CNML Question Bank

A. Relationship Management

• Develops relationships across the care continuum to build alliances and partnerships and achieve common goals.
• Manages conflicts and disagreements in a constructive manner.
• Identifies the internal and external relationships that impact the work of the department/unit to achieve department/unit goals.
• Interprets organizational and strategic realities (e.g., labor costs, different models of care delivery, key performance indicators (KPI), supply chain disruption etc.) to navigate changes.
• Recognizes the impact on staff of the organization's decisions and takes appropriate action.

B. Effective Communication

• Communicates with clarity and integrity to build trust with all stakeholders.
• Identifies and understands different communication styles.
• Utilizes appropriate communication style when engaging different audiences.
• Practices transparency and honesty to demonstrate authenticity.
• Builds trust by listening to and engaging staff and others.

C. Influencing Behaviors

• Exchanges ideas to gain cooperation from others to accomplish goals.
• Uses information from multiple sources (e.g., evidence from research, data, reports) to gain consensus and commitment from stakeholders.
• Coaches staff in their development (e.g., conflict management, active listening, communication, etc.).
• Create policies and initiatives to influence desired departmental behaviors.

A. Nursing Practice and Application

• Assists with the development of care delivery models and environmental design to ensure the delivery of safe patient care that is evidence-based, accessible, affordable, and equitable.
• Recognizes the impact of internal and external factors on care delivery and departmental/unit finances.
• Integrates patient quality and safety measures into the care environment.
• Formulates objectives and priorities to implement plans of care delivery consistent with long-term interests of the department/unit.

B. Economics and Policy

• Supports alignment of the department with organizational strategies and with current developments in healthcare economics, policy and legislation.
• Maintains knowledge of population health.
• Influences health care policy through advocacy at various levels of government, as it affects safety, quality, accessibility and affordability of health care.

C. Regulation

• Maintains knowledge of regulatory and accreditation standard/rule changes.
• Seeks resources in support of their department/unit's compliance regarding regulatory requirements.
• Ensures compliance with accreditation standards and local, state, and federal regulatory standards.
• Participates with response to identified deficiencies.

D. Evidence Based Practice

• Evaluates current department/unit practices to determine strengths and barriers in implementing evidence-based practices.
• Promotes integration of evidence-based research into practice at the unit level.
• Supports staff by providing resources for implementation of evidence-based practices.

E. Patient Safety and Quality

• Maintains knowledge of patient safety and improvement sciences.
• Ensures the incorporation of patient safety and improvement sciences with department/unit's practices.
• Participates in risk assessment (e.g., FMEA, root cause analysis, etc.) to ensure safe, compliant and effective care delivery.
• Implements processes that result in prompt escalation of potential performance gaps by utilizing system processes and staff at the unit level.

A. Systems and Complex Adaptive Thinking

• Builds a shared vision that articulates and influences others to translate vision into action.
• Develops new insights into situations by questioning conventional approaches.
• Encourages staff to develop new and innovative ideas.
• Removes barriers to help implement new cutting-edge programs/processes.
• Creates and executes strategies for complex situations (e.g., addressing safety issues with workload capacity, increase nursing time at bedside, reducing hospital acquired conditions (HACs), etc.).
• Participates in nursing and organizational strategy planning and execution.

B. Change Management

• Acts as a catalyst for change by seeking new information and ideas.
• Adapts to new information, changing conditions and unexpected obstacles.
• Assesses through analytics (e.g., gap analysis, swot, etc.) if change is necessary.
• Utilizes common change models (e.g., KOTTER, LEWIN) and other tools for change (e.g., PDSA, LEAN methods).
• Supports staff in managing departmental changes.

C. Diversity, Equity, Belonging and Inclusion

• Recognizes unconscious and systemic bias occurs in care delivery, business operations, and through external influences.
• Leads and supports initiatives that address racism, discrimination and bias in care delivery and business operations.
• Encourages creative tension and differences of opinions.
• Fosters an inclusive workplace where diversity and individual differences are valued and maximized to achieve the vision and mission of the organization.
• Develops the ability of others to perform and contribute to the achievement of their goals consistent with the organization's vision and mission corresponding with individual needs.
• Provides feedback and opportunities for others to learn through formal and informal methods corresponding with individual needs.
• Creates, promotes, and protects a culture that supports staff, patients/clients and stakeholders.

