Evolutionofnursing

The Evolution of the CNL

  • HMO Act

    HMO Act
    Required employers with more than 25 employees to offer HMO health coverage, all employees to pay the same premiums.
  • Regulation of healthcare

    Regulation of healthcare
    The 1980s were years of takeovers and increased health regulation. Smaller insurance companies and hospitals became huge HMOs and care systems.
  • Skyrocketing healthcare costs

    Skyrocketing healthcare costs
    Healthcare costs increase drastically as technology booms.
  • Inadequate nurse staffing/uneven quality of care

    Inadequate nurse staffing/uneven quality of care
    Managed care has pushed hospitals to decrease cost by increasing nurse/pt ratios. Travel nursing emerges.
  • Balance Budget Act of 1997

    Balance Budget Act of 1997
    The Balanced Budget Act (BBA) of 1997 was introduced as a cost-saving measure that significantly cut Medicare reimbursements to hospitals, physicians, home health agencies, and skilled nursing facilities, with planned net spending reductions of $116.4 billion from 1998 to 2002 (Rivers and Tsai 2002).
  • IOM Quality of Healthcare in America; To Err is Human

    IOM Quality of Healthcare in America; To Err is Human
    Part 2 of the development a healthcare improvement strategy regarding patient safety
  • Nursing/nursing faculty shortage ensues

    Nursing/nursing faculty shortage ensues
    Not enough nurses working currently, not enough nursing students enrolled and not enough nursing faculty.
  • IOM: Crossing the Quality Chasm

    IOM: Crossing the Quality Chasm
    Phase 3 of QI--One of its foci is the interface between clinicians and patients.
  • AACN Taskforce

    AACN Taskforce
    Formed to "transform professional nursing education and create a nursing workforce capable of meeting healthcare demands" (Bartels & Bednash, 2005).
  • Global Nursing Dissatisfaction

    Global Nursing Dissatisfaction
    Aiken et al find that nursing dissatisfaction and uneven quality of hospital care is not uniquely American(People to People Health Foundation, 2001). "Fundamental problems in the design of work" were plaguing the profession of nursing. "Reengineering has moved to reduce front-line nurse leadership roles" at a time when they are most needed.
  • JCAHO: Healthcare at the Crossroads

    JCAHO:  Healthcare at the Crossroads
    JCAHO "Creates awareness of the need to assess whether a simple focus on the number of professionals should be replaced by a concern for assuring the critical nurse competencies are present to deliver high quality and safe patient care" (Bartels & Bednash, 2005).
  • Aiken Study

    Aiken Study
    Landmark study by Linda Aiken reported that "hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to rescue rates" (JAMA, 2003).
  • Fundamental Aspects of CNL Role Defined

    Fundamental Aspects of CNL Role Defined
  • AACN White Paper: Role of the CNL

    AACN White Paper: Role of the CNL
    Proposal regarding the education and role of the Clinical Nurse Leader from which our current curriculum has been developed.