O bjective: The Institute of M edicine's Future o f Nursing report identifies the Clinical
Nurse Leader (CNL) as an innovative and necessary new role for m eeting higher
healthcare quality standards. The A m erican A ssociation of Colleges of N ursing CNL
W hite Paper defines core com petencies necessary for practice. The lite ra tu re
docum ents prelim inary evidence of im proved outcom es associated w ith CNL
integration into clinical m icrosystem s. However, the CNL role is n o t y e t clearly
defined in term s of fundam ental activities and responsibilities n ecessary to produce
outcom es. Lack of practice clarity lim its the ability to articulate, im plem ent, and
m easure CNL-specific practice and outcom es. The p urpose of this stu d y w as to
clarify CNL practice com ponents contributing to im proved quality care stan d ard s.
M ethods: An interpretive synthesis w as conducted to integrate th e e x tan t CNL
literature into a coherent understanding of CNL practice. A literature search w as
conducted in CINAHL, Pubm ed, D issertations and Theses, and Google. Results w ere
review ed and included if they described aspects of CNL practice in action. T hirty
im plem entation reports, eight qualitative/m ixed m ethods studies, th ree
quantitative studies, and 254 conference ab stracts w ere included. G rounded theory
m ethodology w as utilized to reanalyze prim ary CNL evidence and identify dom ains
and com ponents of CNL practice.