Utilization of the Clinical Nurse Leader Skill Set at the Macrosystem Level

In response to the growing concern over patient safety, quality, and health care outcomes, the Clinical Nurse Leader (CNL) role was created.  As nurse leaders across the country seek ways to transform processes that will improve patient safety and quality care, it is essential not to limit the CNL skill set to the microsystem. The purpose of this presentation is to describe how, at the macrosystem level, the CNL skill set was utilized at an 1157 bed, magnet designated, academic medical center. 

The Chief Nursing Officer (CNO) and CNL worked together to transform a passive model of shared governance into a functioning framework, supporting further integration into the organizational culture. This new model, the Nursing Practice Congress (NPC), empowers staff to use their knowledge about practice and determine the best course of action.  Decisions rely on evidence based practice and all members are given the resources they need to find relevant information. The model provides a formal forum to openly share and evaluate current clinical practice, gain new knowledge, and work collaboratively with other members of the healthcare team in which systematic review and evaluation of work processes can be examined to evaluate and improve established practices and outcomes.

After the first two years of existence at the organizational level, 36 issues were presented to NPC resulting in the formation of 29 work teams and 19 hospital wide clinical practice changes.  These results of these changes included: a) improvement in patient safety and quality, b) standardization of practice, and c) increased collaboration among a variety of disciplines.  As nurse leaders across the country seek ways to utilize the CNL skill set, it is essential that they are open to the endless possibilities for the role with in their organization.