Updated foundational document reinforces the role of Clinical Nurse Specialists as APRNs, clinical experts, systems leaders, and innovators in healthcare
WAKEFIELD, MA, [September 1, 2026] – The National Association of Clinical Nurse Specialists (NACNS) is proud to announce the release of the Fourth Edition of the Statement on Clinical Nurse Specialist Practice and Education, a comprehensive update to the profession’s foundational document defining Clinical Nurse Specialist (CNS) practice, education, competencies, outcomes, and program standards. The new edition builds upon previous versions published in 1998, 2004, and 2019 and reflects the evolving healthcare environment and expanding contributions of CNSs across patient care, nursing practice, and healthcare systems.
As the only professional association dedicated exclusively to Clinical Nurse Specialists, NACNS developed the Statement to provide a contemporary framework for CNS practice and graduate education while continuing to articulate the unique value and impact of the CNS role. The Fourth Edition incorporates emerging priorities in healthcare, including implementation science, digital health and technology, health equity, emergency preparedness, quality improvement, and systems leadership. It also reaffirms the CNS’s role as an Advanced Practice Registered Nurse (APRN) with expertise spanning direct patient care, nursing practice advancement, and organizational transformation.
“The Fourth Edition of the Statement on Clinical Nurse Specialist Practice and Education reflects the strength, expertise, and continued evolution of the Clinical Nurse Specialist role,” said Jackie Iseler, DNP, MSN, RN, ACNS-BC, CNE, FCNS, President of NACNS. “As healthcare becomes increasingly complex, CNSs remain essential leaders in improving quality, advancing evidence-based practice, strengthening nursing practice, and driving system-wide change. This updated Statement provides a forward-looking framework that supports CNSs in meeting the challenges of today’s healthcare environment while honoring the profession’s longstanding commitment to improving patient outcomes. On behalf of NACNS, I extend my deepest gratitude to Task Force Co-Chairs Kimberly Elgin and Alyson Keen, whose leadership and dedication were instrumental in guiding this extensive revision, as well as to every member of the Task Force who contributed their expertise to this important work.”
The Fourth Edition was developed through a rigorous review and revision process led by the NACNS Statement on Clinical Nurse Specialist Practice and Education Task Force, under the leadership of Kimberly W. Elgin, DNP, APRN, ACNS-BC, PCCN, CMSRN, FCNS, FAAN and Alyson Keen, PhD, RN, ACNS-BC, FCNS, who served as Task Force Co-Chairs. Drawing upon expertise from CNS practice, education, research, and leadership, the Task Force evaluated current healthcare trends, professional standards, educational expectations, and evidence supporting CNS practice to ensure the Statement remains relevant and responsive to the needs of healthcare organizations, educators, and practicing CNSs.
In addition to the work of the Task Force, the revision received extensive input and review from the NACNS Past Presidents Council, the NACNS Program Directors Council, and other key stakeholders, ensuring broad representation from across the CNS community.
The Fourth Edition reaffirms NACNS’s commitment to advancing the visibility, value, and influence of Clinical Nurse Specialists and supporting educational programs that prepare CNSs to practice to the full extent of their education and expertise. The Statement will serve as an essential resource for CNSs, academic institutions, healthcare organizations, policymakers, regulators, and other stakeholders seeking guidance on contemporary CNS practice and education.
NACNS is proud to have the formal endorsement of these partner organizations in support of the 2026 statement:
- Academy of Medical-Surgical Nurses
- Association of Pediatric Hematology/Oncology Nurses
- Hospice and Palliative Nurses Association
About The National Association of Clinical Nurse Specialists
NACNS is the only national association in the U.S. representing the CNS. It is committed to showing the value of the CNS as an APRN, embracing full practice authority for all CNSs, providing support to individual CNSs, CNS programs, and entities employing CNSs, and achieving and maintaining organizational excellence. NACNS strives to meet its vision that every CNS is an APRN with a full scope of practice and is a transformative innovator leading improvement across healthcare environments. For more information or to join NACNS, click here.
