Clinical Nurse Leader Practice Development: An Integrative Review of the Literature.

Background: The Clinical Nurse Leader (CNL) is a skilled clinician qualified in outcomes-based practice and quality improvement. Publications describe the CNL training, integration, and outcomes. However, CNL practice development and its impact has not been fully explored.

Adaptation of a Lean Tool Across Surgical Units to Improve Patient Experience.

Background: High reliability organizations (HROs) sustain consistently excellent outcomes over time. Health care systems need to eliminate major quality failures to become reliable.

Local Problem: Practice variations, unstructured leader rounds, and unfavorable patient experience outcomes with Responsiveness of Hospital Staff prompted leaders to adopt Kamishibai cards (K-cards).

Integration of Lean Visual Management Tools Into Quality Improvement Practices in the Hospital Setting.

Background: Lean management tools have proven effective in achieving high reliability in health care.

Local Problem: Unstructured leader rounds, decentralized prevention bundle repositories, and unfavorable patient experience outcomes prompted leaders on a thoracic and cardiovascular surgery unit to find other methods to address these issues and positively impact outcomes.

Methods: Nurse sensitive indicator prevention bundles, root cause analysis tools, and best practices were used to develop Kamishibai Cards (K-Cards) for each measure targeted.