Special Report
Instructions for Continuing Nursing Education Contact Hours appear on page 15.
Clinical Leadership: A Call to Action
Cecelia Gatson Grindel
he call for nurse leadership
at the bedside has been
emerging over the last 15
years. Since the publication of the
Institute of Medicine’s (IOM) report, To Err is Human, Building a
Safer Health System (IOM, 1999), the
demand has increased for clinical
nurses to take the lead in ensuring
quality patient care, patient safety,
and healthy practice environments.
While clinical nurses are expected
to assume leadership roles to
enhance patient outcomes, guarantee patient safety, and assure efficient work processes, many of them
lack the knowledge and skill. To
assume leadership roles at the point
of service, nurses must master the
essential knowledge and skills of
clinical leaders.
Four landmark IOM reports provide the framework for the development of clinical leaders by identifying the need for (a) environmental
changes in health care to decrease
medical errors (IOM, 1999), (b)
redesign of clinical services to
assure quality care (IOM, 2001), (c)
elimination of variations in practice
(IOM, 2004), and (d) development
of clinical leaders to spearhead
change initiatives in the practice
environment (IOM, 2011). A significant nursing directive has evolved
from these four IOM reports:
Clinical nursing leadership at the point
of service now is recognized as a central
professional competency to ensure
quality patient care and patient safety.
Nurse leaders at the bedside are
clinical experts who provide direct
patient care that continually
improves patient outcomes and
enhances the practice environment.
They are empowered clinical experts
T
Clinical nurses are expected to assume leadership roles to enhance
patient care and assure efficient work processes. Dimensions of clinical leadership and the essential knowledge and skills of the clinical
leader are described.
who demonstrate emotional intelligence, challenge ineffective work
processes, and inspire others to act.
These nurse leaders recognize their
power, professional and ethical
responsibilities, and clinical autonomy to engage in decision-making
related to patient care and nursing
practice in an interprofessional practice environment (Benner, 2001;
Benner, Sutphen, Leonard-Kahn, &
Day, 2008; Cook, 2001; Downey,
Parslow, & Smart, 2011; Kouzes &
Posner, 2007; Stanley, 2006; Weston,
2008).
The benefits of being a clinical
leader at the bedside are many.
Clinical leaders report greater job
satisfaction, increased personal satisfaction in their own accomplishments, and more opportunities for
career advancement. In addition,
they take great pride in the accomplishments of those they have influ-
enced. Clinical leadership at the
point of service also has benefits for
the employing agency. The delivery
of patient care services is enhanced
as patient safety, care, outcomes,
and satisfaction are improved; work
processes are more efficient; errors
are reduced; and waste in the workplace is eliminated. These enhancements support a healthy practice
environment (Downey et al., 2011;
George et al., 2002).
Regardless of the benefits of
being a clinical leader, many nurses
do not seek leadership roles in their
practice environments. Many reasons are given for the declining
interest in a leadership role. Nurses
indicate they are too busy with
patient care, lack the necessary
knowledge and skills for leadership,
do not want to take on more work,
or do not believe they have the
power to lead in their workplace.
Cecelia Gatson Grindel, PhD, RN, FAAN, is Professor Emeritus, Byrdine F. Lewis School of
Nursing & Health Professions, Georgia State University, Atlanta, GA; co-founder and former
President, Academy of Medical-Surgical Nurses (AMSN); and former Chair, AMSN Task Force
for the Clinical Leadership Development Program.
Acknowledgments: The author thanks the subject matter experts of the Clinical Leadership
Development Program (CLDP) Task Force: Michelle Alexander, DNP, ACNS-BC, RN; Lynne M.
