Background The Institute of Medicine�s Future of Nursing report identifies the clinical nurse\nleader as an innovative new role for meeting higher health-care quality standards. However,\nspecific clinical nurse leader practices influencing documented quality outcomes remain unclear.\nLack of practice clarity limits the ability to articulate, implement and measure clinical nurse\nleader-specific practice and quality outcomes.\nPurpose and methods Interpretive synthesis design and grounded theory analysis were used to\ndevelop a theoretical understanding of clinical nurse leader practice that can facilitate systematic\nand replicable implementation across health-care settings.\nResults The core phenomenon of clinical nurse leader practice is continuous clinical leadership,\nwhich involves four fundamental activities: facilitating effective ongoing communication;\nstrengthening intra and interprofessional relationships; building and sustaining teams; and\nsupporting staff engagement.\nConclusion Clinical nurse leaders continuously communicate and develop relationships within\nand across professions to promote and sustain information exchange, engagement, teamwork and\neffective care processes at the microsystem level.\nImplication for nursing management Clinical nurse leader-integrated care delivery systems\nhighlight the benefits of nurse-led models of care for transforming healthcare quality. Managers\ncan use this study�s findings to frame an implementation strategy that addresses theoretical\ndomains of clinical nurse leader practice to help ensure practice success.
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