AACN CNL End-of-Program Competencies Required Clinical Experiences

4/6/2014

Graduate Level Curriculum Elements Nursing Leadership

CNL Role Functions Advocate

CNL Role Expectations

End of Program Competencies

Required Clinical Experiences

Date & Examples of Experiences Completed

Hrs 6777 Hrs Quality 6775 Res 32.0 26.0

Hrs 6776 Adv Ed

Keeps clients well Effects change through informed advocacy for the profession, interdisciplinary health care team and the client.

Spring 2013 - daily rounding Summer 2013 - daily rounding Fall 2013 - daily rounding Spring 2014 - daily rounding Spring 2014 - Joint Commission rounding Includes clients in Communicates Communicate within a conflict Spring 2013 - work with frustrated family care planning effectively to achieve milieu with nurses and other health to achieve comfort level quality client outcomes care professionals who provide care Spring 2014 - worked with individual and lateral integration of to the same clients in that setting staff to facilitate care care for a cohort of and in other settings. clients. Advocates for the Review and evaluate patient care Spring 2013 - asthma protocol, med profession guidelines/protocols and implement usage, immunizations a guideline to address an identified Spring 2014 - education for staff re DC patient care issue like pain planning, f/u appts & family management or readiness for responsibilities discharge; follow-up to evaluate the impact on the issue. Works with interdisciplinary team Strives to achieve social justice within the microsystem Discover, disseminate and apply evidence for practice and for changing practice. Participate in development of or change in policy within the health care organization. Spring 2013 - Work with social service for home care Summer 2013 - Review falls P & P with team Spring 2014 -Met with personnel responsible for updating P &P for CVAD Spring 2014- meeting with other navigators weekly to form continuity of care for all patients related to DC Fall 2013 - presented Falls prevention program to policy committee to implement changes.

Identify clinical and cost outcomes that improve safety, effectiveness, timeliness, efficiency, quality and client-centered care.

14.0 2.0

2.0

2.0

2.0

Identify potential equity and justice issues within the health care setting related to client care. Present to appointed/elected officials regarding a health care issue with a proposal for change. Analyze the care of a patient cohort and the care environment in light of ANA Nursing Standards of Care and the Code of Ethics.

1.5

4.0

Spring 2014 - Bariatric pateints reviewed with coordinator to assure standards of care

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AACN CNL End-of-Program Competencies Required Clinical Experiences

4/6/2014

Graduate Level Curriculum Elements

CNL Role Functions

CNL Role Expectations

End of Program Competencies

Required Clinical Experiences

Date & Examples of Experiences Completed Summer 2013 - Worked with resident liasion re: communication with staff Spring 2014 - worked with physicans and pharmacy to better complete med recs. Prior to DC Advocacy

Hrs 6777 Hrs Quality 6775 Res 0.5

Hrs 6776 Adv Ed

Analyze interdisciplinary patterns of communication and chain of command both internal and external to the unit that impact care.

38.0

30.0

18.0

Nursing Leadership

Member of a Effects change in Actively pursues new health care practice knowledge and skills as Profession the CNL role, needs of Effects change in clients, and the health health outcomes care system evolve. Effects change in the profession

Develop a life long learning plan for Spring 2014- discussed with manager and self. nurse navigator re: future plans Speak at a public engagement to a Spring 2014 - staff meeting re: info from public forum. system wide presentation re: safety Participate in a professional Spring 2013 - Participated in organization/or agency wide Performance Improvement and CNL committee. meetings, attended Shared Governance Retreat for system Member Profession

3.0

3.0

0.0 6.0

0.0

Care Environment Team Management Manager

Properly delegates Properly delegates and and manages utilizes the nursing team resources (human and fiscal) and serves as a leader and partner in the Uses team interdisciplinary health resources care team. effectively Serves as Identifies clinical and leader/partner on cost outcomes that interdisciplinary improve safety, team effectiveness, timeliness, efficiency, quality, and the degree to which they are clientcentered.

Design, coordinate, & evaluate plans of care for a cohort of patients incorporating patient/family input and team member input.

