1. Stausmire, Julie M. MSN, TN, ACNS-BC

Article Content


The objectives of this study were to (1) promote collaborative physician-advance practice nurse clinical practice and professional trust by using a clinical nurse specialist (CNS) to precept family medicine residents during home visits; (2) match specific patient /caregiver needs for education, psychosocial concerns, safety, or medical care to an identified resident learning need and the Accreditation Council for Graduate Medical Education (ACGME) competencies; and (3) use interventions that improve the quality of patient care, promote patient health and safety, prevent injuries, and focus on the holistic needs of the patient and family.



This project highlights the ability of advance practice nurses to share their expertise with residents in an academic clinical practice.



Effective teamwork between nursing and medicine begins with understanding and incorporating the 6 general competencies endorsed by the ACGME competencies into collaborative clinical practice. These include patient care, medical knowledge, interpersonal and communication skills, practice-based learning and improvement, professionalism, and systems-based practice.



This study used 2 institutional review board-approved research studies. The first was a survey to determine resident concerns about home visits, including the use of an advance practice nurse preceptor. The second study was conducted over 2 years and included a post-home-visit survey about the actual experience and the effectiveness of the CNS preceptor.



Data demonstrate a marked difference between resident concerns before a home visit and the actual experience. Significantly, 32% of residents initially voiced concerns about an advance practice nurse preceptor, but 0% of residents indicated concerns at the conclusion of the study.



Using a CNS preceptor encouraged teamwork and professional respect for the expertise of nonphysician educators. The ability to incorporate the ACGME competencies into collaborative clinical practice allows advance practice nurses to participate in the education of residents from all specialties.


Implications for Practice:

Traditionally, nursing and medicine have each had their own language and models of care. Increasingly, both professions are under pressure to demonstrate both educational and clinical outcomes. If advance practice nurses want the opportunity to participate in the education of future physicians and build collaborative practices throughout the residency process, they must understand and be able to incorporate the ACGME competencies into joint clinical practice and research.


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.