Aim: To assess the activities of clinical nurse specialists (CNSs), examining work patterns, job plans and team structures, especially the balance of patient-facing and non-patient-facing activity.
Method: A quantitative evaluation was conducted using diary cards at Imperial College Healthcare NHS Trust. CNSs were asked to record their activity for each ten-minute period of the working day over two weeks.
Results: Data were received from 236 of 261(90.4%) possible respondents and more than one million minutes of data were submitted. On average, CNSs spent 41% of their time in direct patient-facing activities and an additional 21.5% in patient-related activities. However, there was wide variation in how time was spent between individuals and teams, and across divisions within the trust. CNSs estimated that 16.4% of their clinical activity may have prevented an adverse event or patient attendance at hospital.
Conclusion: Data generated from this evaluation will be used to develop coherent job plans for individuals and teams of CNSs and to identify which nurse-led activities are being reimbursed by commissioners of services.