In the United States, clinical nurse specialists are require to have core competence in the area of specialty. The competence is key to patient care outcome, which include the skills, knowledge and confidence to provide best nursing practice(Xu, et al., 2014). The core competence is determined by the education and experience which is continuously modified through redevelopment, remediation, educational consultation, skills and knowledge. Clinical nurse specialists continues to acquire core competence even after basic education is finish. The core competence of clinical nurse specialists is described in three dimensions:
- counselling, cure, inclusive of care and range of function,
- depth of understanding
- breadth of service which include collaboration, continuity and coordination.
In direct practice, clinical nurse specialists should be able to integrate knowledge of clinical practice, results and contemporary nursing theories and apply them to patient care. The holistic approach is to ensure that well-being, health and quality of life is improved.