Clinical Nurse Leader Practice Development: An Integrative Review of the Literature.

BACKGROUND: The Clinical Nurse Leader (CNL) is a skilled clinician qualified in outcomes-based practice and quality improvement. Publications describe the CNL training, integration, and outcomes. However, CNL practice development and its impact has not been fully explored. PURPOSE: This review aimed to synthesize existing literature related to CNL practice development and identify what influences on the care environment and nursing care outcomes. METHODS: An integrative literature review was conducted in 5 bibliographic databases for sources published in English from January 2012 to March 2023. RESULTS: Fifteen publications identified 3 interrelated themes of CNL practice, outcomes, and practice development. Staff development needs were identified across various levels of expertise. CONCLUSION: There is a need to further explore CNL practice development and how it can impact the care environment and care outcomes.

Implementing a QAPI framework for improvement in an academic setting: A roadmap to success.

Designation as an accredited school of nursing (SON) requires "…. a comprehensive framework for ensuring quality in nursing education programs" (NLN CNEA, 2016). Although standards for accreditation of baccalaureate and graduate nursing programs are defined by agencies such as the Commission on Collegiate Nursing Education (CCNE, 2018) and the National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA) (NLN CNEA, 2016), methods for collecting, analyzing, or reporting data are not prescribed, resulting in wide variation in quality management processes among schools. The lack of a standardized approach can lead to inefficiencies, invalid or misleading data, and unnecessary stress for all involved in the quality management process (Hanna, Duvall, Turpin, Pendleton-Romig, & Parker, 2016). In contrast, hospitals and nursing homes frequently implement a quality assurance and performance improvement (QAPI) program, a well-defined, methodical approach to quality management. The QAPI model offers healthcare organizations a systematic, comprehensive, and data-driven strategy for maximizing outcomes (Centers for Medicare & Medicaid Services (CMS), 2016). Recognizing the need to improve and standardize the processes for data collection, analysis, and reporting, this paper describes how leaders at one accredited SON collaborated to translate CMS's QAPI model into the academic setting, establishing the foundation and mechanism to ensure the quality and integrity of the SON's outcomes.

Preparing for a Joint Commission Survey: An Innovative Approach to Learning.

Graduate nurses report feeling unprepared for accreditation site visits, including the promotion of a safe, functional, supportive environment to preserve safety and quality through the provision of care, treatment, and services for patients. To address this gap, an academic health system's department of quality and a school of nursing collaborated on a three-phase capstone course for senior-level BSN students. The course included simulation training for all students; volunteers performed Environment of Care rounds and patient care record audits in the hospital setting. Nineteen students, who performed 74 rounds and 193 audits, reported feeling more knowledgeable during site visits.

Exerting Capacity.

Patient safety has been at the forefront of nursing research since the release of the Institute of Medicine's report estimating the number of preventable adverse events in hospital settings; yet no research to date has incorporated the perspectives of bedside nurses using classical grounded theory (CGT) methodology. This CGT study explored the perceptions of bedside registered nurses regarding patient safety in adult acute care hospitals. Data analysis used three techniques unique to CGT-the constant comparative method, coding, and memoing-to explore the values, realities, and beliefs of bedside nurses about patient safety. The analysis resulted in a substantive theory, Exerting Capacity, which explained how bedside nurses balance the demands of keeping their patients safe. Exerting Capacity has implications for health care organization leaders, nursing leaders, and bedside nurses; it also has indications for future research into the concept of patient safety.