Clinical Nurse Leader Role Demonstrates Positive Impact on Patient Outcomes

Purpose:
AACN defines the Clinical Nurse Leader as a master's prepared clinician certified by the Commission on Nurse Certification.The CNL brings clinical competence and knowledge to the point of care and serves as a resource for the nursing team. The CNL oversees care coordination and integration of care.

Relevance/Significance:
This MSN prepared nurse puts evidence-based practice into action to ensure that patients benefit from the latest innovations in care. The CNL evaluates patient outcomes,assesses cohort risk and has the autonomy to change care plans.This innovative use of the CNL helps to translate continual practice improvements into viable solutions that advance clinical care, drive evidence-based practice and synthesize nursing innovation and technology to drive quality in health care delivery.

Strategy and Implementation:
The emerging role of the CNL at our hospital, began as a pilot program in 2012, when the organization recognized the need for improved continuity of care for intensive care patients. The pilot program led to the development of four CNL designated roles. These roles were identified to improve the care of “at risk” populations including:neuroscience,cardiac,pulmonary,and bone marrow transplant.The current CNL's act as a key agent in evidence based practice, care coordination, and quality and safety outcomes in a population focused model. The foundation of the role had to be developed by building an electronic record used for documentation, determining measurable outcomes, and specific quality/safety measures.

Evaluation:
Key outcomes include: Cardiac-100% medications in hand at discharge, 87% compliance with f/u appointments, innovative discharge preparation Pulmonary- 26% decrease in admissions, decrease in readmission rate from 2.7% to 0.5%,15% decrease in LOS,and asthma core measures compliance Neuroscience- LOS decreased from 3.38 to 3.12, decreased pain and infection in the postoperative patient

Implications for Practice:
In a year's time, patients are benefiting from a more standardized approach to care resulting in tangible care coordination,decreased LOS and improved quality outcomes.Early indications reveal the efforts coordinated by the CNLs are paving the way to population health.