NSG3EPN Engagement in Professional Nursing: Clinical Governance

you are required to;

• Identify one of the 10 standards from the National Safety and Quality Health Service Standards (2017).
• Identify and describe the major risk associated with that standard. This might include:

.What is the potential outcome if best practice is not adhered to?

.What is the incidence/prevalence? o How will this effect patient outcomes? · Identify and describe two strategies that you may employ as a registered nurse to improve patient outcomes for this standard.

Leadership and Management:

This module requires you to complete the Leadership Skills Inventory (on LMS) and reflect upon your result.

In light of your results, please answer the following;

• Identify and explore two leadership skills that Registered Nurses must bring to their role? Use evidence from the literature to support why these skills are important.
• As a result of the inventory, describe one skill that you would like to further develop and briefly identify the strategies that you might use to achieve this.

Organisational culture:

As a registered nurse, you are be responsible for your own learning and professional development.

You are required to;

• Identify the defining characteristics of a learning culture.
• Describe two ways in which you, as a registered nurse, may contribute to a culture of learning within your organisation.

Professional practice

There are many potential sources of stress when working as a registered nurse. Developing and implementing coping strategies to manage stress is an important skill for all nurses.

You are required to;

• Define one of the following terms – role conflict OR role ambiguity – discuss the impact that the chosen concept may have on a registered nurse.
  
  
• Identify and describe two self–care strategies that you will employ to facilitate you staying emotionally and physically well.

Answer:

Clinical Governance

In the Australian healthcare system, there are various ways in which consumer participation helps in shaping healthcare service delivery.  The ways include; decision making, planning, support, and feedback. In this paper, I shall focus much on only two ways, that is, decision making and support. Consumer participation becomes a success when consumers, caregivers, and the community members are closely and meaningfully involved in the process of decision making concerning the health care policies and budgeting, care and the treatment process, and more about the wellbeing of themselves and the community at large. Another strategy for consumer engagement in the shaping of health care services delivery is support offered to the patients, families, and carers. Such a strategy aims at developing knowledge, relevant skills, and actions which enables people to take care of themselves and their neighbors. (O Connor, 2011).

As a registered nurse I will increase consumer participation in planning, implementation, and evaluation of the care that I deliver through the patient-centered care. The patient-centered care refers to the healthcare which is respectful of, and quite responsive to the patient’s preferences, needs, and values of patients and the consumers. The broadly accepted scope of the patient-centered care includes respect, emotional support, physical comfort, relevant information, and in-time communication. Also, the continuity and the transition, care coordination, family and carer engagement, and easy access to care. Research that has been conducted has proven that the patient-centered care has greatly improved patient care experience and developed public value for health services (Hasson, 2010). I shall offer emotional support to my clients, patients and families/carers feel happy and satisfied when their current circumstance is taken seriously and overall emotional feeling shown by a health care provider.  Through emotional support, consumer participation will be enhanced in arriving at an informed decision since the patient, family or carer will open up and share his/her views and ideas. I shall offer physical support to my clients as much as I can, in cases of an emergency I shall freely join the rescue team and family members in rushing the patient to the emergency and causality room and offer possible support services like first aid while waiting for the doctor to arrive. In the process of trying to stabilize the patient, family members or other consumers will feel more comfortable and secure to share relevant information on how maybe the accident occurred and give patient history (Cavanaugh, 2014). By sharing all these I may get vital information on how to handle the patient. fourthly, I will keep consumers’ information confidential and private as much as I can as per the professional ethics and code of conduct.

Also, will use the better mode of communication which will enable my clients to share more easily in a language they understand well and I shall offer relevant education to the patient, family or carer in taking of the patient. I shall involve patient, family, and friends present in decision making by giving the views and ideas priority. Informed decision-making results to the provision of better and safe health care services to the patient (Segal, Dunt, & Day, 2014). consumers participation will increase in the process since the decision-making process involves each and every one present. Lastly, I shall observe and remain sensitive to the matters which are sensitive to nonmedical, beliefs and spiritual dimensions of health care.

Quality and Safety

One of the 10 standards from the National Safety and Quality health Service Standards (2017) is the standard for blood and blood products. The standard gives a description on the systems and the strategies for an equally safe, effective and in appropriate management of the blood and its products in ensuring that the patients receive safe blood free of contamination. The major risk involved with the blood and blood products standard is the procedural errors in the blood transfusion process (Muniz et al., 2012). The errors occur at different parameters, which include; blood transfer to a different patient due to incorrect patient labelling. Another error is that arising due to the incorrect labelling of the blood sample. Finally, another procedural error arises during the administration of blood or its products to the wrong sick person.

