Introduction
The CNL® is a master’s educated nurse, prepared for practice across the continuum of care within any healthcare setting in today’s changing healthcare environment. This document delineates the entry-level competencies for all Clinical Nurse Leaders (CNLs). These CNL competencies build on the American Association of Colleges of Nursing (AACN) The Essentials of Master’s Education in Nursing (2011).
AACN, representing baccalaureate and graduate schools of nursing, in collaboration with other healthcare organizations and disciplines, first introduced the Clinical Nurse Leader (CNL) in 2003, the first new nursing role in over 35 years, to address the ardent call for change being heard in the healthcare system. The competencies deemed necessary for the CNL originally were delineated by the AACN Task Force on Education & Regulation II (TFERII) in the Working Paper on the Clinical Nurse Leader. In 2007, the AACN Board of Directors approved the White Paper on the Education and Role of the Clinical Nurse Leader. The White Paper provided the background, rationale, and description of the CNL role and education as well as the expected outcomes and competencies for all CNL graduates. The background, rationale, and description of CNL practice as well as the assumptions for preparing the CNL remain particularly relevant; therefore, the White Paper is included as an attachment to this document.
The competencies delineated here have been revised and updated to reflect CNL practice within the changing healthcare environment. Therefore, these competencies replace the competencies in the White Paper on the Education and Role of the Clinical Nurse Leader (February, 2007). In addition to the CNL master’s level competencies, the Curriculum Framework and Clinical/Practice Expectations for CNL programs are included. These components provide the basis for the design and implementation of a master’s or post-master’s CNL education program and prepare the graduate to sit for the Commission on Nurse Certification (CNC) CNL Certification Examination.
CNL Practice
The CNL is a leader in the healthcare delivery system in all settings in which healthcare is delivered. CNL practice will vary across settings. The CNL is not one of administration or management. The CNL assumes accountability for patient-care outcomes through the assimilation and application of evidence-based information to design, implement, and evaluate patient-care processes and models of care delivery. The CNL is a provider and manager of care at the point of care to individuals and cohorts of patients anywhere healthcare is delivered. Fundamental aspects of CNL practice include:
Clinical leadership for patient-care practices and delivery, including the design, coordination, and evaluation of care for individuals, families, groups, and populations;
- Participation in identification and collection of care outcomes;
- Accountability for evaluation and improvement of point-of-care outcomes, including the synthesis of data and other evidence to evaluate and achieve optimal outcomes;
- Risk anticipation for individuals and cohorts of patients;
- Lateral integration of care for individuals and cohorts of patients
- Design and implementation of evidence-based practice(s);
- Team leadership, management and collaboration with other health professional team members;
- Information management or the use of information systems and technologies to improve healthcare outcomes;
- Stewardship and leveraging of human, environmental, and material resources; and,
- Advocacy for patients, communities, and the health professional team.
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