Bender Miriam
Program in Nursing Science, University of California, Irvine, CA, USA.
J Nurs Manag. 2016 Jan;24(1):E23-31. doi: 10.1111/jonm.12285. Epub 2015 Feb 5.
The Institute of Medicine's Future of Nursing report identifies the clinical nurse leader as an innovative new role for meeting higher health-care quality standards. However, specific clinical nurse leader practices influencing documented quality outcomes remain unclear. Lack of practice clarity limits the ability to articulate, implement and measure clinical nurse leader-specific practice and quality outcomes.
Interpretive synthesis design and grounded theory analysis were used to develop a theoretical understanding of clinical nurse leader practice that can facilitate systematic and replicable implementation across health-care settings.
The core phenomenon of clinical nurse leader practice is continuous clinical leadership, which involves four fundamental activities: facilitating effective ongoing communication; strengthening intra and interprofessional relationships; building and sustaining teams; and supporting staff engagement.
Clinical nurse leaders continuously communicate and develop relationships within and across professions to promote and sustain information exchange, engagement, teamwork and effective care processes at the microsystem level.
Clinical nurse leader-integrated care delivery systems highlight the benefits of nurse-led models of care for transforming health-care quality. Managers can use this study's findings to frame an implementation strategy that addresses theoretical domains of clinical nurse leader practice to help ensure practice success.
医学研究所的《护理的未来》报告将临床护理领导者确定为实现更高医疗质量标准的一个创新性新角色。然而，影响已记录质量结果的具体临床护理领导者实践仍不明确。实践的不明确限制了阐述、实施和衡量临床护理领导者特定实践及质量结果的能力。
采用解释性综合设计和扎根理论分析，以形成对临床护理领导者实践的理论理解，从而促进在各种医疗环境中进行系统且可复制的实施。
临床护理领导者实践的核心现象是持续的临床领导，它涉及四项基本活动：促进有效的持续沟通；加强专业内和跨专业关系；建立和维持团队；以及支持员工参与。
临床护理领导者在专业内部和跨专业之间持续沟通并发展关系，以在微观系统层面促进和维持信息交流、参与、团队合作及有效的护理流程。
整合临床护理领导者的护理提供系统凸显了由护士主导的护理模式对改善医疗质量的益处。管理者可利用本研究的结果制定实施策略，该策略涉及临床护理领导者实践的理论领域，以帮助确保实践成功。
