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00002800-199611000-0001000002800_1996_10_300_mcgonigle_informatics_6miscellaneous< 19_0_2_1 >Clinical Nurse Specialist© Williams & Wilkins 1996. All Rights Reserved.Volume 10(6)November 1996p 300Nursing Informatics: Quantifying the CNS Role[Executive Practice]McGonigle, Dee Ph.D., R.N.C., F.A.C.C.E.DEE McGONIGLE is an associate professor of nursing at Penn State University. She developed and teaches the nursing informatics course and is co-editor for The On-Line Journal of Nursing Informatics. Her responsibilities include virtual coursework and expanding student/faculty use of the Internet. She recently received funding to develop a template for virtual course work.Introduced by Dee McGonigle, Ph.D., R.N.C., F.A.C.C.E.The role of the clinical nurse specialist (CNS) is challenged as facilities retool to meet the needs of their consumers in a competitive, cost-oriented milieu. Therefore, the healthcare market of today poses greater demands on the practicing nurse as it continues to adjust and adapt in the managed care environment. Who is bringing in money? Who is servicing the client at the least cost? Why should we pay advanced practice nurses (APNs) more money? Can you receive third-party reimbursement? How do you fit into our realignment efforts? What is your place in our new mission? In the flux of downsizing, reorganization, and “cost-containment,” we must justify our worth to keep our piece of the healthcare pie. FigureNo Caption Available.This is the era of “show me.” Administrators playing the budget game by cutting allotments to the bone want to know why they should spend their scarce healthcare dollars on professional nurses, let alone APNs. Our profession has been challenged by the introduction of care technicians and increased workloads resulting from elimination of registered nurse (RN) positions and the use of licensed practical nurses (LPNs) and nursing assistants to handle basic client care. How, then, can we demonstrate why healthcare dollars should be spent for professional nursing services when other healthcare professionals are saying that lower-cost technicians can suffice? We must unify our efforts and clearly show that CNSs positively impact the quality of care. This relationship between CNSs and quality patient outcomes is being established and must be disseminated. Demonstrated cost-effectiveness and savings through the use of CNSs will catch any administrator's eye. Show them how they can pay APN salaries and save money, and you're in the game plan! If you cannot document your necessity, the game continues with new rules, and you're out.Picella's article provides an overview of a relational database and how it organizes and manages data. This author describes the data collection tool and the need for standardization to glean the best data. Because a database is only as good as the human interface accessing it, determining the input data needed to yield the necessary output is important. Picella used three relational databases to handle information about coding, CNS clients, and the persons the CNS interacts with in their organizational structure. This combination of databases and select report generation provide an avenue to assess the CNS roles and activities quickly. This technological integration provides the CNS with a powerful answering device for the questions raised about cost-effectiveness and worth.Qualitative information is also important when assessing the nurse/client relationship. According to Reilly et al.,1 there are disadvantages in using databases to manage qualitative data. Because the relational database technology is best used for quantifying data, another means of addressing the qualitative component should be developed to augment this quantification and enhance our knowledge of the impact CNSs make on client care.Broadening this exciting beginning by extending the participation to CNSs across the country via the Internet would also be important. This superhighway can link us together. Perhaps a set of standards could be established for data collection on CNS roles and activities. As other areas of the healthcare field are attempting to delineate their expertise and fit into this new game plan, CNSs must also, as a unified group, chunk out their piece of this ever-evolving healthcare pie.REFERENCE1. Reilly C, Holzemer R, Henry S. The use of a relational database management system for the categorization of textual data. In: Grobe SJ, Pluyter-Wenting ESP, editors). Nursing informatics: an international overview for nursing in a technological era. Amsterdam: Elsevier 1994:815. [Context Link]Nursing Informatics: Quantifying the CNS RoleMcGonigle, Dee Ph.D., R.N.C., F.A.C.C.E.Executive Practice610