Connelly, PhD, RN; Jocelyn Corrao, MSN, MBA, RN-BC; Heather Craven, PhD, RN, CMSRN;
Sheila Kennedy-Stewart, MSN, RN, CMSRN; Robyn Hilliard, MSN, RN, CMSRN; Karen
Maxwell, MSN, RN-BC; Alice Poyss, PhD, RN, APRN-BC; Laura Tobin, MSN, RN, ACNS-BC,
PCCN; and AMSN Board Liaison Robyn Hertel, EdS, MSN, RN, CMSRN. Special thanks to
AMSN’s Rosemarie Marmion, MSN, RN-BC, NE-BC, and Maura King, BA, for coordinating all
aspects of the CLDP project. Recognition also goes to the original CLDP Task Force who developed the curriculum: Terry Jones, PhD, RN (Chair); Heather Craven, PhD, RN, CMSRN; Mary
Sue Dailey, APN-CNS; Pamela Dutton-Fischer, BSN, RN, CMSRN; Erin Fruth, BSN, RN,
CMSRN; Cecelia M. Grindel, PhD, RN, CMSRN, FAAN; Cynthia Sauerwein, MSN, RN, LCCE;
and AMSN Board Liaison, Linda H. Yoder, PhD, MBA, RN, AOCN, FAAN.
January-February 2016 • Vol. 25/No. 1
9
Also some nurses do not recognize
or acknowledge their professional
responsibility to assume a leadership role in their practice environment. In reality, nurses have the
freedom and authority to make
nursing care decisions concerning
patient care and work processes
(Weston, 2008).
Determination of Essential
Knowledge and Skills
In recognition of the need for
clinical leadership at the point of
service, the Academy of MedicalSurgical Nurses (AMSN) assembled a
task force of clinical and leadership
experts to develop a curriculum for
leadership development for medical-surgical nurses at the point of
service. This task force reviewed the
literature and the IOM reports,
obtained input from nurse experts
and leaders, and evaluated research
findings from AMSN’s Nurses
Nurturing Nurses program. Following a series of discussions, the content was rank-ordered to determine
essential knowledge base and skills
for clinical leaders. The curriculum
information was compiled into
eight categories, each containing
two topics. Ten of the topics were
designated as basic knowledge for
clinical leaders at the bedside. Two
topics focused on the role, characteristics, and skills of the clinical
leader and the part motivation
plays in clinical leadership; these
areas are not presented in this article. The remaining six topics were
categorized as advanced knowledge
and skills for the clinical leader at
the bedside and will be addressed in
the future.
The core knowledge topics are
discussed in the next section. The
competency skills of clinical leaders
at the bedside follow.
Core Knowledge for
Clinical Leadership
The eight core topics of knowledge have been classified into clinical practice and the practice envi-
ronment categories (see Table 1). A
brief overview of every topic is presented; however, the author
encourages readers to engage in an
in-depth inquiry into each topic.
After a topic is reviewed, use the
Clinical Leadership Knowledge
Assessment Form (see Figure 1) to
rate knowledge of the topic. Reflect
on what you know and what you
think you would need to do to
strengthen your knowledge about
each topic.
Foundations of Quality Care
Clinical leaders have a strong
foundation in health care quality so
they can take an informed, active
part in quality management initiatives. Quality patient care is
grounded in six aims: (a) keep
patients safe from injuries; (b) pro-
TABLE 1.
Core Knowledge for Clinical Leadership
Clinical Practice
• Foundations of Quality Care
• National Patient Safety Goals
• Core Measures & Hospital
Consumer Assessment of
Healthcare Providers and Systems
• Reduction in Practice Variations
• Critical Appraisal of Clinical
Evidence
Practice Environment
• Hospital Systems
• Cost Drivers for Nursing Services
• Healthy Practice Environments
FIGURE 1.
Clinical Leadership Knowledge Assessment Form
How Knowledgeable Are You about the Following?
Clinical Practice
Quality Initiatives
Not at All
Somewhat
Very
Knowledgeable Knowledgeable Knowledgeable Knowledgeable
National Patient Safety Goals
Core Measurements and HCAHPS*
Reduction in Practice Variations
Critical Evaluation of the Literature
Practice Environment
Hospital Systems
Cost Drivers for Nursing Services
Health Practice Environments
* HCAHPs: Hospital Consumer Assessment of Healthcare Providers and Systems
© 2015 Academy of Medical-Surgical Nurses. Reprinted with permission.
