The Role of the Clinical Nurse Leader in Promoting a Healthy Work Environment at the Unit Level

Sherman, Rose O.; Edwards, Barbara; Giovengo, Karen; Hilton, Nancy

doi:10.1097/cnq.0b013e3181bad5a8

Cited by 13 publications

(9 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Collaborations provided access to policies outside organizations' jurisdiction authority and enhanced advocacy capacity [26,48,56,59,62]. However, the nursing literature particularly described how organizations with different mandates, purposes, histories, organizational structures, cultures, and membership responsibilities experienced competition, conflict, diminished ability to speak as a collective voice, and policy inertia [37,39,47,81,84,86,88,89,94,98,99]. Challenges to collaborations were partly attributed to a rise in specialty nursing organizations that ignored issues outside their specialties.…”

Section: Factors Influencing Priority Setting and Policy Advocacymentioning

confidence: 99%

Priority setting and policy advocacy by nursing associations: A scoping review and implications using a socio-ecological whole systems lens

MacDonald¹,

Edwards²,

Davies³

et al. 2012

Health Policy

View full text Add to dashboard Cite

Section: Factors Influencing Priority Setting and Policy Advocacymentioning

confidence: 99%

Priority setting and policy advocacy by nursing associations: A scoping review and implications using a socio-ecological whole systems lens

MacDonald¹,

Edwards²,

Davies³

et al. 2012

Health Policy

View full text Add to dashboard Cite

“…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%

Clinical Nurse Leader Impact on Microsystem Care Quality

et al. 2012

View full text Add to dashboard Cite

• 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...

show abstract

“…Additional factors for why the organisation should consider implementation of the CNL role were to improve professional development of staff and to enhance team collaboration (Sherman et al . ). As in many other hospitals, nursing was at a crossroads at SLMC.…”

Section: The Cnl Rolementioning

confidence: 97%