Darmody Julie V
College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, USA.
Clin Nurse Spec. 2011 Sep-Oct;25(5):244-52. doi: 10.1097/nur.0b013e31822b33db.
Reporting relationships between clinical nurse specialists (CNSs) and administrators (ADMs) can facilitate or constrain CNS practice and affect patient outcomes. Limited information is available comparing reporting relationships and perspectives of CNSs and ADMs.
The purpose of the present study was to describe CNS and ADM reporting relationships and compare their perspectives about the activities and outcomes of CNS practice in acute care settings.
The present study uses a descriptive survey.
Four healthcare organizations in the midwestern United States.
Clinical nurse specialist participants (n = 30) were master's degree prepared and employed in an acute care setting. Administrator participants (n = 7) were responsible for supervision and evaluation of CNSs in their organization.
Questionnaires were developed from literature and content review by experts. The CNS and ADM questionnaires contained separate sections for CNS and organization information with parallel construction of questions about CNS activities and outcomes.
There was variability across organizations related to reporting relationships and structure of CNS work. No significant differences were found when comparing CNS and ADM perspectives of work activity proportions and the importance of 10 activities and 7 outcomes. The most important CNS activities included developing clinical protocols and guidelines, quality improvement, and coordination of care. The most important outcomes included evidence-based nursing care and skilled and competent nursing staff.
Comparing perspectives of work activity time, priority activities, and outcomes provides a basis for collaboration between CNSs and ADMs in reporting relationships.
Clinical nurse specialists should develop positive interactions and shared understanding with ADMs to improve effectiveness and enhance patient outcomes.
报告临床护理专家（CNS）与管理人员（ADM）之间的关系，可能会促进或限制CNS的工作实践，并影响患者的治疗结果。关于CNS和ADM之间的报告关系及观点的比较信息有限。
本研究的目的是描述CNS和ADM的报告关系，并比较他们对急症护理环境中CNS工作活动和结果的看法。
本研究采用描述性调查。
美国中西部的四个医疗机构。
临床护理专家参与者（n = 30）拥有硕士学位，受雇于急症护理环境。管理人员参与者（n = 7）负责监督和评估其所在机构中的CNS。
通过文献和专家内容评审编制问卷。CNS和ADM问卷分别包含CNS和机构信息部分，以及关于CNS活动和结果的平行问题。
各机构在CNS的报告关系和工作结构方面存在差异。在比较CNS和ADM对工作活动比例以及10项活动和7项结果的重要性的看法时，未发现显著差异。最重要的CNS活动包括制定临床方案和指南、质量改进以及护理协调。最重要的结果包括循证护理以及熟练且称职的护理人员。
比较工作活动时间、优先活动和结果的观点，为CNS和ADM在报告关系中的合作提供了基础。
临床护理专家应与ADM建立积极的互动和共同理解，以提高效率并改善患者治疗结果。