10
January-February 2016 • Vol. 25/No. 1
Clinical Leadership: A Call to Action
vide effective patient-centered care
based on scientific knowledge; (c)
provide care that is responsive to
patient preferences, needs, and values; (d) deliver timely care; (e)
ensure the efficient, cost-effective
delivery of services by avoiding
waste of equipment, supplies, ideas,
and time; and (f) assure quality care
is provided regardless of sex, ethnicity, geographic location, and socioeconomic status (IOM, 2001).
The knowledge content for quality care begins with an awareness of
the many dimensions of quality as
viewed by the patient, nurses,
health care professionals, health
care organization leaders, insurers,
and national quality organization
leaders. An awareness of the responsibilities and collaborative efforts of
quality organizations such as government agencies (e.g., Centers for
Medicare & Medicaid Services
[CMS]; Agency for Healthcare
Research and Quality [AHRQ]),
independent nonprofit organizations (e.g., The Joint Commission;
Institute for Safe Medication
Practices), and professional organizations (e.g., American Nurses
Association [ANA]; American Medical Association) is essential as these
organizations assess dimensions of
the quality of care, provide funding
for health care, and offer resources
to assure quality of care. To participate effectively in quality initiatives, clinical leaders must be familiar with Donabedian’s structure,
process, outcome (SPO) model
(Donabedian, 2005) and other quality improvement models (e.g., Plan,
Do, Study, Act [PDSA]; Focus,
Analyze, Develop, Execute [FADE])
and tools (e.g., process maps, fishbone diagrams, surveys) (AHRQ,
2013; Wiseman & Kaprielian,
2014). [Rate your knowledge about the
foundations of quality care.]
National Patient Safety Goals
(NPSGs)
Although evidence suggests the
effectiveness of many patient safety
practices has improved substantially over the past decade (Shekelle et
al., 2013), numerous threats to
patient safety remain in all facets of
care delivery. Common obstacles to
a safe system include (a) complex
and risk-prone systems; (b) a lack of
comprehensive verbal, written, and
electronic communication systems;
(c) tolerance of stylistic practices
wherein providers do it their way;
(d) a lack of standardization of practices; (e) fear of punishment that
inhibits reporting; and (f) a lack of
ownership for patient safety (IOM,
1999). Without an awareness of the
sources of these barriers, nurse leaders at the bedside are less likely to
identify safety issues.
Essential knowledge about the
NPSGs begins with a brief history of
the development of the NPSGs and
Sentinel Event Alerts (The Joint
Commission, 2014). With insight
about the configuration of each
NPSG, nurses can identify specific
directives for patient care. By recognizing updated NPSGs are published annually and knowing variation exists in the listed goals from
year to year, nurses can be certain
they are knowledgeable about current required health care strategies
and universal protocols. [Rate your
knowledge about the NPSGs.]
Core Measures and Hospital
Consumer Assessment of
Healthcare Providers and
Systems (HCAHPS)
Core Measures (The Joint Commission, 2015) and HCAHPS (2015)
are quality initiatives focused on
quality patient care and an understanding of what patients really
want from providers. Patients want
care that is patient-centered, safe,
effective, efficient, timely, and equitable. They also want providers who
listen without interrupting, are
truthful, and explain care clearly and
fully. Patients want providers to collaborate with other team members
so messages are consistent between
the patient and all providers, thus
ensuring care will be coordinated
and flow smoothly (Anderson,
Barbara, & Feidman, 2007).
To ensure consumers’ expectations are met, hospitals are ranked
on the process of care (Core
Measures) and patient satisfaction
(HCAHPS); these rankings are available to consumers. To foster positive rankings, clinical leaders must
January-February 2016 • Vol. 25/No. 1
understand relationships between
(a) the Core Measures set and evidence-based care, (b) patient-centered care behaviors and consumer
comparisons, and (c) published hospital rankings and financial incentives for hospitals (CMS, 2013).
Nurse leaders who are cognizant of
HCAHPS patient satisfaction questions will structure care so patients
need are met and patient satisfaction is high. Finally, clinical leaders
are very aware of the Value-Based
Purchasing Program (CMS, 2013)
and its relationship to hospital payment for patient care services. [Rate
your knowledge about Core Measures
and HCAHPS.]
Variations in Practice
Variations in practice, sometimes
referred to as fragmented care, can be
found at the hospital systems level.
