The Impact of a Clinical Nurse Specialist in Emergency Medicine on Patient Satisfaction and Waiting Times in the Emergency Department

Abstract

Crowding in emergency department (ED) has been a global issue and has led to a long waiting time and low patient satisfaction. The clinical nurse specialist (CNS) role has taken more prominence in the delivery of services designed to enhance patient outcomes given the advanced skills associated with this role and the changing system. This systematic review shows how CNS practice in EDs influences patient satisfaction and waiting time. PubMed, CINAHL, Scopus and Web of Science were searched extensively to identify those that were published within the period between 2012 and 2025. The selection criteria included peer-reviewed studies, in English language and which reviewed CNS or advanced practice nurse roles in the emergency department and whose outcome measures satisfaction or throughput. Fifteen studies were included: systematic reviews, cross-sectional surveys, quality improvement, and role-specific evaluations. The results remained the same and showed that CNS and other advanced practice roles significantly correlate with reduced waiting times, improved triage accuracy, fewer stay days, and improved patient satisfaction. The majority of the evidence addresses nurse practitioner or advanced practice nurse interventions, but there are new studies that point to the contributions that CNSs can make to triage, communication, and the coordination of care. Overall, CNSs are significant in enhancing the efficiency of ED and patient experience. Any future study should aim at controlled experimentation so as to achieve direct causal links between CNS practice and quantifiable ED outcomes.