Experience is the best teacher, according to a Latin Proverb. Along those lines, the American Association of Colleges of Nursing (AACN) recently released a list of 24 experiences it considers crucial for preparing clinical nurse leaders, or CNLs.
“Over the last decade, schools of nursing have taken a variety of approaches to preparing CNLs in master’s level programs that meet the competency and curricular expectations identified for this new role,” explains AACN’s “Recommended CNL Practice Experiences” document, released in May. But “[w]hen considering the clinical education of CNLs, practice experiences vary among nursing education programs. This variation may be due to type of program (e.g. post-BSN, RN-MSN, second degree MSN program), geographic location and practice partnerships.”
AACN’s list of recommended experiences seek to bridge the gaps and ensure students in all types of CNL programs graduate with the know-how needed to take on their new leadership roles. The list was put together by faculty in CNL programs, practicing CNLs and other representatives from the practice arena.
Although not exhaustive and certainly not mandated (some can even be done virtually, according to the document), AACN explains “the practice experiences identified here are deemed critical for the successful preparation of graduates in complex health systems and in diverse practice settings.”
Here’s a brief look at the two dozen recommended activities and experiences CNLs should have under their belts by the time they graduate. (The full AACN document offers additional discussion on many of the recommendations.) How does the list stack up against your experience?
1. Conduct a microsystem analysis using a quality improvement process, including how the microsystem interfaces with the meso- and macrosystem.
2. Identify clinical and cost outcomes and their relationship to clinical/patient outcomes that improve safety, effectiveness, timeliness, efficiency, quality and patient-centered care.
3. Assess a microsystem’s resources (including human and physical resources), perform a gap analysis, prioritize the identified needs, and communicate these needs to stakeholders.
4. Develop and conduct a change process to implement a new or revised evidence-based practice protocol or guideline.
5. Participate in the assessment of a practice guideline or practice process. Recommend how processes or policies should be changed. Using this analysis, participate in the change process.
6. In a practice setting, identify and analyze the potential impact of equity, financial and social justice issues on outcomes of care.
7. Analyze actual and potential risks for a patient cohort or population within a specific care environment or setting. Based on this evaluation, identify gaps in care and need for changes.
8. Communicate to an audience in an informal setting (e.g., staff meeting in the microsystem, class) ideas or information regarding a practice issue, proposed policy change, etc.
9. Observe role models engaging in communication and conflict resolution; analyze communication patterns, current processes and outcomes.
10. Analyze interprofessional patterns of communication and chain of command, both internal and external to the microsystem, that impact processes and outcomes of care.
11. Participate in a professional organization or agency-wide committee or task force.
12. Assess a microsystem’s processes for care transitions within and outside the system, including communication patterns and mechanisms, coordination, safety and outcomes. Assess for gaps and propose recommendations for change.
13. Working with an interprofessional team, design, coordinate and evaluate plans of care for a cohort of patients, including plans for care coordination and transition within and outside the institution.
14. Lead a multidisciplinary team meeting (e.g., huddle, team rounds). Include the client and/or family as part of the team meeting.
15. Present to leaders or other stakeholders outside the academic setting regarding a healthcare issue and/or recommendations for a change.
16. Using patient information system data, assess relevant data, design and implement a plan of care for a cohort or select group of patients (e.g., patients with congestive heart failure, stroke, a chronic disease, or an at-risk cohort.)
17. Use an aggregate dataset to prepare reports and justify needs for select patient care improvements (e.g., falls, pressure ulcers, hospital-acquired infections).
18. Evaluate practices and outcomes of care for potential cost savings.
19. Conduct an analysis of an adverse event, which includes a trend analysis, identification of a serious event and root causes, and analysis of outcome data.
20. Work with a quality improvement team or designee to engage in designing and/or implementing a process for improving patient safety.
21. Present a recommendation regarding the use or implementation of an existing or new/emerging patient/healthcare technology.
22. Conduct an assessment of a patient cohort with complex or multiple health problems, identify clinical needs and gaps in care, and develop plans of care to improve patient outcomes, including coordination of care among providers and teams.
23. Evaluate individual patients for care coordination and lateral integration opportunities using advanced clinical knowledge and illness/disease management methods to improve patient outcomes.
24. Conduct a group health education class/session for a patient or healthcare staff cohort.
Are you currently utilizing any of these recommendations at your organization? Why or why not? Leave us a comment, we’d love to hear from you.
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