The potential outcome from such procedural errors will lead to the blood infections amongst patients. For instance, a number of infections such as the serum hepatitis and HIV virus spread. HIV/AIDS has become rampant due to errors arising during transfusion. The disease remains a killer if the best practices are never followed by the healthcare professionals. Other infections out of procedural errors include bacterial infections, transmissions of malaria, the Epstein barr infectious virus, the Cytomegalic infectious virus, the syphilis condition, the Babesia of the microti infection and the Trypanosoma infectious of the cruzi (Medicine et al., 2013). There have been high incidences reported for such erroneous procedures during massive blood transfusions. This affects negatively the patient outcomes. In that patient response to drugs will be very low and resulting to continued illness and increase of their critical condition. Such blood reactions may also cause severe complications such as the severe electrolyte imbalance, the coagulopathic condition, the citrate toxicity and the hypothermic condition.

As a registered nurse I will have two strategies to be laid down in the process of improving the patient outcomes under the blood and blood products standard. Firstly, I will ensure that all patients requiring blood transfusion are properly identified and labelled clearly, their conditions clearly outlined and their blood groups well displayed. Also, cross matching must be conducted before any transfusion is done (Sandman, 2009). Secondly, as a nurse, I shall ensure that the blood and blood products are well labelled and their expiry dates displayed clearly. Before transfusion get done, biodata for every patient must be counter checked all the time.

Leadership and Management

The leadership skills inventory is mainly designed for the healthcare leaders to enable them to be at a position to assess themselves on their abilities in a correlation to the Anderson’s model. The model lays its foundation on five scopes. The dimensions include the individual management skills, the interpersonal Communication skills, the consultation skills for the developing firms and the versatile skills (Reilly & Jurchak, 2017). Under the leadership skill inventory model, the consumer participants are supposed to respond to at least a fifty-six itemized self-assessment in a scale of 1-10. Such responses range across the new skills, known skills and those which a participant can teach others. It is advisable for Registered Nurses to learn and acquire both the self-management skills and the interpersonal communication skills (Gottlieb, 2012). The self-management skills enable a registered nurse to manage her/himself well based on a well-drawn schedule displaying the days on duty and those on off duty, kind of conditions to be handled, expected cases to be dealt with and readiness for any emergencies.

A registered nurse will always monitor and evaluate her/himself on the preparedness to receive patients under any state and try as much as possible to enable them regain stability and facilitate the faster recovery process. Also, through self-management a registered nurse shall be at a position to re-examine her/his role as a nurse and offer safe and quality services as per the nursing practice standards (Tancredi, 2009). Another key skill to be mastered by a registered nurse is that of interpersonal communication skills. This is a major skill since it links the health professional and the patient. through interpersonal communication skill, patient will feel free to share how s/he is feeling and what s/he expects to be done as soon as possible (Edwards & Elwyn, 2009). Further, the skill allows the health professional to ask the patient questions openly and cautiously not to hurt or touch on her/him privacy. Effective communication creates room for better prescriptions and instructions on dosage from the healthcare professional. Communication is an essential tool in a healthcare organization to both the professionals, stakeholders, patients, family members and caregivers.

Organizational Culture

The following are the defining characteristics of a learning culture in an organization. Firstly, learning information is kept open, freely shared and easily accessible to all. In a good learning culture, you get that relevant and necessary data is never hidden or hoarded by the management. In such organizations the managers and other employees do readily get access to information, thus, sharing a similar reference framework. Secondly, learning is emphasized and given priority value (Stoter, 2010). Learning culture is jerked up through a number of both internal and external workshops organized by an organization. Such workshops create room for the training and other training-related activities to be offered to employees at an equal scope. Thirdly, where there is a learning culture support, mistakes committed by employees or any failures are not rewarded with suspensions or warning letters. Such employees are encouraged and guided on how to correct their mistakes and tactics of future success in their endeavors. Some firms have written on bill boards displaying that learning is a process due each day and people learn through mistakes (Ozcan & Linhart, 2010). No organization shall punish an employee for coming up with new ideas that never but instead should encourage that person to try again, through such, innovation get fastened. Lastly, all employees working in an organization are expected to be willing and ever ready to learn. Learning should be taken up by each as a habit which should be done step by step in order to improve individual performance as well as steer positive progress of an organization in service delivery.

