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AACN-CNL exam Format | AACN-CNL Course Contents | AACN-CNL Course Outline | AACN-CNL exam Syllabus | AACN-CNL exam Objectives

Exam Code: CNL

Exam Name: AACN Clinical Nurse Leader (CNL)

Total Questions: 140 multiple-choice questions (some are unscored pretest questions)

Time Allotted: 3 hours

Passing Marks: Minimum scaled score of 350 out of 500



- Nursing Leadership (~36%)

- Clinical Outcomes Management (~34%)

- Care Environment Management (~30%)



- Nursing Leadership

- Horizontal Leadership

- Apply leadership change and complexity theories

- Guide the healthcare team to use clinical judgement when providing patient care

- Facilitate delegation of patient care coordination activities

- Provide coaching and mentoring to the healthcare team

- Act as a role model for the healthcare team

- Coordinate the evaluating and updating plans of care with the healthcare team

- Facilitate coordination of applicable healthcare team members and stakeholders to meet care objectives

- Manage the healthcare team to provide timely and efficient care

- Develop effective working relationships across the healthcare system

- Advocate for the CNL role



- Interprofessional Communication and Collaboration Skills

- Analyze communication structures and chain of command that impact care within the healthcare team and across settings

- Demonstrate effective written spoken and non-verbal communication skills

- Utilize communication skills that effectively navigate high-stakes or difficult conversations within the healthcare team

- Employ strategies to build relationships within healthcare team including both clinical and administrative members

- Employ strategies that promote diversity equity and inclusion to bridge barriers across the healthcare system

- Integrate emotional intelligence in communication and collaboration with patients families and the healthcare team

- Leverage the roles and responsibilities of the interprofessional team to influence care delivery

- Utilize effective communication strategies to adapt information to the target audience



- Healthcare Advocacy

- Identify health disparities across populations

- Perform an advanced exam of microsystems across the care continuum to determine patient population care needs

- Protect patient rights by being an advocate in the healthcare system

- Ensure that patients families and communities are well informed in creating a patient-centered plan of care

- Advocate for necessary healthcare delivery changes and advancements to key stakeholders

- Identify and propose microsystem resources to meet the needs of target populations

- Determine shared understanding among the healthcare team before decisions are made

- Advocate for patients particularly the most vulnerable



- Implementation of the CNL Role

- Demonstrate professional identity and practice in developing the CNL role

- Explain the capacity of CNL practice to Strengthen healthcare processes and outcomes

- Exhibit qualities of a microsystem leader within and across interprofessional teams

- Apply current and new CNL evidence and competencies into practice

- Disseminate CNL practice outcomes at system regional national or international level

- Collaborate with a network of CNL professionals at the system regional national or international level



- Lateral Integration of Care Services

- Coordinate the healthcare of patients across the care continuum

- Integrate an interprofessional approach to identify and acquire resources for patient populations

- Coordinate patient care within and across specific episodes of illness and throughout the care continuum

- Apply systems and organization theory in the design delivery and evaluation of healthcare delivery across the care continuum

- Patient Assessment

- Perform an advanced comprehensive exam of the patient across the lifespan (e.g. culture socioeconomic status health literacy vulnerabilities)

- Perform an advanced exam of microsystems across the care continuum to determine patient population care needs



- Ethics

- Apply patient-centered ethical decision-making framework to clinical situations

- Apply legal and ethical guidelines to advocate for patient well-being and preferences

- Identify ethical dilemmas and the impact on patient care and outcomes

- Analyze how ethical decision making from both a personal and organizational perspectives may create conflicts of interest

- Collaborate with ethics committees or resources and recognize their role in health care delivery

- Demonstrate knowledge of professional and ethical boundaries (e.g. power dynamics dual relationships)



- Clinical Outcomes Management

- Illness/Disease Management

- Coordinate the provision and management of care at the microsystem level and across the care continuum

- Evaluate care for patients with emphasis on health promotion and risk reduction

- Evaluate readiness needs and interventions for safe transition of care

- Evaluate patient care based on analysis of outcomes evidence-based knowledge and patient's goals

- Analyze microsystems of care and outcome datasets to anticipate patient risk and Strengthen quality of care delivery

- Apply theories of chronic illness care and population health management to patient and families

- Coordinate community resources social networks and decision support mechanisms into care management

- Recognize differences in responses to illness and therapies based on patient's risk factors and preferences

- Apply advanced pathophysiology exam and pharmacology to anticipate illness progression response to therapy and to guide teach and engage patients and families regarding care

- Use knowledge of cost and affordability issues in managing patient illness/disease across the care continuum

- Synthesize literature and research findings as the foundation for the design of interventions for illness and disease management

- Coordinate and implement education programs for patients and health professionals

- Identify epidemiological patterns in order to manage illness and disease



- Health Promotion- Disease Prevention & Risk Reduction

- Collaborate with the healthcare team to promote health and/or prevent disease

- Employ strategies to engage patients in therapeutic partnerships with the healthcare team

