed CNS practice in 3 practice domains (spheres of influence), emphasizing patient safety and quality care outcomes, leadership, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into 3 spheres of influence-patients, nursing practice, organization/system-including the development of clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, CNS practice in end-of-life care decisions, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNSs' contribution to the well-being of individuals, families, communities, as well as to the advancement of the nursing profession.


The conference abstracts were published here to facilitate sharing this emerging new knowledge with those who were unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics. Watch out for next year's call for abstracts and consider submitting for presentation at NACNS' next annual conference in Portland, Oregon, on March 4 to 6, 2010.