The clinical nurse leader: a catalyst for improving quality and patient safety

Stanley, Joan; Gannon, Jane M.; Gabuat, Jesse; Hartranft, Susan; Adams, Nancy; Mayes, Christy; Shouse, Gina M.; Edwards, Barbara; Burch, Danita

doi:10.1111/j.1365-2834.2008.00899.x

Cited by 59 publications

(56 citation statements)

References 2 publications

(2 reference statements)

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“…Improved patient satisfaction after implementing the CNL role has been reported in several case studies (Hartranft et al, 2007;Smith & Dabbs, 2007;Smith et al, 2006;Stanley et al, 2008). Tachibana and Nelson-Peterson (2007) showed a direct but unquantified link between the CNL role and improved patient satisfaction through patient letters that specifically mention the CNL's effect on their care.…”

Section: Patient Satisfactionmentioning

confidence: 98%

“…Preliminary reports of improved care quality resulting from CNL (or modified CNL) integration into care delivery structures include improved nursing quality outcomes (Gabuat, Hilton, Linnaird, & Sherman, 2008;Hartranft, Garcia, & Adams, 2007;Sherman, Edwards, Giovengo, & Hilton, 2009;Smith & Dabbs, 2007;Stanley et al, 2008), efficiencies in multidisciplinary care coordination and care costs (Hix,McKeon, & Walters, 2009;Ott et al, 2009), and improved communication and collaboration across disciplines (Bowcutt & Goolsby, 2006;Poulin-Tabor et al, 2008, Smith, Manfredi, Hagos, Drummond-Huth, & Moore, 2006Tachibana & Nelson-Peterson, 2007).…”

Section: The Cnl Rolementioning

confidence: 99%

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Clinical Nurse Leader Impact on Microsystem Care Quality

et al. 2012

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• Background: The current fragmented healthcare system, characterized by a lack of collaborative, patient-centered care processes, creates significant barriers to providing quality patient care. The clinical nurse leader (CNL) is theorized to provide clinical leadership at the point-of-practice to maintain cross-disciplinary collaborative processes that lead to integrated quality care.• Objectives: The aim of this study was to assess the impact of CNL integration into an acute care microsystem on care quality, as measured by patient satisfaction with care.• Methods: A short interrupted time series design was used to measure patient satisfaction with multiple aspects of care 10 months before and 12 months after integration of the CNL role on a progressive care unit, compared with a control unit. Data were obtained from Press Ganey surveys, and analysis was completed using a publicly available program for short time series data streams.• Results: Clinical nurse leader implementation was correlated with significantly improved patient satisfaction with admission processes (r = + .63, p = .02) and nursing care (r = + .75, p = .004), including skill level (r = .83, p = .003) and keeping patients informed (r = .70, p = .003). There was no significant correlation with improved patient satisfaction with physician care (r = .31, p = .14) or discharge processes (r = .33, p = .23) post-implementation. Control data showed no significant changes in patient satisfaction measures throughout the study time frame.• Discussion: The positive correlation between CNL-mediated collaborative care processes and improvements in patient satisfaction with care quality provides empirical evidence of outcomes achievable through CNL implementation.Research is needed to explore the full range of achievable outcomes and to determine the specific processes by which these outcomes are realized. • Key Words: clinical nurse leader & healthcare quality & microsystem redesignCurrent healthcare delivery is plagued by disciplinary silo approaches to patient care, including a lack of formal interdisciplinary collaborative processes. Until recently, overburdened healthcare providers were not educated to collaborate and build consensus regarding goals of care with the patient and members of an interdisciplinary team. This fragmented approach to patient care has been associated with preventable adverse outcomes, including increased mortality and morbidity, 30-day readmission rates, length of stay, and costs (Fewster-Thuente & Velsor-Friedrich, 2008). In response to this evidence, the Institute of Medicine (IOM) has identified creation of effective work teams as a priority for redesigning and improving healthcare (IOM, 2001). Teamwork and effective interdisciplinary collaboration have been linked to improved quality of care and patient outcomes (Zwarenstein, Goldman, & Reeves, 2009). Unfortunately, there is limited evidence describing effective processes for creating and sustaining a collaborative environment. The clinical nurse leader (CNL) is theorized to...

