In December 2020, our leadership team decided to focus on educating and equipping bedside nurses to manage care of patients with diabetes and become skilled in providing diabetes education and resources. Realizing the strong impact a clinical nurse leader (CNL) could have on improving diabetes outcomes, the Diabetes CNL role was created in February 2021.
An in-depth assessment was conducted to evaluate the current state of diabetes education provided in our level 1 Trauma Center with more than 900 beds. The CNL was incorporated into the leadership team with the diabetes liaison meetings and introduced with an outline of the new and expanded role to include diabetes education. The Diabetes CNL took on projects that would provide updated resources for nurses such as a diabetes resources webpage, updating diabetes unit reference charts, creating a clinical case management (CCM) diabetes readmission discharge pathway, tracking and trending data to drive quality metrics, and having monthly meetings with unit liaisons to educate and discuss issues or needs of bedside staff.
The daily routine for this CNL includes reviewing the hospital's diabetes census report to identify blood glucose trends or elevated hemoglobin A1c levels and connecting with the nurse to implement effective care coordination and risk management. An example of a project completed by the Diabetes CNL is a new CCM discharge readmission risk pathway. A modified example is provided in Supplemental Digital Content Figure (available at: http://links.lww.com/JNCQ/B44). This pathway includes prescriptions lists, educational needs and resources, and additional recommendations for patients who may have financial or social determinants of health. In conclusion, a CNL is a diverse role that can be applied to many aspects of inpatient and outpatient care to improve the standards of care.