The physical design of the organization and the inaccessibility to updated technology, such as diagnostic
equipment and user-friendly medical
records, can be sources of fragmented
care. Variations can occur as a result
of ineffective organizational leadership, the shortage of experienced
interprofessional teams, and poor
communications among health care
providers. Issues related to medical
coverage and services (e.g., access to
insurance and medical services;
high deductibles and co-pays) and
the research-practice gap (e.g., lack
of organizational culture for research implementation; nurse preparedness and willingness to participate in research) also contribute to
fragmented care. Patients are affected by variations in all these dimensions. In addition, variations in
practice play a significant role in
health care cost. Nurse leaders at the
bedside can minimize costs by implementing evidence-based practices and eradicating fragmented
care (IOM, 2001).
Clinical leaders at the bedside
recognize sources of fragmented
care and use structured approaches
to eliminate them. These leaders
implement evidence-based policies,
protocols, and pathways, and share
evidence-based and best practices
with nurse colleagues. They advo-
11
cate for the patient’s preferences and
values and set the bar high for safe,
efficient unit practices (e.g., consistency in care via patient assignments; efficient and effective bedside report processes). Clinical nurses reduce variations beyond the unit
by participating in hospital councils, committees, or projects and
becoming nurse champions for
interprofessional initiatives. They
also contribute to the refinement of
communication technology, such as
inefficient patient care documentation processes (Cook, 2001; Laschinger & Finegan, 2005; Stanley,
2006). [Rate your knowledge about
variations in practice.]
Critical Appraisal of Clinical
Evidence
In recent years, clinical experts
have emphasized the importance of
using evidence to guide nursing and
medical practice. However, the
translation of evidence to practice is
relatively slow. Clinical leaders
accelerate the process for integrating new clinical evidence into daily
practice by learning how to appraise
the literature, determine an intervention’s potential for translating
into practice, and transition the
best clinical practices into patient
care (IOM, 2011).
Using the evidence-based process
to appraise clinical evidence, clinical leaders guide team members in
formulating the research question.
They search the literature for current evidence and begin to appraise
the evidence by summarizing
important elements of research articles in an evidence table. The team
then decides if the evidence supporting the new procedure is strong
enough to influence clinical practice. If so, members integrate the
research evidence with other types
of intangible evidence, such as
patients’ preferences and values and
clinical expertise. The new procedure then is applied in clinical practice and evaluated for its effectiveness. Clinical leaders enhance the
translation of evidence into practice
by guiding colleagues in use of the
evidence-based process to appraise
the literature critically and evaluate
the need for a specified change in
12
the practice environment (Melnyk
& Fineout-Overholt, 2010; Melnyk,
Fineout-Overholt, Stillwell, & Williamson, 2010; Polit & Beck, 2014).
[Rate your knowledge about critical
appraisal of the evidence.]
Practice Environment Core
Knowledge
Hospital Systems
Nurse leaders’ source of influence
lies in their ability to take actions
that improve patient care, enhance
patient outcomes, and promote a
healthy practice environment. To
influence the delivery of patient care
services, clinical leaders must understand their hospitals’ structures and
their relationship to communication
within the organizations. Nurse leaders benefit from knowing about the
arrangement of hierarchical management, lines of authority and the
chain of command related to decision-making, and the flow of communication from the top down and
the bottom up. With this information, clinical leaders can contact specific individuals to whom they can
address their concerns or from
whom they can seek support for
their initiatives (Laschinger &
Finegan, 2005; Rao, 2012).
In most cases, delivery of nursing
services is guided by a professional
practice model. The model is selected based on its fit with the organization’s mission, available resources,
and the patient population. Understanding the various practice models fosters selection of the best practice model for the delivery of patient
care or, if needed, gives direction to
selecting a new model or modifying
the current model. Most hospitals
select a nursing governance model
(e.g., shared governance model) as
the framework that empowers clinical leaders to serve on hospital,
nursing, and other leadership committees and participate in decisionmaking related to patient care and
work processes (Barden, Quinn,
Donahue, & Fitzpatrick, 2011;
Bonsall, 2011). [Rate your knowledge
about your organization’s structure,
culture, and professional practice and
governance models.]
