Perspectives of Adult Health on The Importance of Clinical Governance and Quality Improvement Agenda
5B Summative Assessment (2 parts)
PART 1: 3000 word Essay (90% of marks)
Please read the clinical scenario (below) related to patient safety and use the ‘Essay Assessment Criteria’ as a guide to structure your essay (found in assessment section). The essay assessment / marking guidance will assist you with flow and structure and will help keep you on track as to the expected module content and learning. Please note that students can structure the essay in whichever way that suits their style of writing but all criteria should be considered.
All points made must be supported by referring to relevant literature (the reading list provides you with a broad range of literature although it is expected that students will also undertake their own literature search). Reference literature using APA 7th citation style.
This essay should be a continual piece of writing; please avoid using too many headings as this will impact on the quality and flow of your essay. Ideally, the essay should have an introduction, main body and conclusion.
Clinical Scenario related to Patient Safety
A frail patient, aged 84, with a history of falls, was admitted via Accident and Emergency with respiratory problems for which he was treated with Intermittent Positive Pressure Ventilation. He was taken directly to the Intensive Care Unit where he was ventilated overnight. His intubation was removed the next morning and he was subsequently transferred to the ward at 19.00 hours. The Ward was busy but after visiting their relative, the patient’s family asked for bedrails to be put in place and this was carried out. At 03.00 hours the patient was found to be lying on the floor and he suffered a fractured hip and subsequently died 2 days later.
PART 2: Reflective Summary (10% of marks)
In 500 words, we ask you to reflect on your learning from the module, considering how you will use what you have learned in your practice. As you reflect, cite three different online conversations that you posted (one of which could be a response you made to a peer). This may be a posting that helped you to develop your thinking, or perhaps even changed your views. You will need to attach screen shots of these three chosen conversations so we can follow the thread which has been effective in your learning.
MARKING CRITERIA
The Essay = 90% and the Reflective summary = 10%.
The 3000 word essay at level 9 should be structured in order to make it easy for your reader/marker to follow and understand. The headings and subheadings below are a suggestion as to content and structure; a good essay will integrate all the key points seamlessly.
The weighting (below) is important and will give you an indication of how to plan and structure your essay.
Clinical based Scenario: A frail patient, aged 84, with a history of falls, was admitted via Accident and Emergency with respiratory problems for which he was treated with Intermittent Positive Pressure Ventilation. He was taken directly to the Intensive Care Unit where he was ventilated overnight. His intubation was removed the next morning and he was subsequently transferred to the ward at 19.00 hours. The Ward was busy but after visiting their relative, the patient’s family asked for bedrails to be put in place and this was carried out. At 03.00 hours the patient was found to be lying on the floor and he suffered a fractured hip and subsequently died 2 days later.
Section Marking Criteria Student Guidance:
1. Introduction:
Outlines effectively and clearly what will be discussed in the assignment, including an outline of the content. You should also consider the context of clinical governance and quality improvement in complex, contemporary healthcare (10% weighting of the marks)
You should outline what you are going to discuss in the assignment.
Briefly introduce the importance of clinical governance and quality improvement agenda. Citing relevant government and health documents.
It is expected that this will supported by relevant literature.
2.Main Body: This is the main part of your essay. It is essential that all discussions are supported by relevant literature /evidence. There are 3 main sections to focus on:
Critique the process of risk assessments in complex care environments
(20%)
Discuss and analyse patient safety culture (20%)
The contribution of clinical nurse leadership to quality care provision (20%)
(note: this section can be more general and not specifically related to the scenario)
(60% weighting of the marks)
Critique the evidence base related to clinical decision making and professional judgement and accountability in relation to risk
Discuss the use of bedrails in relation to patient safety and justify your argument by referring to the literature.
In relation to the scenario provided identify which risk assessments should have been undertaken for this patient and support with relevant literature.
Critique initiatives that support patient safety such as the Scottish patient Safety Programme (SPSP)
Consider the importance of team work and situational awareness
Examine the literature in depth as to what constitutes a patient safety culture and discuss how this type of culture can be facilitated within a healthcare setting.
Critique the role of quality improvement in contemporary healthcare re the management of risk.
Discuss how a clinical nurse leader can influence quality and patient safety in complex clinical environments. Consider which styles of leadership support a safe patient culture.