Summer 2013 - Falls prevention involvement Spring 2014 - many hours on phone getting f/u appts

Monitor/delegate care in the patient Spring 2014 -work with wound care, palative care, hospice, social workers to care setting. expidite care Present to the multidisciplinary team Spring 2013 - Work with physicians to a cost saving idea that improves facitliate care for sucicidal pt, chemo pt, patient care outcomes and improves and long term sedation patient Spring efficiency 2014 - worked with staff and manager to work on "fall monitors" and costs assoicated for best care Summer 2013 - Work with EEG team for improved consistency Conduct a multidisciplinary team Spring 2014 - Hospice care and rehab meeting; incorporate client and/or planning with family family as part of the team meeting Team Manager

0.5

1.0

0.5

7.0

0.0

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AACN CNL End-of-Program Competencies Required Clinical Experiences

4/6/2014

Graduate Level Curriculum Elements

CNL Role Functions

CNL Role Expectations

End of Program Competencies

Required Clinical Experiences

Date & Examples of Experiences Completed

Hrs 6777 Hrs Quality 6775 Res

Hrs 6776 Adv Ed

Care Environment Information Management Manager

Uses information systems / technologies Improves health care outcomes

Uses information systems and technology at the point of care to improve health care outcomes

Using patient information system data, design and implement a plan of care for a cohort of patients. Use aggregate data sets to prepare reports and justify needs for select care improvements. Evaluate the impact of new technologies on nursing staff, patients and families.

Spring 2013 - Daily Summer 2013 - Daily Spring 2014 - Daily Spring 2013 - Daily Summer 2013 - Daily Spring 2014 - Daily Spring 2013 - Daily Spring 2014 - New glucose meter Information Manager

4.0

4.0

4.0

4.0

3.0

11.0

8.0

0.0

Participates in Care Environment Systems Analyst / Risk system reviews Management Anticipator

Participate in establishing and reviewing interdisciplinary patient care plans with team.

Spring 2013 - Conduct "clean sweep" card compliance for EMR on all pts with staff for Joint commission visit Spring 2014 - interdisciplinary meeting with nurses, MD, social worker, pharmacist, palative care re: hospice care 4.0 2.0

Evaluates / anticipates client risks to improve patient

Apply evidence-based practice as basis for client care decisions

Summer 2013 - Review Falls prevention with staff Spring 2014 - CVAD update Conduct a microsystem analysis by: Spring 2013 - gather and correlate data for a variety of performance improvement Identifying a clinical issue with a projects Spring Conducting a trend analysis of 2014 - identified educational needs for incident reports staff related to patient quality care Evaluating a sentinel event and Summer 2013 - Falls prevention conducting a root cause analysis collection of data, evaluate, dissiminate (RCA) findings, conduct inservice, & begin Incorporating analysis of follow up outcome data Spring 2014 - Incident reports re: I &O Analyzing barriers and facilitators documentation & education teaching within the organization related to worked with staff & chart audits the identified issue Spring 2014 - RCA for death d/t improper removal of CVL - action plan set with Writing an action plan related to navigators and implementation house the analysis wide. Presenting/disseminating to appropriate audience.

3.0

12.0

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AACN CNL End-of-Program Competencies Required Clinical Experiences

4/6/2014

Graduate Level Curriculum Elements

CNL Role Functions

CNL Role Expectations

End of Program Competencies

Required Clinical Experiences

Date & Examples of Experiences Completed

Hrs 6777 Hrs Quality 6775 Res

Hrs 6776 Adv Ed

Work with quality improvement team and engage in designing and implementing a process for improving patient safety.

Spring 2014 - review Falls basics & work on getting pts. moved to different rooms & fall monitor beds Systems Analyst

7.0

14.0

0.0

Clinical Outcomes Clinician Management

Designs/ coordinates/ evaluates care

Assumes accountability for healthcare outcomes for a specific group of clients within a unit or setting recognizing the Delivers care in a influence of the mesotimely, cost and macrosystems on effective manner the microsystem.

Plan and delegate care for clients with multiple chronic health problems, identify nursing interventions to impact outcomes of care. Using an existing database, evaluate aggregate care outcomes for a designated microsystem with focus on specific nursing interventions

Spring 2014 - Stroke info for family Spring 2014 - review cost of sitters vs. family visitation schedue/ staffing assignments/moving pt to different room/changing beds. Spring 2014 - INR not done and held up DC for 24 hours, reviewed with staff.

Emphasizes health Assimilates and applies promotion/risk research-based reduction information to design, implement and evaluate client plans of care.