Cost Drivers for Nursing
Services
Clinical leaders at the point of
service are needed around the world
to be full partners in redesigning
health care. With a basic understanding of hospital revenues and
expenses, these nurses are knowledgeable about the cost of patient
care and sources of revenue that pay
for nursing services. As a result, they
can make meaningful suggestions
for transforming patient care (CMS,
2013; Nichols & O’Malley, 2006;
Quizlet.com, 2014).
Clinical leaders at the bedside are
aware of the major components of a
hospital’s budget and can identify
where the cost of nursing services
fits. They are also aware of the four
key drivers of nursing care costs:
staffing, workload, workflow, and
work activities. These leaders can
advocate for safe staffing practices
because they know patient volume,
acuity, skill mix, practice model,
and productive vs. nonproductive
hours should be considered in
determining unit staffing and
staffing patterns. They participate
in determining workload because
they recognize the effect of nurse
workload on service quality.
Clinical leaders take action to assure
efficiency in workflow processes so
nurse time and energy are saved
and the delivery of quality patient
care is ensured. They are also aware
of the effect of direct (patient care)
and indirect (e.g., change of shift
reports, justification of the scheduled drug count, committee meetings) nurse activities on the cost of
nursing services. Finally, these leaders recognize the importance of the
balance between productivity and
quality of services, and its influence
on the cost of nursing services. In
essence, nurse leaders can integrate
knowledge related to the cost of
nursing services into work redesign,
safe staffing projects, and more
(ANA, 2014a, 2014b, 2014c). [Rate
your knowledge about cost drivers for
nursing services.]
Healthy Practice
Environment (HPE)
Optimal patient care does not
just happen. Historically, clinical
January-February 2016 • Vol. 25/No. 1
Clinical Leadership: A Call to Action
excellence has been credited as the
key to quality patient outcomes.
Data indicate the practice environment also plays a significant part in
determining patient outcomes. In
its report Keeping Patients Safe:
Transforming the Work Environment
of Nurses, the IOM (2004) confirmed the typical nursing practice
environment is characterized by
many serious threats to patient safety and the existence of an HPE.
These threats are found within
organization management practices, workforce deployment practices, work design and processes,
and the organizational culture.
Clinical leaders at the point of service can assist in creating and maintaining an HPE because they know
what it is, how to recognize threats,
and how to initiate strategies to
support it (Aiken, Clarke, Sloane,
Lake, & Cheny, 2008).
To create and sustain an HPE,
clinical leaders will identify and act
to eliminate threats to safety (e.g.,
ineffective nurse management, inadequate staffing, lack of nurse
knowledge and skills, inefficient
work processes, unhealthy organizational culture). For example,
nurse leaders will approach a colleague who is changing intravenous
tubing incorrectly and guide him or
her through the correct method.
They will support nurses’ participation in decision making related to
patient care and work processes on
the unit. These leaders know the
process for evidence-based change
management and will work with
the nurse manager and colleagues
to ensure the plan for change
reflects this approach. Clinical leaders are empowered to speak to nursing administrators about inadequate staffing and high nurse
turnover, and their relationship to
patient safety and errors. They take
action to resolve ineffective work
processes, such as inefficient shift
reports and excessive or poor use of
resources. In addition, they address
issues that arise in a toxic organizational culture. For example, a clinical leader will intervene in specific
incidents of bullying and work with
the nurse manager to eradicate this
behavior on the unit. Nurse leaders
cannot control the organization’s
culture. However, they can promote
positive attitudes among colleagues
and lead change to improve patient
care and support a healthy practice
environment (Dearmon et al., 2013;
Hall, Doran, & Pink, 2008). [Rate
your knowledge about HPEs.]
Leadership Competency
Skills
Leadership competency skills for
nurse leaders at the bedside are
grounded in clinical expertise, supported by emotional intelligence,
and actualized by expert skills in
communication, coordination, and
collaboration (the 3Cs).