3. Conclusion (7) &
Impact on future practice (3)
This section should summarise the main aspects of your essay. There should be no new points being made or references here. All 3rd person.
(10% weighting of the marks)
The conclusion should summarise what the key learning points are in your essay and provide some implications for future practice. You should not merely list the key learning points but discuss the learning and application to practice.
In addition discuss what has been learned in relation to this module and the impact of this on future nursing practice.
4. Presentation & Sequencing Assignment presented in accordance with University Guidelines
Logical sequencing of assignment
Accurate grammar & spelling
Accurate referencing using APA 7th
(5% weighting of the marks)
Do not write using 1st person – this is not a reflective essay
Arial, Font size 12, 1.5 line spacing
Any quotes used in text should include the page number within your essay. However, quotes should be kept to a minimum – for level 9 it is expected that you paraphrase using your own words.
Accurate spelling and grammar. Use spell and grammar checkers in ‘Word’ or ask a friend or colleague
5. References Accurate use of APA 7th in accordance with School of Health & Social Care referencing guidance.
( 5% weighting of the marks)
Should be relevant, up to date (ideally within last 10 years) and demonstrate wide reading.
You are required to use APA 7th. If you are unclear about what this means consult University WEB SITE or contact Library staff. http://libguides(dot)napier(dot)ac(dot)uk/shsc/ref
Remember to ensure all references in the text are written in full on the list.
Avoid plagiarism, by using the student drop box for checking student originality/similarity box. http://www2(dot)napier(dot)ac(dot)uk/ed/plagiarism/
References are not included in the word count.
Reflective summary section
500 words
1st person writing
Based on 3 of your own chosen online discussions write a reflection on how these have developed your thinking and development. This section should also indicate impact of learning on future practice.
Be creative and reflect insightfully. (10% weighting of the marks )
Choose and submit the 3 relevant screenshots ( note: 1 of these can be a response you made to another student)
A reflective model may be used.
This is a separate section to the above essay. For additional information please see marking rubric within the assessment section.
References can be cited in this section if required.
This section is to be written in 1st person
Perspectives of Adult Health on The Importance of Clinical Governance and Quality Improvement Agenda
Name
Institution
Due Date
Perspectives of Adult Health on The Importance of Clinical Governance and Quality Improvement Agenda
Introduction
The concept of quality within a healthcare organization entails the presence of a complex network of contingent and interacting factors. Because of the diverse perspectives, there have been different definitions applicable to healthcare quality alongside the various dimensions as issued within related literature (Johnson & Sollecito, 2018). The complex nature of the healthcare system results from the presence of a diverse spectrum of employees alongside departments that work in a hierarchical as well as non-flexible structure. This scenario is characterized by different professional groups outlined by different activities and objectives as well as subcultures focusing on the provision of healthcare services. This makes it challenging for a successful quality improvement methodology within a setting to succeed in other settings due to differences in underlying factors. Despite such challenges, healthcare quality remains one of the crucial elements that concern the world (Johnson & Sollecito, 2018). In this case, clinical governance refers to a set of purposeful activities designed to explore a complex situation alongside improving the level of quality care provided. Clinical governance provides the bridge that ensures quality delivery between managerial as well as clinical approaches (Travaglia et al., 2011).
Clinical governance lead towards improvement of safety as well as quality within healthcare services. The implementation of CG focuses on various intervention measures that invariably aim to strengthen the seven pillars model to optimize the health system, therefore improving the quality of care. In this case, the main elements of CG comprise risk management, patient involvement, clinical audits, lifelong learning, as well as evidence-based practices (Veenstra et al., 2017). The nature of the existing relationship between the patient and the professional also contributes to quality improvement and, ultimately, high-quality healthcare delivery. Further, improvement in communication quality increases the probability of operating on shared beliefs and values, which eventually contributes towards a collective vision as shared by all stakeholders within the organization. Communication is key to the existing partnership between patients and professionals since it enhances correct diagnosis and involves patients in the development of treatment plans. This study discusses issues on risk assessment, patient safety culture, and the contributions of clinical nurse leadership to quality care provision. There is also discussion and critique on the use of bedrails in relation to patient safety.