D. Decision Making

• Seizes opportunities and takes calculated risks to advance department/unit's mission and vision.
• Identifies and objectively analyzes department/unit's problems and issues.
• Evaluates availability, relevance and accuracy of information.
• Generates and evaluates alternative solutions.
• Makes decisions that impact department/unit operations and incorporates an understanding of the impact and implications of their decisions.
• Makes timely, equitable, and appropriate decisions when data is available and when it is limited.
• Delegates responsibilities based on scope of practice, education, appropriate competence, and experience.
• Fosters professional governance in philosophy, structure and implementation.
• Empowers team to make independent decisions that affect their practice.

E. Transformation and Innovation

• Encourages the use of organization's framework on advancing innovation.
• Allocates resources for the development of innovation teams or methods.
• Supports the implementation of innovative ideas.

A. Professional Accountability

• Upholds professional ethical principles in decision making through personal, department/unit and staff accountability.
• Supports, promotes and role models standards of nursing and leadership professional practice (clinical, educational, certification and leadership) for colleagues and constituents.
• Solicits feedback from trusted sources about personal strengths and opportunities for improvement and incorporates the information into practice.
• Maintains competency through nationally recognized leadership certification.
• Participates in professional organizations that advance one's leadership practice and career development.
• Encourages staff to engage in their career development.

B. Organizational Accountability

• Aligns behavior with personal values and determines fit with the organization's culture.
• Ensures the voice of the patient is central and present in decision-making.
• Ensures a culture of accountability by holding self and others accountable for measurable high quality and cost effective outcomes.
• Follows up regularly with staff to ensure that desired outcomes are being achieved.
• Recognizes career opportunities for staff based on strengths and interests.
• Exhibits leadership presence (e.g., attending team meetings, vocal, fostering discussions, lead rounds, etc.).

C. Health Equity and Social Determinants of Health

• Reviews organization's needs assessment to identify current health equity issues.
• Creates action plan to see how to close the gap on department/unit health equity issues.
• Provides staff with tools and resources to provide culturally competent care (e.g., translation resources, discharge materials, appropriate referrals).
• Supports staff in participation of community-based activities that address community care.
• Coordinates and facilitates orientation related to culturally competent care.
• Evaluates culturally competent care through performance appraisals.
• Monitors performance data to ensure the delivery of culturally competent care.

D. Governance

• Interacts with and educates the organization's governing body regarding health care and the value of nursing as directed by senior leadership.
• Interacts and educates the organization's governing body regarding quality and patient safety principles as directed by senior leadership.
• Articulates the governing body's (e.g., Board) role in how the organization's mission is achieved.
• Assists leadership in preparing reports for the Board.

A. Financial Management

• Manages department budget by understanding and utilizing organization's financial processes.
• Maintains knowledge of reimbursement models that affect care delivery.
• Maintains knowledge of healthcare economics and business models to set priorities and measurable goals.
• Participates in creation of department budget.
• Manages department budget (e.g., allocation of resources, staffing, supply chain management, etc.)
• Monitors department budget to ensure accuracy of expenses and identify variances.
• Makes adjustment of budget as indicated by variances.
• Supports financial health as it is influenced by nursing and other clinical decisions and outcomes.

B. Strategic Management

• Communicates to staff high reliability concepts (e.g., safety huddles, use of evidence, deferring to expertise, etc.) as identified by the organization.
• Utilizes multiple sources of evidence-based data in goal setting and decision-making.
• Ensures departmental objectives are in place to achieve the strategic mission.
• Participates in the negotiation, monitoring and management of contract and service agreements.
• Aligns and creates nursing/clinical objectives, goals and tactics required to achieve the organization's strategic outcomes.
• Recognizes and supports the benefit and impact of technology on care delivery, clinical information, and financial outcomes.
• Uses evidence-based metrics to align department/unit's goals and objectives with patient outcomes.

C. Human Resource Management

• Builds and manages a diverse workforce based on organizational, professional nursing, clinical goals and outcomes, data, budget considerations, and staffing needs.
• Ensures that employees are recruited, selected, on boarded, educated, evaluated, and recognized according to established standards, applicable employment laws, and the organization's mission vision and values.
• Manages a multisector workforce and a variety of work situations.
• Assesses the unit's culture to ensure the presence of a safe and healthy work environment.
• Addresses any gaps associated with the cultural assessment of a safe and healthy work environment.
• Advances organizational policies that allow employees to practice at the top of education and or license.
• Establishes mechanisms that provide for identification and mentoring of staff for career progression.