The effectiveness of the clinical nurse leader practice - systematic review

  • Marlene Celeste Carvalho Lisbon Nursing School, Lisbon, Portugal
  • Pedro Ricardo Lucas Lisbon Nursing School, Lisbon, Portugal
Keywords: Leadership, Clinical nurse leader, Microsystem, Efficacy


Introduction: The leadership of clinical nurse leaders is a topic of increasing importance, since nurses, as leaders, are the fundamental piece to communicate with the team and achieve objectives and results, such as the quality of nursing care, the patient safety and health innovation.

Objectives: To analyze the scientific evidence about the effectiveness of nurses in the development of skills associated with the practice of clinical leader.

Methods: Systematic literature review with 3 steps. 1) An initial search at CINHAL and MEDLINE. 2) A broader search, using the same keywords and search terms, in the remaining databases of the EBSCO Host platform. 3) Search the bibliographic references of the selected articles. The selected studies were from the period between 2010 and 2019.

Results: Twelve articles were selected in different contexts of clinical nurse leader practice. Most reported findings that relate the effectiveness of clinical nurse leaders with clear improvements in performance and, consequently, improvement in health care outcomes.

Conclusions: The skills of the clinical nurse leader are part of an advanced practice, with better performances that lead to an increase in the quality of nursing care, health care and an increase in patient safety.


American Association of Colleges of Nursing (AACN). (2007). Implementing a new nursing role – the Clinical Nurse Leader – for improved patient care outcomes. Final report of the implementation task force. Washington, DC: Author.

Baernholdt, M., & Cottingham, S. (2011). The Clinical Nurse Leader - new nursing role with global implications. International Nursing Review, 58(1), 74-78. doi:10.1111/j.1466-7657.2010.00835.x.

Bender, M. (2016 a). Clinical nurse leader integration into practice: developing theory to guide best practice. Journal of Professional Nursing, 32(1), 32–40.

Bender, M. (2016 b). Conceptualizing clinical nurse leader practice: an interpretive synthesis. Journal of Nursing Management, 24(1), 23 - 31.

Bender, M., L’Ecuyer, K., & Williams, M. (2019). A clinical nurse leader competency framework: concept mapping competencies across policy documents. Journal of Professional Nursing.

Bender, M., Williams, M., & Su, W. (2016). Diffusion of a Nurse-led healthcare innovation: Describing certified clinical Nurse Leader integration into care delivery. Journal of Nursing Administration, 46(7–8), 400–407.

Bombard, E., Chapman, K., Doyle, M., Wright, D. K., Shippee-Rice, R. V., & Kasik, D. R. (2010). Answering the Question, “What Is a Clinical Nurse Leader?” Journal of Professional Nursing, 26(6), 332–340.

Clavo-Hall, J. A., Bender, M., & Harvath, T. A. (2018). Roles enacted by Clinical Nurse Leaders across the healthcare spectrum: A systematic literature review. Journal of Professional Nursing, 34(4), 259–268.

Gerrish, K., Guillaume, L., Kirshbaum, M., Mcdonnell, A., Tod, A., & Nolan, M. (2011). Factors influencing the contribution of advanced practice nurses to promoting evidence-based practice among front-line nurses: Findings from a cross-sectional survey. Journal of Advanced Nursing, 67(5), 1079–1090.

Gilmartin, M. J. & Nokes, K.(2015). A Self-Efficacy Scale for Clinical Nurse Leaders®: Results of a Pilot Study. Nursing Economic$. 33 (3). 133-143.

Gilmartin, M. J. (2014). Variations in clinical nurse leaders’ confidence with performing the core role functions. Journal of Professional Nursing, 30(4), 307–316.

Houskamp, E. S. (2013). A Case Study Investigating The Development, Implementation, And Perceptions of Transformational Leadership Practices of The Clinical Nurse Leader. ProQuest Dissertations and Theses. Retrieved from 2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&genre=dissertations+&+theses&sid=ProQ:ProQuest+Dissertations+&+.

Levac, D., Colquhoun, H. & O’Brien, K. K. (2010). studies: advancing the methodology. Implement Science; 5(69):1–9.

Moher, D., Liberati, A., Tetzlaff, J. & Altman, D. G. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Annals of Internal Medicine; 151:264–269. DOI: 10.7326/0003-4819-151-4-200908180-00135.

Nunes, E. & Gaspar M. (2016). A liderança em enfermagem e a satisfação dos pacientes em contexto hospitalar. Revista Gaúcha de Enfermagem; 37(2):1983-1447.

OCDE (2017). Health at a Glance 2017: OCDE Indicators. OCDE Publishing, Paris.

Perry, A. (2013). The clinical nurse leader: Improving outcomes and efficacy in the emergency department. Journal of Emergency Nursing.

Peters, M., Godfrey, C., McInerney, P., Soares, C. B., Khalil, H. & Parker, D. (2015). Methodology for JBI reviews. The Joanna Briggs Institute Reviewers’ Manual. Adelaide (Australia): The Joanna Briggs Institute; 2015: 1–24.

Rankin, V., Raleyea, T., & Sotomayor, G. (2018). Clinical Nurse Leaders forging the path of population health. Journal of Nursing Professional. 34. 269-272.

Sorbello, B. C. (2010). Clinical nurse leader sm stories: a phenomenological study about the meaning of leadership at the bedside. (tese de doutoramento). Florida Atlantic University, Florida.

Sotomayor, G. & Rankin, V. (2017). Clinical Nurse Leaders: Fulfilling the Promise of the Role. MEDSURG Nursing, 26(1), 21–32. Retrieved from

Wesolowski, M. S., Casey, G. L., Berry, S. J., & Gannon, J. (2014). The clinical nurse leader in the perioperative setting: A preceptor experience. AORN Journal.

Wilson, L., Orff, S., Gerry, T., Shirley, B. R., Tabor, D., Caiazzo, K., & Rouleau, D. (2013). Evolution of an innovative role: The clinical nurse leader. Journal of Nursing Management, 21(1), 175–181.

Life and Healthcare Sciences