CNL Summit 2013 Abstract
Abstract Title:
Clinical Nurse Leaders at the forefront guiding healthy behaviors in
prenatal care and pediatrics with a focus on childhood obesity utilizing the national initiative
"Let's Move" with a foundation in Pender's Health Promotion Model
Authors & Credentials:
Chelsea Condon BBA (CNL student), Sarah Dillon BS (CNL
student), Kelly A. Phillips PhD, RN, CNS, CNL, Lauren Snyder BA (CNL student), Tandy
Szabo BA (CNL student), Kimberly Vriezelaar BEd (CNL student)
Institution: The University of Toledo College of Nursing
City/State: Toledo Ohio
Primary Contact Email:
kelly.phillips5@utoledo.edu
Background Information:
Current health care delivery is beleaguered by fragmented approaches to patient care that
are linked to adverse outcomes. In addition, escalating health care costs continue to drive the
need for evidence-based practice improvements. The educational preparation of the Clinical
Nurse Leader (CNL) allows them to address gaps in the areas of prenatal health care and
childhood obesity. Because of their clinical knowledge and leadership skills, CNLs are optimal
coordinators of care prepared to implement evidence-based practice and can apply their
education to coordinate multidisciplinary care.
Nutrition and weight management before, during, and after pregnancy has a profound
effect on the development of infants. Prenatal nutrition has a strong influence on birth weight and
further development of the infant. Maintaining a healthy weight during pregnancy lowers risks
for infants to develop chronic conditions later in life such as childhood obesity.
The prevalence of obesity among children and adolescents has almost tripled since 1980
(CDC, 2012). Programs such as “Let’s Move”, a government initiative to address the childhood
obesity epidemic have been implemented to promote healthy behaviors such as physical
activities and healthy eating. Health Promotion Model theorist, Dr. Nola Pender, created a
program called “Girls on the Move” to increase children’s physical activity participation. On the
macro-system level, the CNL can promote health initiatives such as these to engage the
community and promote healthy behaviors prenatally and beyond.
Aim:
The presentation will reflect on the beneficial leadership attributes of the CNL and how
they are able to lead an interdisciplinary team or participate as a resource for a team. Past
examples will be cited utilizing evidence-based practice as a foundation for problem solving
across diverse health care settings and improving patient outcomes. The focal point of the
presentation will be promoting the need for leadership in women's health, specifically related to
prenatal nutrition, and in pediatric nursing leadership related to childhood obesity.
Emphasis is being placed on increasing care for the aging population with little attention
being given to infants and children thus producing a need for Clinical Nurse Leaders (CNLs) to
design effective ways to decrease health disparities and promote healthy transitions into
adulthood for children with chronic conditions. The increase in prevalence of chronic conditions
in children has produced a need to educate pediatric nurse leaders to address the complex issues
facing these children and their families. Simultaneously, The Bureau of Health Professions
(BHP) estimates that there will be a shortfall of 1 million nurses by year 2020 (National Center
for Health Workforce Analysis, BHP, Health Resources and Services Administration, 2005).
Methods/Programs/Practices:
A literature review was conducted to identify how leadership skills within the CNL role
can be used to promote healthy behaviors in prenatal care and help to reduce the prevalence of
childhood obesity. A conversation with Dr. Nola Pender regarding her Health Promotion Model
and “Girls on the Move” provided the theoretical framework to identify strategies that can be
applied by CNLs. The national initiative “Let’s Move” was used to identify current strategies
that are being utilized to promote healthy behaviors beginning with prenatal care and throughout
adolescence.
The CNL skills within the core competency of health promotion, risk reduction, and
disease prevention include the ability to help clients and populations access and interpret health
information to identify healthy lifestyle behaviors. Initiation of community partnerships to
establish health promotion goals and implementing strategies to meet those goals, is also a skill
within the core competency. Dr. Pender's comments that were shared with our group support the
need for leadership while implementing this core competency within the following statement. "I
sit on the U.S. Preventative Services Task Force and we know that it takes multiple programs at
all levels to make health promotion and prevention happen. So, the community based programs
that are sound, as many of them as we can get going at all levels is essential to provide the
environment for the CNL to provide counseling. All the programs whether media, school based,
or community based are critical, the more we get going the better it is."
Outcome Data:
Research has shown that the CNL role has helped bridge gaps in patient care. The
literature indicates an improvement in organization, professional development, and professional
relationships through the utilization of CNLs. Because CNLs are educated to employ evidencebased practice while coordinating care for an individual, it is expected that they will promote a
national health initiative to decrease obesity in children beginning with proper prenatal care.
Because the CNL role has a focus on leadership, CNLs have the ability, opportunity, and vision
to successfully promote healthy behaviors and lifestyles in the fields of women's health and
pediatric nursing.
Conclusion:
The rise in childhood obesity reveals a need for increased leadership in the fields of
women's health and pediatric nursing. The role of the CNL has been found to possess the ability
to fulfill such needs and promote quality of life in children.
Initiatives such as “Let’s Move” and “Girls on the Move” provide examples of strategies that
can be applied in the nursing field to promote healthy behaviors in children. The leadership skills
of nurses in the CNL role provide the ability to successfully address health promotion related to
childhood obesity with their pediatric patients.
The research supports a vision for the future with CNLs at the forefront guiding
improvement in women's health and pediatrics with a focus on nutrition. The growth of this
dynamic leadership role hinges on proven performance, positive marketing and promotion of the
role, thus ultimately impacting the value of the CNL role on improving patient outcomes.