Abstract: Objective: To construct and apply a "hierarchical multidimensional" specialist nurse training and management plan guided by clinical needs, to provide a reference for the construction of specialist nurse teams. Methods: A hierarchical advancement mechanism based on core competencies was established at primary, intermediate, and advanced levels. Concurrently, multi-dimensional promotion pathways were set up across clinical, managerial, and educational tracks. Specialty nursing clinics, multidisciplinary collaboration, and subspecialty nursing practices were implemented. Specialty nursing teams were formed to achieve "networked" re-training of specialist nurses throughout the hospital. Results: After 4 years of implementation, the clinical practice (4.41±0.51 vs 4.81±0.38), management (4.62±0.62 vs 4.69±0.55), and professional development (4.71±0.31 vs 4.86±0.32) dimensions scores of specialist nurses were all improved (P<0.05). At present, there are 694 specialist nurses in 41 nursing specialties in the hospital, with an average of over 50000 online consultations per year for patients. By 2024, the total number of consultations in the hospital has reached 7031. Conclusion: The echelon construction and management scheme of "hierarchical multidimensional" for specialist nurses has effectively improved their core specialized competencies, reflected the refined and professional value of nursing, and is worthy of clinical promotion.

Key words: specialist nurse; nursing management; talent cultivation; human resource