1. King Saud university Collage of nursing Master program Nursing administration Special Problems in Clinical Specialization (NUR 574 ) Prepared by : Ohood Alharthi Supervised by : Dr.Fatma M.Baddar

2. Clinical Nurse Leader Role

3. Outlines: What is the Clinical Nurse Leader?
What are the fundamental aspects of the CNL role?
what are the main themes of the CNL Curriculum Framework?
What are the Clinical Nurse Leader competencies?
What dose a Clinical Nurse Leader do?
Is the Clinical Nurse Leader needed in the health care system?
What is the educational preparation of a Clinical Nurse Leader?
What are the professional values of the Clinical Nurse Leader?

4. Outlines:
How the a clinical nurse leader different from a clinical nurse specialist or other advanced practice nurse?
What education-practice models have been developed to prepare the CNL for the practice?
Who is eligible to sit for the CNL certification examination?
Dose this initiative involve an evaluation component?
Why is AACN leading the CNL initiative?

5. Introduction:
The CNL oversees the care coordination of a distinct group of patients and actively provides direct patient care in complex situations. This clinician puts evidence-based practice into action to ensure that patients benefit from the latest innovations in care delivery. The CNL collects and evaluates patient outcomes, assesses cohort risk, and has the decision-making authority to change care plans when necessary. This clinician functions as part of an interdisciplinary team by communicating, planning, and implementing care directly with other health care professionals.

6. Introduction
The CNL is a leader in the health care delivery system, not just the acute care setting but in all settings in which health care is delivered. The implementation of the CNL role, however, will vary across settings.
The CNL role is not one of administration or management. The CNL assumes accountability for client care outcomes through the assimilation and application of research-based information to design, implement, and evaluate client plans of care.
The CNL is a provider and manager of care at the point of care to individuals and cohorts of clients within a unit or healthcare setting.
The CNL designs, implements, and evaluates client care by coordinating, delegating and supervising the care provided by the health care team, including licensed nurses, technicians, and other health professionals.

7. What is the Clinical Nurse Leader?
The Clinical Nurse Leader is an emerging nursing role developed by the American Association of Colleges of Nursing (AACN) in collaboration with an array of leaders from the practice environment.  Two AACN task forces were convened to identify
(1) how to improve the quality of patient care and
(2) how to best prepare nurses with the competencies needed to thrive in the current and future health care system.

8. What are the fundamental aspects of the CNL role?
Leadership in the care of the sick in and across all environments.
Design and provision of health promotion and risk reduction services for diverse populations.
Provision of evidence-based practice.
Population-appropriate health care to individuals, clinical groups/units, and communities.
Clinical decision-making.
Design and implementation of plans of care.
Risk anticipation.
Participation in identification and collection of care outcomes.

9. Cont. Fundamental aspects of the CNL role:
Accountability for evaluation and improvement of point-of-care outcomes.
Client and community advocacy.
Education and information management.
Delegation and oversight of care delivery and outcomes.
Team management and collaboration with other health professional team members.
Development and leveraging of human, environmental and material resources.
Management and use of client-care and information technology.
Lateral integration of care for a specified group of patients.

10. Main themes of the CNL Curriculum Framework?
Nursing Leadership Horizontal Leadership Effective Use of Self Advocacy Conceptual Analysis of the CNL Role Lateral Integration of Care
Care Environment Management
Team coordination
Healthcare Finance/econ
Systems/organizations
Health policy
Quality management
Informatics
Clinical Outcomes Management
Illness/Disease Management
Knowledge Management
Health Promotion
Evidence-based practice

11. :What are the Competencies of CNL
CNL has the ability to:
develop and use higher-order problem-solving and critical thinking skills.
integrate concepts from behavioral, biological, and natural sciences in order to understand self and others.
interpret and use quantitative data.
use the scientific process and scientific data as a basis for developing, implementing, and evaluating nursing interventions.
apply knowledge regarding social, political, economic, environmental and historical issues to the analysis of societal, professional and client problems.

12. Cont. Competencies of CNL:
synthesize information and knowledge as a key component of critical thinking and decision making.
communicate effectively in a variety of written and spoken formats.
engage in effective working relationships.
appreciate cultural differences and bridge cultural and linguistic barriers.
understand the nature of human values.
develop and articulate personal standards against which to measure new ideas and experiences.
appreciate and understand the character of professions.

13. What dose the clinical nurse leader do?
The CNL oversees the lateral integration of care for a distinct group of patients and may actively provide direct patient care in complex situations.
  The CNL puts evidence-based practice into action to ensure that patients benefit from the latest innovations in care delivery.
The CNL collects and evaluates patient outcomes, assesses cohort risk, and has the decision-making authority to change care plans when necessary. 
The CNL as clinician functions as part of an inter professional team by communicating, planning, and implementing care directly with other health care professionals, including physicians, pharmacists, social workers, clinical nurse specialists and nurse practitioners.

14. Is the Clinical Nurse Leader needed in the health care system?
Nurse executives stated that this role emerged in the practice setting and continued development on an
Ad hoc basis. Individuals to fill this and similar roles had previously been recruited based on available clinicians with appropriate education and experience, personal characteristics, and self-selection. Stakeholders affirmed the need to produce these clinicians through a formal degree-granting program.

