A study protocol to evaluate the implementation and effectiveness of the Clinical Nurse Leader Care Model in improving quality and safety outcomes

Nurs Open. 2021 Nov;8(6):3688-3696. doi: 10.1002/nop2.910. Epub 2021 May 3.


Aims: Patients are harmed or die every year because of unsafe, inappropriate or inadequate healthcare delivery. Registered Nurses are a recognized patient safety strategy. However, variability in research findings indicate the relationship is not as simple as "more nurses=better outcomes." Hence, currently there exists no evidence-based frontline nursing care model. One emerging model is the Clinical Nurse Leader care model.

Design: This Hybrid Type II Implementation-Effectiveness study will evaluate the effect of the care model on standardized quality and safety outcomes and identify implementation characteristics that are sufficient and necessary to achieve outcomes.

Methods: This study leverages a natural experiment in 66 clinical care units in nine hospitals across five states in the United States that have implemented the Clinical Nurse Leader care model.

Results: Findings will elucidate Registered Nurse's mechanisms of action as organized into frontline models of care and link actions to improved care quality and safety.

Keywords: clinical nurse leader; evidence-based care delivery; implementation; nursing care delivery.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Delivery of Health Care
  • Evidence-Based Nursing
  • Humans
  • Nurses*
  • Patient Safety
  • Quality of Health Care
  • United States