The CNL Skill Set

• Clinical leadership for patient-care practices and delivery, including the design, coordination, and evaluation of care for individuals, families, groups, and populations.
• Participation in identification and collection of care outcomes.
• Accountability for evaluation and improvement of point-of-care outcomes, including the synthesis of data and other evidence to evaluate and achieve optimal outcomes.
• Risk anticipation for individuals and cohorts of patients.
• Lateral integration of care for individuals and cohorts of patients.
• Design and implementation of evidence-based practice(s).
• Team leadership, management, and collaboration with other health professional team members.
• Information management or the use of information systems and technologies to improve healthcare outcomes.
• Stewardship and leveraging of human, environmental, and material resources.
• Advocacy for patients, communities, and the health professional team.

Employers, chief nursing officers and certified Clinical Nurse Leaders  in a variety of practices settings report that CNLs have the following impact on patient care and healthcare delivery:

• CNLs are quickly making significant progress on raising patient, nurse, and physician satisfaction; improving care outcomes; realizing sizable cost-savings.
• CNLs elevate the level of practice for all nurses on the unit by promoting critical thinking and innovation in nursing care. CNLs empower other nurses to ask questions and seek the best solutions possible.
• CNLs are essential to decreasing fragmented care and are prized for their expertise in enhancing communication, improving care hand-offs, and laterally integrating care.
• CNLs constructively manage change and promote a team-based approach to care.
• The CNL looks at the bigger picture, including outcomes and patient satisfaction, when considering next steps, needed changes, and improvements to the setting.

The Robert Wood Johnson Foundation Innovative Care Delivery Model Study make these important points about the impact of CNLs in practice:

• CNLs act as the “red thread” for the patient, arranging and coordinating complex care needs for patients and families. They truly are information-flow managers.
• CNLs serve as a clinical resource and connection point to interlink patient safety and unit strategic goals into practice.
• The CNL serves as a patient and family advocate by involving them through interdisciplinary rounds/approach. They ensure that patients and families are informed of all diagnostic procedures, medical consultation, and available resources.
• CNLs bridge the communication gap between all health service providers, which permits a seamless transition through the healthcare continuum.
• CNLs collaborate with the direct care providers to ensure a safe environment for patients where needs are prioritized and individualized, and evidence-based nursing is utilized. They also serve as a mentor, coach, educator, and a resource to all direct care providers to assist them in providing care to complex patients.