The conceptualization and enactment of the ACNP role varies across settings
, potentially leading to variability in outcome achievement. A conceptual f
ramework for evaluating the ACNP role is proposed. The framework is an adap
tation of the Nursing Role Effectiveness Model which was developed to facil
itate the identification and investigation of nursing-sensitive outcomes. T
he framework represents the complex system of interrelated factors that are
present in the ACNP practice situation and that affect role effectiveness.
It includes three components: (i) structure - encompassing patient, ACNP a
nd organizational variables; (ii) process - consisting of the ACNP role com
ponents (clinician, educator, researcher and administrator) and the ways in
which the role is enacted; and (iii) outcomes - including patient- and cos
t-related outcomes. The framework proposes specific relationships among the
structure, process and outcomes components. Empirical support for the fram
ework propositions is provided, based on a review of pertinent literature.
Implications for future ACNP impact studies are discussed.