Contribute to interdisciplary plans of care based on best practice guidelines and evidence-based practice.

Spring 2014 - worked with Bariatric coordinator for nutrition, safety, exercise management for post -op Clinician 0.0 0.0 0.0

Clinical Outcomes Outcomes Management Manager

Uses data to Synthesizes data, change practice and information and improve outcomes. knowledge to evaluate and achieve optimal client and care environment outcomes. Achieves optimal client outcomes

Fall 2013 - set up PPT for patients with pain for assessment, intervention, and outcomes with documentation based on best practice Spring 2014 - CRE education & rapid response protocols reviewed with documentation Revise patient care based on Spring 2013- Patient teaching for breast analysis of outcomes and evidence- pump use and storage of milk based knowledge. Spring 2014 - NGT placement with staff RN at BS & reviewed policy to literature Coordinate care for a group of patients based on desired outcomes consistent with evidence-based guidelines and quality care standards. Fall 2013 - worked on staff with director to maximize patient care delivery process in PACE

12.0 0.5

Analyze unit resources and set priorities for maximizing outcomes

6.0

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 Achieves optimal client outcomes AACN CNL End-of-Program Competencies Required Clinical Experiences 4/6/2014

Graduate Level Curriculum Elements

CNL Role Functions

CNL Role Expectations

End of Program Competencies

Required Clinical Experiences

Date & Examples of Experiences Completed

Hrs 6777 Hrs Quality 6775 Res

Hrs 6776 Adv Ed

Conduct a patient care team research Spring 2014 - chart audits & results shared at staff meeting review seminar Spring 2014 - attended EBR conference Outcomes Manager Clinical Outcomes Educator Management Uses teaching/ Uses appropriate learning principles/ teaching/learning strategies principles and strategies as well as current Uses current information, materials information/ and technologies to materials/ facilitate the learning of techniques clients, groups and other Facilitates clients health care learning, professionals. anticipating their health trajectory needs. Facilitates client care using evidencebased resources. Facilitates group & other health professions learning and professional development Present a seminar or case study at a Spring 2014 - case sudy re; education for grand rounds or team meeting. AMI pt and outcome d/t readmission.at PI meeting Conduct health education of Summer 2013- Education to family re: individual patient or cohort based on isolation precautions & plan of care risk profile. Spring 2014 - Delirium Management and education for staff Create or review an education module directed at patients and Spring 2014 - Developed slide program staff; develop a self-management re: CVAD & Port Access at 2 staff guide for patients and families. meetings. Develop and implement a professional development session Spring 2014- implemented CVAD for other professional nursing and program with Return demo ancillary staff. Develop a health education plan for Spring 2014 - Flow chart for Bariartric a unit-specific issue common to patients multiple clients. Implement & evaluate the health education plan, evaluating the role Fall 2013 - evaluated all educational of the team, the teaching learning material given to patients of post-op. methods used, the client interactions, the expected & actual Reviewed with staff, manger, and parents and assess quality and frequency of use outcomes, including health status per hospital policy. changes. Educator 0.0 0.5 0.0 18.0

1.0

24.0 1.0 24.0

Total CNL Hours by Course

60.0

60.0

60.0

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AACN CNL End-of-Program Competencies Required Clinical Experiences

4/6/2014

Hrs 6773 Resid

70.0

20.0

15.0

10.0

2.0

8.0

6.0

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AACN CNL End-of-Program Competencies Required Clinical Experiences

4/6/2014

Hrs 6773 Resid

5.0 136.0

4.0

0.5

16.0 20.5

7.0

10.0

2.0

4.0 23.0

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AACN CNL End-of-Program Competencies Required Clinical Experiences

4/6/2014

Hrs 6773 Resid

10.0

10.0

5.0 25.0

2.0

4.0

2.0 4.0

6.0 6.0

6.0 6.0 3.0

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AACN CNL End-of-Program Competencies Required Clinical Experiences

4/6/2014

Hrs 6773 Resid

4.0 43.0

15.0

8.0

2.0 25.0

2.0

0.5

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AACN CNL End-of-Program Competencies Required Clinical Experiences

4/6/2014

Hrs 6773 Resid

10.0 12.5

1.0

2.0

8.0

3.0

1.0

15.0

300.0

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