e-Newsletter of Moravian College and Moravian Theological Seminary | February 15, 2013 Twitter Facebook

Moravian CNL graduates break new ground in the Valley

Helen Smith MS, RN, CNL, left, and Jan Broniec, MS, RN, CNL are the first two graduates of Moravian's clinical Nursing Leader track.

Jan Broniec, MS, RN, CNL and Helen Smith MS, RN, CNL are the first two graduates of Moravian College’s new Clinical Nursing Leader (CNL) track of its Master of Science Program in Nursing and are currently the only CNLs in the Lehigh Valley.

They enrolled in the program as part of Moravian’s partnership with St. Luke’s University Health Network (SLUHN), and work to improve the quality and efficiency of care and reduce re-admission for heart failure patients discharged from St. Luke’s Hospital. The CNL is the newest accredited graduate-level certification for nurses since the creation of the nurse practitioner role in the 1960s. The primary aim of the CNL is to coordinate patient care and decrease the fragmentation of care that often occurs between the hospital setting and the home or rehabilitation settings.

Lori Hoffman, associate professor of nursing, says that CNLs ensure that “patient care is individualized and there is continuity throughout their episodes of illness to wellness care.” CNLs coordinate patient care by working with nurses, physicians, social workers and therapists to ensure that the team operates efficiently and the care maximizes the patients’ quality of life.

The coursework for CNL track students at Moravian focuses on ethics, bioinformatics, improvement of nurse and doctor communication, individualized patient care and making decisions based on the most relevant evidence. Broniec says, “It [the training she received at Moravian] was excellent preparation. We had great teachers and were surrounded by people who were passionate about championing the role.”   
The partnership between Moravian and SLUHN allowed Broniec and Smith, who were nurses at St. Luke’s with backgrounds in cardiac care, to train for their new roles as CNLs. Broniec and Smith both began working at St. Luke’s on October 1, 1990. They met at worker orientation and have been friends and co-workers ever since. They began Moravian’s CNL program together in September of 2010, completed the program together last October, and passed their certification exam together in December.

Broniec and Smith wanted to earn advanced degrees, but neither wanted to give up the direct impact they had on patients through their work at St. Luke’s. The CNL role allowed them to earn those degrees and still play an integral part in the patient care process. Broniec says the partnership between Moravian and St. Luke’s made the pair more comfortable about their decision because of their financial support during the coursework and a guarantee of employment once they completed the program and certification.

During their CNL internship experiences with Kerry Cheever, professor of nursing, Broniec and Smith completed capstone projects, which they recently had the opportunity to present at the American Association of Colleges of Nursing 2013 CNL Summit. In her project, Smith worked with an interdisciplinary team of doctors, nurses and other caregivers to help patients initiate palliative care earlier in their disease trajectory. The goals of the project were to help patients manage their symptoms at home, to keep them out of the hospital, and to improve their quality of life.

Broniec’s project consisted of an educational intervention held for rehabilitation staff at nursing homes. She educated staff members about heart failure management practices employed by the most successful nursing facilities. Broniec intended the intervention to ease the transition of care between hospitals and rehabilitation centers and prevent patient readmission to the hospital.

Since starting their new roles at St. Luke’s as CNLs, Broniec and Smith have worked to improve the quality of the hospital’s care and make it more efficient. Improving hospital efficiency is especially important with new changes to Medicare that penalize hospitals with high readmission rates.

“We have a 360-degree view of the hospital, not just the narrow view [they would have as a bedside nurse]. We see where there are gaps [in patient care] and how we can make them better,” says Broniec. “Improving quality and reducing costs is necessary to improving healthcare sustainability.”

Their efforts have been successful so far. Since it initiated the CNL Heart Failure Coordinator role, St. Luke’s hospital has seen a reduction in the frequency of heart failure readmission, with a rate that dropped by 2 percent—from 24 to 22 percent—in its first year.

The progress seen by hospitals instituting CNL programs throughout the country has been remarkable and has made the CNL a highly desired position. Smith says, “I’m hoping to see more CNLs come up through the ranks. The future of nursing is in this role.”