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Editor's note: This is an excerpt from Rebecca Hendren's Nov. 3 online column, "New Clinical Nurse Leader Role Benefits Patient Care and Quality."

If your organization doesn't employ any clinical nurse leaders, perhaps it's time it did.

Units with CNLs have been shown to have shorter length-of- stay and readmission rates, improvements in quality and patient safety such as decreased fall and infection rates, and lower RN turnover. In fact, these master's degree-prepared nurses have been shown to have such a positive effect on patient care and the healthcare environment that the VA has committed to having a minimum of three CNLs at every one of its facilities by 2016.

"These individuals take the evidence that's out there in the literature and help to improve practice, as well as to evaluate patient outcomes," says James L. Harris, DSN, APRN-BC, MBA, CNL, FAAN, deputy chief nursing officer in the office of nursing services at the Veterans Health Administration. "CNLs are individuals who can coordinate care and break down barriers. They can eliminate fragmentation in healthcare."

In the hospital and health system setting, the CNL role should explode as the graduate degree gains popularity and the opportunities presented by this role become better understood.

Adding CNL positions prepares organizations to meet quality improvement initiatives and deliver on these goals. CNLs are also uniquely positioned to plan and coordinate care across entire patient populations or service lines, working with the multidisciplinary healthcare team across the care continuum, and helping organizations reduce length of stay and prevent readmissions.

Harris advises that administrators not think of the CNL role as a replacement position, but rather as one that can be added to an environment to provide a higher level of clinical expertise.

Karen M. Ott, RN, MSN, director for clinical practice at the office of nursing services at the Veterans Health Administration, says that CNLs drive quality improvement processes and provide the clinical expertise that is desperately needed by bedside caregivers.

"Clinical leadership is really a full-time job and the management part is really a full-time job, and for someone to try and do both doesn't work effectively," says Ott.

To understand the effect that CNLs can have on an organization, Ott recommends hiring a CNL for a turbulent unit and seeing what happens. She believes when an organization has one CNL, it will soon want more, and a good place to start is on an inpatient unit—such as a busy med-surg unit—with many admissions and discharges.

"A unit where bedside nurses are consumed with tasks all day is ripe for a CNL who can come in and provide leadership," says Ott.

"The key to growth will be when the private sector sees the outcomes that these individuals have," notes Ott. "We're firmly supportive of continuing to implement this role in the VA."


Rebecca Hendren is an editor with HealthLeaders Media. She can be reached at rhendren@hcpro.com.

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