The clinical nurse leader role, introduced more than a decade ago as way to improve patient outcomes, patient safety, and quality of care, has been delivering promising, but mixed results in one Florida hospital system, which was an early adopter.
The more things change, the more they stay the same. Cliché? Some might say so, but at times it seems more like a universal law of healthcare.
Yes, technology has changed immensely in recent years and the Patient Protection and Affordable Care Act has introduced some new challenges since its passage in 2010, but we're still grappling with many of the same issues that we were two decades ago.
Take medical errors, patient safety, quality of care, and patient outcomes, for example. Those are hot topics these days, but they've been around for a long time. In fact, those were some of the very reasons the American Association of Colleges of Nursing introduced the clinical nurse leader role in 2003.
The History of the CNL
The CNL is a master's-prepared advanced generalist who works at the point of care and applies evidence-based information to influence patient care methods and outcomes. Because the focus of the CNL is on coordinating care across multiple disciplines, The Clinical Nurse Leader Association likens the role to that of an air-traffic controller.
The CNL role began taking shape in 1999 shortly after the Institute of Medicine released its report "To Err is Human," which highlighted the need to improve healthcare quality by reducing medical errors. In response, the AACN created two task forces to determine how to improve the quality of patient care and how to best prepare nurses to provide high-level care in a changing healthcare system.
After much research and discussion, the CNL role—the first new nursing role in 35 years—was born.
Diane Raines, DNP, RN, NEA-BC, senior vice president and chief nursing officer at Baptist Health in Northeast Florida, says her organization saw the value of the CNL role from the get-go.
"In our children's hospital, we were early adopters," says Raines, who credits her colleague Carolyn Johnson, RN, with having the vision to use CNLs as soon as they became available clinically. "She really grabbed on to that role because she saw a need for a coordinating generalist on the unit."
Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.