Abstract
The role of the clinical nurse specialist (CNS) in a cost-conscious environment includes the need to be alert to opportunities for cost-containment. Efforts to improve the quality of nursing care need to be balanced with the ability to manage costs. The CNS is in a key position to guide and influence decision-making about cost savings. This article reviews costs in health care and the elements of total nursing costs. CNSs can affect costs in three areas: direct costs, indirect costs, and supplies/equipment. Practical examples in each of the three areas are given for actions that are potentially useful to the CNS who desires to reduce the costs to patients and document the cost savings generated by nursing.

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