CNL case studies
CNL · Put your knowledge to work in context.
The Clinical Nurse Leader (CNL®) is a master's-educated nurse prepared for practice across the continuum of care within any healthcare setting. AACN developed the role in 2004 in collaboration with leaders from healthcare practice and education to address a critical need: improving the quality of patient care outcomes. The CNL case studies are 5 cases and about 4,509 words.
1The 13-Drug Discharge With No Follow-Up
R is a 68-year-old admitted 4 days ago with acute decompensated heart failure (EF 30%, eGFR 38, A1c 9.1%). His discharge medication list now has 13 drugs reconciled from three prescribers (cardiology, nephrology, endocrinology); his pre-admission list had 9.
795 words, about 4 min2The Fall Rate That Tripled Overnight
A 32-bed medical unit's fall rate jumped from 2.4 to 4.1 falls per 1,000 patient days between Q3 and Q4 against a benchmark of 3.0. Three things changed at once: a new mobile incident-reporting app let any staff member file in seconds, the quality department adopted a broader definition capturing "falls with any assistance," and the unit's case mix shifted toward observation patients (mean length of stay 4.8 to 3.1 days).
890 words, about 4 min3Friday at 4 p.m. With a New Anticoagulant
A 74-year-old woman is being discharged after a 6-day stay for a COPD exacerbation; new-onset atrial fibrillation was started on apixaban 5 mg twice daily. Her home list includes aspirin 81 mg, which was continued.
930 words, about 5 min4"He's Just Splinting"
Postoperative day 1 after a converted open cholecystectomy: a 58-year-old man with BMI 41 and diagnosed obstructive sleep apnea is on the surgical floor. The bedside nurse documents respiratory rate 28, SpO2 90% on 2 L, heart rate 118, and pain 8/10, and notes he is increasingly drowsy.
927 words, about 5 min5Four Pressure Injuries in One Quarter
A 28-bed medical unit recorded zero hospital-acquired pressure injuries in Q3 and four in Q4 - two stage 2 and two unstageable. Chart audit shows Braden scores documented on 96% of admissions but reassessment after a change in condition in only 41%, and turning documented on 58% of high-risk patients.
967 words, about 5 min