Clinical Expertise
Clinical expertise is based in education, ongoing professional development, training, and clinical experiences, and is enhanced by an attitude of positive thinking and professional values. Clinical leaders
approach life with optimism and
confidence. Positive thinking is a
way of life that is integrated into all
aspects of nurse leaders’ lives, professional and private. These leaders’
professional values center on providing the highest level of patient
care. As a result, these nurses exhibit a high level of professional integrity and accountability for their
work. They are committed to improving nursing practice and
patient care. They recognize their
professional responsibility to act
when issues or problems arise, and
they motivate others to act. These
clinical leaders have respect for self
and others, and their colleagues
have respect for them (George et al,
2002; Laschinger & Finegan, 2005).
Emotional Intelligence
Leaders must be able to recognize
and regulate their emotions and
manage those of others. Leaders
who do so are said to have a high
level of emotional intelligence,
which is “the capacity for recognizing our own feelings and those of
others, for monitoring ourselves,
and for managing emotions in ourselves and in our relationships with
others” (Goleman, 1995, p. 317). To
January-February 2016 • Vol. 25/No. 1
manage their own emotions, individuals must have a conscious
awareness of their emotions (selfawareness). With this awareness,
they can regulate their personal
response to the situation (self-management). Social awareness and relationship management emphasize
identifying and managing the emotions of others while controlling
personal emotional responses. Recognizing and managing the emotions of others allows a nurse leader
to handle disruptive or emotional
situations effectively. To do so, the
clinical leader keeps calm, speaks
appropriately, and most importantly, separates the emotions from the
individuals. In doing so, this leader
manages the group’s relationships
by keeping the conversation directed at resolving the issue at hand. In
summary, emotional intelligence
requires personal reflection and
management of personal emotions
as well as the ability to listen,
observe, process, and negotiate with
others during an emotional encounter (Druskat & Wolff, 2001;
Goleman, 1995, 1998) (see Table 2
for emotional intelligence skills
assessment).
The 3Cs
In addition to clinical expertise
and emotional intelligence, clinical
leaders at the point of service rely
on their communication, collaboration, and coordination skills to motivate others to act. Proficiencies in
interpersonal (one-on-one) and
group communication are the basis
for effective coordination of activities and collaboration with others.
Interpersonal communication is the
critical element for situations, such
as coaching/mentoring, educating,
managing conflict, and addressing
bullying. Expert group communication skills facilitate good group
interactions and patient care coordination. These skills also foster
interprofessional collaboration that
enhances patient care and patient
satisfaction. With expertise in the
3Cs, nurse leaders successfully lead
committees and manage difficult
group situations. In addition, they
identify ineffective work processes
and motivate colleagues to initiate
13
1.
2.
3.
4.
5.
6.
TABLE 2.
Emotional Intelligence Self-Assessment
Are you able to read other individuals’ feelings and behaviors?
Are you able to look beyond the behavior to recognize hidden motivations or
agendas?
When you experience strong emotions (fear, anger), do you later reflect on
the situation that led to the emotion?
When you experience strong emotions (fear, anger), do you behave and
speak appropriately?
When you experience strong emotions (fear, anger), are you able to stay on
task?
When you experience strong emotions (fear, anger), are you able to separate the cause of the emotion (another person) from the emotion?
Note: The more “yes” responses you have, the higher your level of emotional intelligence.
Source: Druskat & Wolff, 2001.
Patient Care
TABLE 3.
Ineffective or Inefficient Practices
• Lack of coordination
of patient activities
• Non-acuity based
assignments
• Slow response to call
lights
Work Processes
• Lengthy or poor shift
report processes
• Disorganized grand
rounds
• Nurse retrieval of
medications from
pharmacy
• Inefficient
documentation
of vital signs
Unit Organization
• Unorganized supply
room
• Inconvenient location
of equipment
• Inadequate training re:
new procedures,
equipment, etc.
change to manage problems, thus
improving the delivery of patient
care services (Druskat & Wolff,
2001).
A great deal of effort goes into
assuring the delivery of patient care
is efficient and effective. However,
ineffective or inefficient practices
can be found in patient care, work
processes, and the unit’s organization (see Table 3). In some cases,
inefficient practices have been the
norm for so long nurses do not recognize the inefficiency. Thus, no
action is taken. In other cases, nurses do not want to tackle inefficiencies as they are busy providing
patient care; thus they create workarounds. Rather than addressing
the problem with nursing managers, these nurses use inefficient
methods that may increase the incidence of error (Benner et al., 2008).
