Assignment: CNL Role Evidence
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according to the CNL role competencies established by AACN.4 Documents include examples of com- plex patient care interventions and outcomes, error reduction strategies based on systematic assessment, demonstration of interprofessional collaboration, and systematic microsystem improvement. A professional resume with cover letter to potential employer; a personal mission, vision, and values statement; and earned certificates, such as continuing education, are usually included in the portfolio (Table 1).
For the role systems analyst/risk anticipator, students include a de-identified Microsystem Assess- ment in their portfolio to demonstrate QSEN and CNL competencies related to systematic microsys- tem improvement. At the start of the clinical immer- sion, CNLs complete a comprehensive assessment of an aspect of the healthcare system. Examples include assessment of nursing practices and protocols; per- formance of an environmental safety or safety cul- ture assessment; microsystem profile that analyzes
the system’s purpose, patients, employees, processes, and patterns; microsystem core and supporting pro- cesses inventory to determine staff’s perception and rank order; and those processes that need improve- ment. Other criteria include discharge process cycle time to measure the time from the patient being dis- charged until the patient has left the unit, interdisci- plinary team observation, care transition maps to diagnose the quality of patient care transitions be- tween both healthcare practitioners and settings as care needs dictate, and medication administration interruption analysis that analyzes patterns of inter- ruptions, waits, and delays in the process of safe med- ication administration. Specific details for these and other assessments are described in a previous pub- lication.24 The data from these assessment documents are used to identify opportunities for practice im- provement. One student led a process improvement project to reduce the patient no-show rate for a clin- ical research unit. Using QI analysis tools including
Table 1. Examples of Documents/Content for Clinical Nurse Leader (CNL) Portfolio
CNL Role Evidence in Portfolio
Clinician Complex patient concept map National Database of Nursing Quality Indicators Pressure Ulcer Prevention Training Cultural assessment
Outcomes manager Care path analysis for complex acute care Community assessment project Microsystem Core and Supporting Processes Inventorya
Discharge process cycle timeb
Client advocate Presentation to an official on a healthcare issue or impending bill Advance directive interview
Educator Teaching project for community safety in pediatric population Health literacy teaching project: revision of patient education materials using
principles of health literacy
Information manager Personal digital assistants at point of care competency evaluation Quality improvement project presentation Microsystem Profilec
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