15. What is the education preparation of a clinical nurse leader?
The CNL is an advanced generalist clinician with education at the master's degree level. Graduate education is necessary because the CNL must bring a high level of clinical competence and knowledge to the point of care and to serve as a resource for the nursing team.

16. What are the professional values of the Clinical Nurse Leader?
Altruism:
is a concern for the welfare and well being of others. In professional practice, altruism is reflected by the CNL’s concern for the welfare of clients, other nurses, and other health care providers.
Sample professional behaviors include:
demonstrates understanding of cultures, beliefs, and perspectives of others.
advocates for clients, particularly the most vulnerable.
takes risks on behalf of clients and colleagues.

17. What are the professional values of the Clinical Nurse Leader?
Accountability:
is the right, power, and competence to act. Accountability includes the autonomy, authority and control of one’s actions and decisions. Professional practice reflects accountability when the CNL evaluates individual and group health care outcomes and modifies treatment or intervention strategies to improve outcome
Sample professional behaviors include:
evaluates client care and implements changes in care practices to improve outcomes of care.
serves as a responsible steward of the environment, and human and material resources while coordinating care.
uses an evidence-based approach to meet specific needs of individuals, clinical populations or communities.
manages, monitors and manipulates the environment to foster health and health care quality.
prevents or limits unsafe or unethical care practices.

18. What are the professional values of the Clinical Nurse Leader?
Human Dignity is respect for the inherent worth and uniqueness of individuals and populations. In professional practice, human dignity is reflected when the CNL values and respects all clients and colleagues.
Sample professional behaviors include:
provides culturally competent and sensitive care.
protects the client’s privacy.
preserves the confidentiality of clients and health care providers.
designs care with sensitivity to individual client needs.

19. What are the professional values of the Clinical Nurse Leader?
Integrity is acting in accordance with an appropriate code of ethics and accepted standards of practice. Integrity is reflected in professional practice when the CNL is honest and provides care based on an ethical framework that is accepted within the profession.
Sample professional behaviors include:
provides honest information to clients and the public.
documents care accurately and honestly.
seeks to remedy errors made by self or others.
demonstrates accountability for own actions and those of other health care team members under the supervision of the CNL.

20. What are the professional values of the Clinical Nurse Leader?
Social Justice
is upholding moral, legal, and humanistic principles. This value is reflected in professional practice when the CNL works to assure equal treatment under the law and equal access to quality health care.
Sample professional behaviors include:
supports fairness and non-discrimination in the delivery of care.
promotes universal access to health care.
encourages legislation and policy consistent with the advancement of nursing care and health care.

21. How the a clinical nurse leader different from a clinical nurse specialist or other advanced practice nurse?
The CNL is not prepared as an advanced practice nurse (APN) as the APN is currently defined.  The CNL is an advanced generalist in contrast with the specialized focus of the practice by clinical nurse specialists (CNS) and nurse practitioners. Advanced practice nurses are prepared with specialist education in a defined area of practice.  The CNL and APN roles complement one another.

22. The Comparison of Roles:
Clinical Nurse Specialist (CNS)
Population-Based Specialist:
An expert clinician in a particular specialty or subspecialty of nursing practice.
Works at both Microsystems and system levels, within three spheres of influence: client, personnel and organizational systems. Even if unit-based, exerts influence on behalf of their specialty population at the system level.
Clinical Nurse Leader (CNL)
Unit-Based Generalist
A generalist providing and managing care at the point of care to patients, individuals, families and communities.
Works within clinical Microsystems which are small, functional, front-line units such as a hospital unit, outpatient clinic or home health agency.

23. What education-practice models have been developed to prepare the CNL for the practice?
The AACN Board approved three educational models as the starting point for the development of programs to prepare the CNL.  Models were developed to accommodate graduates of BSN programs and second-degree students.  Since that time, additional models have developed to accommodate ADN graduates (RN to MSN) and MSN graduates with a post-master’s certificate.  All models culminate with a CNL-focused master’s degree or post-master’s certificate.

24. Who is eligible to sit for the CNL certification examination?
Only individuals who graduate from a CNL or advanced generalist master’s degree program in nursing that meets the criteria delineated in the CNL Curriculum Framework and prepares individuals with the competencies identified in AACN’s white paper on The Education and Role of the Clinical Nurse Leader (2007)are eligible to sit for this certification examination.

25. Dose this initiative involve an evaluation component?
Evaluating CNL outcomes is a critical component of this initiative. AACN is working with experts in outcomes measurement to build evaluation criteria into the education-practice models.  AACN convened an Evaluation Committee in 2004 to provide oversight and guidance to the Implementation Task Force in designing the evaluation component of the CNL Project.  Several CNL Education/Practice Partnerships are currently replicating the Evaluation Framework developed by the Implementation Task Force and piloted by Ten Valley Healthcare

26. Why is AACN leading the CNL initiative?
AACN's role as a leader in nursing education encompasses the responsibility for developing, supporting and testing new models and approaches to improve nursing education and practice. AACN will continue to use a consensus-building process as the CNL programs continue to evolve.

27. Summary:
The Clinical Nurse Leader (CNL) is an advanced generalist who focuses on the improvement of quality and safety outcomes for patients or patient populations. The role differs from that of a Clinical Nurse Specialist (CNS) in that the CNL is a masters prepared registered nurse with a focus on clinical and leadership skills and training in health care systems management at the clinical unit level while the CNS has master's-level preparation in an advanced practice specialty