Clinical leaders are proactive.
Their leadership skills extend
beyond addressing ineffective work
processes. They can envision a better way to do things. They see the
opportunity to improve the status
quo and they motivate colleagues
FIGURE 2.
Leadership Competency Skills
How Competent Are You in Doing the Following…?
Using emotional intelligence
Coaching/mentoring colleagues
Educating patients, families, colleagues
Resolving conflict
Defusing lateral violence/bullying in the workplace
Addressing a colleague who was not doing a procedure correctly
Collaborating with nurses re: patient care issue
Calling together an interprofessional team to discuss a patient care issue
Calling together an interprofessional team to discuss a workflow issue
Leading teams/committees
Leading team/committee meetings
Preparing for team/committee meetings
Initiating a change initiative
Leading a change initiative
Presenting clinical updates to colleagues
Presenting information at a team/committee meeting
Presenting at a professional conference
Not at All Somewhat
Very
Competent Competent Competent Competent
© 2015 Academy of Medical-Surgical Nurses. Reprinted with permission.
14
January-February 2016 • Vol. 25/No. 1
Clinical Leadership: A Call to Action
Instructions For Continuing Nursing Education Contact Hours
Clinical Leadership: A Call to Action
Deadline for Submission: February 28, 2018
To Obtain CNE Contact Hours
1. For those wishing to obtain CNE contact hours, you must read the
article and complete the evaluation through the AMSN Online
Library. Complete your evaluation online and print your CNE
certificate immediately, or later. Simply go to www.amsn.org/library
2. Evaluations must be completed online by February 28, 2018. Upon
completion of the evaluation, a certificate for 1.3 contact hour(s) may
be printed.
Learning Outcome
After completing this learning activity, the learner will be able to discuss
the dimensions of clinical leadership and the essential knowledge and
skills of the clinical leader at the bedside.
Fees — Member: FREE Regular: $20
to join in the quest to provide better patient care. Clinical expertise,
emotional intelligence, and expert
skills in communication, coordination, and collaboration serve as the
foundation for action by clinical
leaders at the point of service. These
nurse leaders mold their skills to fit
the situation at hand (Hall et al.,
2008; Weston, 2008). [See Figure 2 to
assess your leadership skills proficiency. Then select one skill you would like
to enhance and identify a strategy to do
so!]
Conclusion
Clinical leaders at the bedside
challenge the process. They identify
work inefficiencies, motivate nurse
colleagues to act, and lead change
initiatives to correct problems.
Whether the inefficiency relates to
poor policies, procedures, or workflow, these nurse leaders recognize
their responsibility to act to improve the delivery of patient care
services. They also envision better
ways to deliver patient care services
and engage others in testing innovations. The results of their clinical
leadership are enhanced patient
care, improved patient outcomes
and patient satisfaction, and the
attainment of a healthy practice
The author(s), editor, editorial board, content reviewers,
and education director reported no actual or potential
conflict of interest in relation to this continuing nursing
education article.
This educational activity is jointly provided by Anthony J.
Jannetti, Inc. and the Academy of Medical-Surgical Nurses
(AMSN).
Anthony J. Jannetti, Inc. is accredited as a provider of
continuing nursing education by the American Nurses
Credentialing Center’s Commission on Accreditation.
Anthony J. Jannetti, Inc. is a provider approved by the
California Board of Registered Nursing, provider number
CEP 5387. Licensees in the state of California must retain
this certificate for four years after the CNE activity is
completed.
This article was reviewed and formatted for contact hour
credit by Rosemarie Marmion, MSN, RN-BC, NE-BC,
AMSN Education Director.
environment. Take the challenge!
Be a clinical leader at the bedside in
your practice environment!
REFERENCES
Agency for Healthcare Research and Quality
(AHRQ). (2013). Plan-do-study-act
(PSDA) cycle. Retrieved from https://
innovations.ahrq.gov/qualitytools/plando-study-act-pdsa-cycle
Aiken, L.H., Clarke, S.P., Sloane, D.M., Lake,
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