- Apply interventions based on evidence to meet specific patient needs

- Design and implement interventions to modify risk factors and promote engagement in healthy lifestyles for diverse populations

- Assess risk predictive and genetic factors that influence the health of patients

- Coordinate clinical and health promotion programs for patient populations to reduce risk prevent disease and prevent disease sequelae (e.g. heart failure Enhanced Recovery After Surgery (ERAS) diabetes)

- Incorporate principles of diversity equity and inclusion into health promotion and disease prevention strategies

- Incorporate theories and research in creating patient engagement strategies to promote and preserve health

- Develop community partnerships to establish risk reduction strategies to address identified needs of the microsystem population



- Healthcare Policy

- Recognize the effect of healthcare policy on health promotion risk reduction and disease and injury prevention

- Recognize the interactive effect of socioeconomics on national/global health policy related to health outcomes

- Analyze the effect of local state and/or national healthcare policy as they apply to the standards of care and scope of practice in the microsystem

- Identify the influence of regulatory guidelines and quality controls within the healthcare delivery system



- Care Environment Management

- Knowledge Management

- Collect data that documents the characteristics conditions and outcomes for various patient groups

- Apply knowledge of technology equipment treatment regimens and medication therapies for various patient groups

- Compare and evaluate trends of institutional and unit data to national benchmarks

- Analyze variations in clinical outcomes to determine where nurses have the greatest impact at the microsystem level

- Synthesize data information and knowledge to evaluate and achieve optimal clinical outcomes

- Integrate exam data into information management systems to support shared decision making

- Disseminate microsystem data that impacts health outcomes

- Employ strategies to engage the healthcare team to impact clinical outcomes



- Healthcare Systems/Organizations

- Apply knowledge of change theory to manage group dynamics and promote information dissemination across healthcare systems

- Appraise existing organizational policies and procedures based on current evidence

- Implement system-based strategies that decrease healthcare disparities

- Apply systems thinking theories to address problems and develop solutions

- Evaluate how health care delivery systems are organized and their effect on patient care within microsystems

- Evaluate the economic legal and political factors that influence health care delivery



- Team Coordination

- Employ strategies to ensure skilled nursing procedures are incorporated to promote safety

- Evaluate the microsystem culture/climate that influence healthcare team dynamics

- Establish strategies to maintain effective team structures to ensure shared decision making

- Employ conflict mitigation and resolutions strategies

- Promote a positive and healthy work environment and a culture of retention



- Quality Improvement & Safety

- Employ quality improvement methods in evaluating individual and aggregate patient care processes

- Evaluate healthcare outcomes through the acquisition of data and the questioning of inconsistencies

- Redesign patient care utilizing quality improvement tools (e.g. Failure Modes Effect Analysis (FMEA) Root Cause Analysis (RCA) Plan-Do-Study-Act (PDSA) Cycles)

- Employ strategies to guide the healthcare team in quality improvement activities

- Identify variability and/or gaps in care practices and processes

- Employ standardized work practices to address and Strengthen gaps in processes



- Evidence-Based Practice

- Create framework within the microsystem to integrate patient and family preferences interprofessional clinical expertise and best evidence into clinical decisions

- Develop advanced exam for clinical decisions by applying evidence-based practice

- Synthesize quantitative or qualitative evidence to promote critical thinking

- Select relevant sources of evidence to meet specific needs of patients microsystems or communities when planning care

- Identify relevant measurement strategies that will Strengthen patient outcomes and promote cost effective care

- Demonstrate expertise in the evidence appraisal process



- Healthcare Finance & Economics

- Propose cost effective strategies to the healthcare team that Strengthen efficiency and patient care outcomes

- Employ financial stewardship for the environmental human and material resources while coordinating patient care

- Identify high cost /high volume activities to benchmark costs nationally and across care settings

- Identify the impact of financial policies on healthcare delivery and patient outcomes

- Interpret the impact of both public and private reimbursement policies that may affect patient care decisions

- Evaluate the effect of healthcare financing on access to care and patient outcomes

- Demonstrate knowledge of healthcare economic concepts (e.g. Return on Investment (ROI) Value-Based Purchasing (VBP) bundled payments)



- Healthcare Informatics

- Analyze information health technology sources

- Evaluate care utilizing informatics and patient care technology

- Apply multiple sources of systems data in designing processes for care delivery

- Evaluate clinical information systems to provide feedback related to efficient and accurate documentation

- Evaluate the impact of new technologies on patients families and healthcare delivery

- Assess the relationships between information systems accurate communication error reduction and healthcare system operation

- Utilize technology for health promotion and disease prevention

- Collaborate with quality improvement and information technology teams to design and implement processes for improving patient outcomes

- Evaluate innovative technologies for inclusion in processes to anticipate patient risk

- Demonstrate efficient and appropriate use of healthcare technologies to maximize healthcare outcomes

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