The vision of the Clinical Nurse Leader Association is to improve patient outcomes through a focus on safety and quality outcomes and the implementation of evidence based practice at the point of care.
Reni Mattathil DNP, MSN, RN-BC, CNL
Dr. Mattathil is a seasoned nurse with more than 34 years of nursing experience. The last three years, she has been serving as a Clinical Nurse Leader on acute care medical-surgical units at Dallas VA Medical Center, Dallas Texas. She also serves as a part-time Clinical Instructor with Chamberlain University in their BSN program.
She serves on two similar units with a total capacity of 33 beds. These units are capable of taking care of a wide variety of patients including major surgeries of different specialties, and cardiac and chronic disease patients. Dr. Mattathil focuses on improving the outcomes of the units and she uses her expertise in evidence-based practice for every issue that affects outcomes. As a CNL, she works with local and national stakeholders and serves in different capacities that will help her to receive and share expertise on various issues.
In 2022, her units experienced an almost 70% increase in Hospital Associated Pressure Injuries (HAPI) in less than three months. She collaborated with Nurse Managers and front-line staff to find out the root causes of the acute spike. Based on the best evidence and staff input she led a back-to-basic HAPI prevention project. As a result of the project, the HAPI rate of the unit decreased to 0% for four months. With her consistent and ongoing effort, the units have been able to maintain a low HAPI rate (the average <1 %) ever since the project was initiated.
Preventing and managing hypoglycemia has always been a favorite subject for Dr. Mattathil. She chose the same subject titled, “Hypoglycemia Management Bundle” as her doctorate project. The bundle has mainly four components and all areas had a great outcome. Hypoglycemia episode rates decreased from 26.78 per 1,000 patient days before the implementation to 10.27 per 1,000 patient days after the implementation with a p-value of < 0.001. Patient education increased from 0.5% before the implementation to 100% after the implementation with a p-value of < 0.001. Insulin given with food increased from 0.7% before the implementation to 76.2% after the implementation with a p-value of < 0.001. Hypoglycemia protocol initiated immediately increased from 9.4% before the implementation to 82.4% after the implementation with a p-value of < 0.001. 15-minute recheck occurred increased from 9.4% before the implementation to 82.4% after the implementation with a p-value of < 0.001.
Many professional organizations and agencies accepted this project. In 2022, This project received an ICNLA research grant, and she presented this at the CNL summit. This abstract was chosen for the 2022 QSEN International forum. Also, this project was presented at the 2023 Fuld National Institute EBP summit, Nurses Month celebration, and poster presentation by the Office of Nursing Service, Washington DC. Also, this project was published in Nursing Care Quality as a peer-reviewed, CEU-offered QI project.
Currently, she is working on a project that will improve documentation. Her unit and other similar units are experiencing ongoing issues with a lack of proper documentation. As a CNL, she assessed the situation and found out that the lack of knowledge about the items audited from the documentation was the main reason behind the non-compliance. Therefore, she created a team with the support of the Nurse Manager and front-line staff that created a test to assess the existing knowledge of the staff. After that, she provided education and a post-test. The pre-test revealed that a lack of knowledge was the main issue behind the non-compliance. While the project is ongoing, the national leadership team liked the project, and she has presented it at one of the national meetings. Furthermore, she has received invitations to present this project in different VAs from the individual facility leadership.
She is an active member of many VA enterprise-wide committees. She also participates in the National Field Advisory Council on Metabolic Syndrome and Diabetes, offering her expertise to create competencies and information to improve diabetes and metabolic disease. Additionally, she is a member of the National Nurse Practice Council and has led or participated in many initiatives that improve nursing practice. She was selected to work with the VA national leadership team to create education for unlicensed assistive personnel medication administration. This education was created for enterprise-wide use.
Apart from sharing her knowledge and skills within the facility she works; she is involved in the community and various professional organizations. She works closely with the Commission on Nurse Certification serving as an item writer and reviewer for the CNL Certification Exam. She also enjoys volunteering her time with credible organizations in their humanitarian efforts both nationally and internationally.