As a registered nurse, I shall contribute to a culture of learning within my organization through two ways. First, I shall make sure that all necessary nursing information and data is accessible to both my juniors, equals and my seniors. I shall share freely ideas on a given concept with my fellow colleagues without prejudice. I will create a platform where all essential information is disseminated and displayed for all parties concerned to easily access it. Lastly lay down the strategy of organizing both internal and external workshops in order to promote a learning in my organization (Organization, 2011). I shall also create a learning spirit through giving awards to new innovators, offering promotions and salary increment to those who have advanced their studies and giving a word of encouragement to the young people who have recently joined the organization.

Professional Practice

Role conflict emerges in circumstances when there exist divergent demands amongst two people in which the person meant to comply to the demand finds it difficult and fails to comply. Usually employees do experience role conflict upon finding themselves being pulled into different directions as they make an effort to react towards to the various roles in the position they hold. The concept may be for either short-term or stand for a longer-term. Role conflict impacts negatively on the performance of a registered nurse (Burns, 2010). In an organization where employees’ relationships are strained service delivery fails, remains of poor quality. This will definitely impact on the patient outcomes negatively. Role conflict makes it difficult for a registered nurse to freely consult and share information with others.

As a registered nurse I will employ the following two self-care strategies to help me stay emotionally and physically well; maintaining social support and getting adequate sleep. As a nurse I will develop a strong social network with as many friends as possible.  A strong social support facilitates a happier and healthier life. It also acts as a stress buffer and reliever. Having many friends creates an opportunity of going out after work and having funny while sharing life experiences. The second strategy, will ensure that I get enough rest through sleeping adequately. As a nurse, am aware that lack of enough sleep impacts retrogressively on the ability to deal with stress, being productive and carry out daily activities properly. Although, tight schedules and stress might make sleep to be more elusive (Coyne & Harder, 2011). It is quite difficult to balance between having little time to get enough sleep, difficult moments falling into sleep with poor quality sleep as a result of stress. However, there exists a number of ways to improve my sleeping habits in order to stay emotionally and physically well. First, I shall draw a schedule so that I may manage my time effectively creating adequate time from other commitments for sleep. Also, I shall try as much as possible to find relaxation methods to assist me to fall asleep and get quality sleep throughout the night.

References

Burns, H. (2010). Patient safety: developing policies for engagement in the prevention of harm to patients. Journal Of Professional Nursing, 20(1), 4-75. doi: 10.1016/j.profnurs.2004.01.002

Cavanaugh, K. (2014). Prioritizing Patient-Centered Care Implementation and Research for Patients with Kidney Disease. Seminars In Dialysis, 28(2), 131-140. doi: 10.1111/sdi.12326

Coyne, I., & Harder, M. (2011). Children’s participation in decision-making. Journal Of Child Health Care, 15(4), 312-319. doi: 10.1177/1367493511406570

Edwards, A., & Elwyn, G. (2009). Shared decision-making in health care. Oxford: Oxford University Press.

Gottlieb, L. (2012). Strengths-based nursing care. New York: Springer Publishing Company.

Hasson, H. (2010). Systematic evaluation of implementation fidelity of complex interventions in    health and social care. Implementation Science, 5(1). doi: 10.1186/1748-5908-5-67

Medicine, I., Policy, B., & Events, F. (2013). Engaging the Public in Critical Disaster Planning and Decision Making. Washington: National Academies Press.

Muniz, G., Sweeny, D., Davis, D., Hinojosa, J., & Vedlitz, A. (2012). Citizen participation in health policy-making.

O Connor, A. (2011). Modifying Unwarranted Variations In Health Care: Shared Decision Making Using Patient Decision Aids. Health Affairs. doi: 10.1377/hlthaff.var.63

Ozcan, Y., & Linhart, H. (2010). Analytics and decision support in health care operations management.

Reilly, K., & Jurchak, M. (2017). Developing Professional Practice and Ethics Engagement. Nursing Administration Quarterly, 41(4), 376-383. doi: 10.1097/naq.0000000000000251

Sandman, L. (2009). The Concept of Negotiation in Shared Decision Making. Health Care Analysis, 17(3), 236-243. doi: 10.1007/s10728-008-0103-y

Segal, L., Dunt, D., & Day, S. (2014). Introducing coordinated care (2): evaluation of design features and implementation processes implications for a preferred health system reform model. Health Policy, 69(2), 215-228. doi: 10.1016/j.healthpol.2004.02.001

Stoter, D. (2010). Staff support in health care. Abingdon, Oxon, OX: Blackwell Science.

Tancredi, L. (2009). Ethics of health care. Washington: National Academy of Sciences.

World Health Organization. (2011). National health development networks in support of primary health care. Geneva.