Assignment: CNL Transformational Care
Assignment: CNL Transformational Care
The flexibility and broad scope of this role support employment in a variety of practice setting.10 Imple- mentation of the CNL role is being explored by more than 175 practice institutions and employers4; however, roles vary across settings.
The CNL curriculum includes didactic and clin- ical content for preparation as an advanced nurse
generalist with specific focus on nursing leadership, clinical outcomes management, and care environment management.4 In addition to graduate coursework in health assessment, pharmacology and pathophys- iology, 400 to 500 hours of clinical experiences are expected. Curriculum topics include epidemiology, EBP, health policy, finance, QI, informatics, and health- care systems complexity.
Historically portfolios were used in non-healthcare professions including art, architecture, and finance. Portfolios are used today by the nursing profession in academic settings and for career advancement.11,12
The components and formatting of the portfolio have been refined over time to current electronic versions.13-18 Because CNLs are knowledge workers, a portfolio is an effective strategy to demonstrate their unique skill set for transforming care at the bedside. In academia, the portfolio has become a collection of student work19 providing evidence of achieved competence.20
Practice innovations for complex patients, error reduction strategies, examples of interprofessional collaboration, and microsystem improvements are examples of CNL transformational care practices. Portfolios that include both successful and unsuc- cessful outcomes can profile CNL problem-solving skills. Evaluations of current practices demonstrate critical synthesis21 and command of process evalua- tion, both guiding principles for future patient care delivery.22 Ongoing maintenance of the portfolio pro- vides the CNL with evidence of career development useful for licensure and certification renewal.18,23
Academic and practice leaders from UTHSC and Methodist Le Bonheur Healthcare in Memphis, Tennessee, collaboratively developed the CNL port- folio with application for both the academic and practice settings. A 2-phase pilot project was used to evaluate the use of portfolios. Phase 1 addressed CNL use of a portfolio including competencies ac- quired in nursing coursework, clinical experiences, and CNL clinical immersion outcomes.
Documentation of CNL Competencies
The CNL portfolio is developed at the beginning of the program in the informatics course using an elec- tronic format. During the advanced leadership and internship classes, UTHSC CNL students organize evidence of professional nursing competencies ac- quired through coursework and clinical experiences in preparation for graduation. Students complete the portfolio at the conclusion of a 315-hour CNL clin- ical immersion experience. The portfolio is organized
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