Care Delivery Model Toolkit

Tool Kit for the Implementation of the Clinical Nurse LeaderSM
Extensive resource published by the American Association of Colleges of Nurses. The toolkit includes links to articles, presentations, pilot project descriptions and evaluations, and other resource material

Clinical Nurse LeaderSM Job Description (pdf)
A sample job description is provided by AACN.

Available Resources

American Association of Colleges of Nurses (AACN) Clinical Nurse LeaderSM Website
Contains detailed information on the new role, including links to various articles and tools, a selection of which are described here.

The Role of the Clinical Nurse LeaderSM
A white paper describing the role.

Listing of Articles and Press on the Clinical Nurse LeaderSM role

For More Information

For any questions not answered by materials provided within this profile, please contact Sandra E. Walters at Sandra.Walters2@va.gov.

Utilization

VA Tennessee Valley Healthcare System (TVHS) collected data for the three months prior to and the three months after assigning a CNL as a Unit-Based Care Manager to a variety of units, and the data revealed a reduction in readmissions.

  • On the medical ICU, the readmission rate for the primary discharge DRG (heart failure) was reduced from 6.6 percent prior to the CNL to 5.7 percent with the CNL.
  • On the acute medical unit, the readmission rate for the primary discharge DRG (heart failure) was reduced from 15.4 percent prior to the CNL to 13.0 percent with the CNL.

The same data study revealed a slight increase in RN hours worked per patient day.

  • On the acute medical unit, RN hours per patient day increased from 2.4 prior to the CNL to 2.66 with the CNL.
  • On the acute surgery unit, RN hours per patient day increased from 2.69 prior to the CNL to 3.17 with the CNL.

Patient

In addition to the reduction in readmission rates described above, VA TVHS data from the three months prior to and the three months after assigning a CNL to acute care and intensive care units revealed an improvement in specific quality indicators.

  • On the acute surgery unit, patient falls decreased from 1.07 percent prior to the CNL to 0.53 percent with the CNL.
  • On the acute surgery unit, the surgical infection rate 30 days post-operative for general surgery decreased from 8.8 percent prior to the CNL to 5.4 percent with the CNL.
  • On the surgical ICU, the surgical infection rate 30 days post-operative for CABG cases decreased from 2.0 percent prior to the CNL to 1.6 percent with the CNL.
  • On the medical ICU, the VA TVHS saw an increase in ventilator-associated pneumonia post CNL assignment. 

Patient

TVHS has continued to experience a steady increase in patient satisfaction scores since implementation of the CNL role.

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