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Section: Patient Satisfactionmentioning

confidence: 98%

Section: The Cnl Rolementioning

confidence: 99%

Clinical Nurse Leader Impact on Microsystem Care Quality

et al. 2012

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“…The action of educating the nursing staff is a management practice of the nurse that assumes peculiar characteristics according to the specificities of the acting setting; thus, when nurses educate the staff, they takes a position of facilitator in the acquisition and sharing of knowledge, in the updating of the professional, promoting the capability of selforganization, which contributes to a qualified nursing care (17) . The involvement of the user, the integral care, the professional initiatives, the interactions between professional sectors were aspects reported as essential to effectuation of practices of permanent education.…”

Section: Discussionmentioning

confidence: 99%

Gerenciando práticas educativas para o cuidado de enfermagem qualificado em cardiologia

Koerich

Erdmann

2016

Rev. Bras. Enferm.

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Approval: 06-01-2016 ABSTRACT Objective: to understand signifi cances attributed by nurses who manage nursing care to the individual affected by cardiovascular disease to relations, interactions and associations of the educational practices in a cardiovascular reference hospital. To elaborate a theoretical explanatory model based on signifi cances attributed in the light of the complex thinking. Method: qualitative study, which used Theory Based on Data (TBD) as methodological reference. Twenty-two professionals of nursing participated in the study. Results: the results indicate need of professional qualifi cation to ensure the safety of patients, institutional support for the realization of educational practices, attitude of openness and availability of dialogue of the health professionals and other institutional conformations for the workers' development. Conclusion: the study presents a new space for the nurse's action that can be used to qualify and optimize the nursing practice, as it provides visibility to management and care in health institutions. Descriptors: Nursing; Nursing Management; Permanent Education; Hospital Service of Education; Cardiology. RESUMO Objetivo: compreender os signifi cados atribuídos por enfermeiros gestores do cuidado de enfermagem ao indivíduo acometido por doença cardiovascular às relações, interações e associações das práticas educativas em um hospital referência cardiovascular. Elaborar um modelo teórico explicativo com base nos signifi cados atribuídos à luz do pensamento complexo. Método: estudo qualitativo, o qual utilizou a Teoria Fundamentada nos Dados (TFD) como referencial metodológico. Participaram do estudo 22 profi ssionais de enfermagem. Resultados: os resultados apontam a necessidade de qualifi cação profi ssional para garantia da segurança do paciente, apoio institucional para a efetivação das práticas educativas, atitude de abertura e disponibilidade dialógica dos profi ssionais de saúde e de outras conformações institucionais para o desenvolvimento dos trabalhadores. Conclusão: o estudo apresenta um novo espaço de atuação para o enfermeiro que pode ser utilizado de forma a qualifi car e potencializar a práxis em enfermagem, por conferir visibilidade à gestão do cuidado de enfermagem nas instituições de saúde. Descritores: Enfermagem; Gestão em Saúde; Educação Permanente; Serviço Hospitalar de Educação; Cardiologia. RESUMEN Objetivo: comprender los signifi cados atribuidos por enfermeros gestores de atención de enfermería al paciente de enfermedad cardiovascular respecto de relaciones, interacciones y asociaciones de prácticas educativas en hospital cardiovascular de referencia. Elaborar modelo teórico explicativo basado en los signifi cados atribuidos a la luz del pensamiento complejo. Método: estudio cualitativo, utilizando la Teoría Fundamentada en los Datos (TFD) como referencial metodológico. Participaron 22 profesionales de enfermería. Resultados: los resultados expresan la necesidad de califi cación profesional para garantizar la seguridad del paciente, a...

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“…Novice nurses can be mentored in a way that allows them to learn both in theory and in practice. 21 The CNL can work closely with the nurse educator, reinforcing new procedures and protocols and acting as a resource. Implementation of the CNL role has also shown better core measure compliance, improved nurse turnover, and higher staff and physician satisfaction.…”

Section: Cnl or Cns?mentioning

confidence: 99%

The Clinical Nurse Leader: Improving Outcomes and Efficacy in the Emergency Department

Perry

2013

Journal of Emergency Nursing

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The clinical nurse leader: a catalyst for improving quality and patient safety

Cited by 59 publications

References 2 publications

Clinical Nurse Leader Impact on Microsystem Care Quality

Clinical Nurse Leader Impact on Microsystem Care Quality

Gerenciando práticas educativas para o cuidado de enfermagem qualificado em cardiologia

The Clinical Nurse Leader: Improving Outcomes and Efficacy in the Emergency Department

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