Clinical nurse leader (CNL)–integrated care delivery is an emerging nursing model being adopted across diverse health care systems. To generate an evidence base for CNL practice, we need measurement tools that link this practice to quality and safety outcomes. Bender et al describe the development and face, content, and construct validity of the CNL Practice Survey for measuring outcomes of CNL practice. A team of advanced practice nurses, a nurse scientist, and Lean specialists developed a crosswalk of evidence-based practice (EBP) with Lean to explicitly embed the use of evidence in their organization's 4-step problem-solving method. The blended EBP-Lean model is used to guide their improvement work. The authors explain the model and provide an example of using it to update their practice related to changing peripheral intravenous catheters. Ventilator-associated pneumonia (VAP) bundles have improved outcomes in acute care hospitals. An interesting article is this issue reports on implementation of a VAP bundle in a skilled nursing facility. The primary goal was to improve oral health, a significant factor for VAP, and nurse adherence to the bundle. Improvements in oral health and adherence were demonstrated. We also have 3 articles on falls including use of a virtual breakthrough series collaborative, with “take aways” for using this model in your own setting. Be sure to read the study by Fischer et al: they surveyed nearly 2000 RNs working in 24 hospitals with shared leadership to examine nurses’ involvement in decision making. Council participation was associated with higher decisional involvement scores (P = .03), and the nurse’s experience was a significant predictor of decisional involvement (P < .01). These are a few highlights from the fall issue of JNCQ: read and pass on to colleagues. Thank you JNCQ reviewers! It is because of you that JNCQ is able to publish high quality studies and projects of interest to our diverse readership.
Marilyn H. Oermann, Editor-in-Chief
