Creating a Clinical Ladder Project: Ideas and Strategies for Success

Rebecca Flynn, MSN, RN, AMB-BC, NE-BC
August 8, 2023

Creating a Clinical Ladder Project: Ideas and Strategies for Success

The clinical ladder project is a great way to recognize and reward nurses for their professional skills and accomplishments. It recognizes nurses for their contributions to patient care and their professional development. Implementing a clinical ladder project can be challenging, but many great ideas are out there to help you get started. This blog post will explore some of the best clinical ladder project ideas to help you create an effective program for your nurses.

What is a nursing clinical ladder?

The nursing clinical ladder was developed to encourage valuable clinical nursing behavior that is evidence-based, and recognizes nurses for their education and leadership. The clinical ladder combines professional development and competency-based systems to promote nursing advancement based on a point system that enables nurses to advance their education and certification status. According to JONA, nurses participating in a clinical ladder program are more engaged, have higher job satisfaction, and produce evidence-based care for their patients.

Nursing clinical ladders include the following criteria to determine how far up the ladder the nurse is:

  • Clinical experience
  • Education level
  • National certifications.

The activities a nurse participates in also impact the level they achieve on the clinical ladder. Nurses can earn additional points for work in the following areas:

  • Clinical coach or preceptor
  • Participation in quality improvement projects
  • Shared governance or other leadership activities
  • Leading or participating in professional development activities.

How are projects incorporated into the clinical ladder?

Because evidence-based practice is essential to the clinical ladder program, projects that improve access to care, quality of care, cost-effectiveness, or service are critical to the clinical ladder program. The nursing clinical ladder helps nurses get out of the mindset that "we have always done it this way" by empowering them to research and discover better solutions.

Nursing Management tells us that there are steps nursing leaders and advisors can encourage clinical nurses to use to find projects for their clinical ladder project:

  • Identify researchable problems that occur in the unit
  • Identify patient care problems or protocols that don’t work
  • Ask “why” are we performing tasks in this way
  • Systematically research literature and evaluate current practices
  • Consider clinical experience and patient preferences
  • Implement new ideas and re-evaluate the success

According to Nursing Economics, one of the most significant barriers to the success of the clinical ladder is the need for more support from the nursing administration due to the cumbersome and time-consuming nature of the paperwork involved in reviewing clinical submissions. Staffgarden provides a solution to the paperwork deluge that comes with a clinical ladder project by creating a digital platform where the nurse can upload their project, and the administrator can monitor it in real-time. Clinical ladders encourage quality improvement projects that improve nursing care throughout the hospital. Nurses use evidence-based practice techniques to create more efficient, safer practices for their patients in their daily work and get rewarded for it.

Innovative Nursing Clinical Ladder Project Ideas

Nurses provide innovative projects worldwide, and the nursing clinical ladder only encourages innovation. The Health Foundation shares a list of a few ways that clinical nurses can use their bedside care to improve safety and quality for patients and staff members.

Nurses can use the clinical ladder for many innovative quality and safety ideas:

  • Decrease pressure injuries to patients
  • Improve access for cancer patients
  • Normalize telehealth visits for psychiatric services
  • Streamline patient flow in hospital admissions and discharges
  • Implement rapid assessments for pediatric clinics
  • Improve consistency of Medicare Annual Wellness Exams
  • Improve Metabolic and Diabetes Screenings

Evidence-based practice takes a clinician's work every day and incorporates research, clinical experience, and patient preferences to produce workflows that benefit everyone. Staffgarden takes these clinical projects and creates a repository for the healthcare system so others can go back and see the work that has been done in the past to improve patient safety and quality.

Nurses recognize that healthcare is ever-changing and there is a need for change at the bedside. The nursing clinical ladder rewards nurses for their professionalism and clinical competence. This blog has given a few examples of projects nurses can use as clinical ladder project ideas, but the list is endless. Staffgarden streamlines the process so clinicians can see what their co-workers have done in the past and creates an ease of use that simplifies the submission of projects.

The clinical ladder encourages these nurses to step up and make changes in their daily work by rewarding resourcefulness and hard work. Staffgarden is a software platform that helps nurses create solutions they can share with their team to showcase and model their hard work for the next generation of nurses.


The Health Foundation. (2015, October 27). Twenty-one innovative projects are selected to improve the quality of health care.

Ko, Y. K., & Yu, S. (2014). Clinical ladder program implementation. JONA: The Journal of Nursing Administration, 44(11), 612-616.

Myers, G., & Meccariello, M. (2006). From pet rock to rock-solid: Implementing unit-based research. Nursing Management (Springhouse), 37(1), 24-29.

Nelson, J., Sassaman, B., & Phillips, A. (2008). Career Ladder Program for Registered Nurses in Ambulatory Care. Nursing Economics, 26(6), 393-398.

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