Describing Clinical Nurse Specialist Practice: A Mixed-Methods Study

Purpose/AimsTo describe clinical nurse specialist practice in Qu & eacute;bec, Canada, and propose a dashboard to track role dimensions and outcomes.DesignSequential mixed-methods study across 6 sites in Qu & eacute;bec (June 2021 to May 2022).MethodsPhase 1: Focus groups (n = 8) and individual interviews (n = 3) were conducted to adapt a time and motion tool. Phase 2: Time and motion studies (n = 25; 203 hours 5 minutes) described clinical nurse specialist practice. Phase 3: A rapid literature review and study participants' feedback informed the dashboard's development. Analysis: Descriptive statistics, with content analysis for qualitative data.ResultsThe proportion of time clinical nurse specialists spent in role dimensions included clinical (22.8%), education (11.2%), administrative/leadership (48.6%), research (9.6%), and personal (7.7%). On average, they spent 17% of work time with patients, but this varied across specialties and locations. Key dashboard characteristics and uses were identified.ConclusionsImportant differences were noted in clinical nurse specialist time spent in activities across specialties and regions in Qu & eacute;bec. Approximately one-fifth of work time was spent in direct patient care. Additional research is needed to examine the link between clinical nurse specialist practice and outcomes in other jurisdictions and test the implementation of a dashboard to make their practice more visible.