Risk assessment
There are a number of challenges associated with quality issues that relate to current risk assessment practices within hospitals. Some of the challenges entail lack of consultation with a relevant group of stakeholders, lack of transparency and consistency, including insufficiency in the guidance towards risk assessment. Consequently, the process that involves risk assessment does not guarantee full effectiveness as a means of ensuring safety. The management of diverse needs within the healthcare environment presents complex situations that, if not managed effectively, may result in serious repercussions to the employees, patients, and service providers. In this case, the risk assessment process entails identification and taking necessary and proportionate measures that control various risks.
The process of assessing care alongside patient support needs of individuals alongside daily activities helps in the identification of requirements that ultimately benefit various lives. However, such decisions also have the potential of exposing them to some level of risk. Such a concept requires a balance in decision-making concerning needs, dignity, and individual freedom, including their safety. In terms of patient care experiences, a better safety culture, as provided by hospitals, leads to low rates of infections and a few errors associated with treatments. Improved hospital’s safety culture leads towards better reports on hospital-related incidents. In this case, such an environment helps in the creation of a general positive attitude from practitioners as it pertains to learning from previous mistakes. Consequently, safety culture tends to influence the level of burnout as well as turnover rates. A weak safety culture within a hospital environment encourages a high burnout rate amongst the clinicians, this eventually results in high turnover rates. Ultimately, the safety culture influences very many aspects, such as quality interventions and change through interventions.
Patient safety culture
Patient safety culture presents one of the key components that focus on the provision of quality healthcare services. This is geared towards the minimization of medical errors for the reasons for reducing the rate of death globally. According to Jang et al. (2017), millions of patients are subject to be victims of injuries as well as deaths from various unprotected medical care alongside activities around the world. For instance, medical records in the United States alone show that medical errors result in more than 60,000 deaths in hospitals annually. Further, in developed countries, statistics reveal that one out of ten patients suffers injuries while undergoing medical procedures (Jang et al., 2017). The prevalence of medical errors still records higher percentages despite the various efforts from the healthcare organizations. Such a high rate as revealed may be attributable to cultural factors alongside a lack of safety culture amongst the healthcare professionals. However, one of the obstacles that prove to be the major hindrance towards the improvement of the safety of patient care is the prevailing culture within healthcare organizations (Jang et al., 2017). In this case, the patient safety culture focuses on various values, perceptions, beliefs, and attitudes alongside safe conduct of specific activities within the healthcare organizations (Jang et al., 2017). The various components of such patient safety culture entail; the common belief that various risks surrounding the responsibilities related to healthcare are high, the nature of the organizational commitment capable of detecting and analyzing various patient injuries. These elements may help in the creation of environments that help in balancing the various need for errors found in reporting that lead to disciplinary actions.
Safety culture is considered positive in the event that it directs the behavior of healthcare providers. In this case, patient safety is considered with the highest level of priorities that entails organizational learning, open communications, shared culture as well as teamwork. Such positive safety culture encourages healthcare practitioners to improve in their reporting and analysis of identified errors, therefore providing an effective tool that is capable of improving safety levels based on the assessment of the current safety culture. The creation of a patient safety culture in hospitals should precede the implementation of structural interventions, this considers emphasis on the knowledge of the existing culture. The nature of assessment done concerning the safety culture ensures that a clear perspective on patient safety aspects is obtained, therefore, accorded the necessary attention (Veenstra et al., 2017).
The concept of occupational burnout results from long-term stress within the workplace (Costello et al., 2019) and is usually characterized by a scenario where an individual’s skills prove inefficient to meet various needs in the workplace. The aspect of emotional exhaustion usually portrayed by low energy alongside feelings of depletion of mental capacity and depersonalization all reflects the separation of mental concentration from the job. This is also a reflection of the decrease in personal accomplishments and shows some of the dimensions of burnout. Medical practitioners are always exposed to patient cases that often leave them stressed. These experiences may include but are not limited to patient mortality, heavy workload, interpersonal issues, attending a larger number of patients daily, making emergency decisions are more likely to expose the staff to this syndrome than other occupations (Costello et al., 2019).
The activity of examining the level of patient safety within hospitals proves crucial due to the prevention of such issues as work-burnout, occupational stress, psychological load, and high-stress levels (Costello et al., 2019). A safe culture within healthcare organizations is a representation of a scenario where employees are actively involved and constantly aware of the various potential issues that influence the delivery of quality care. The aspect of recognizing various cultural attributes and the potential impact of cultural weaknesses on safety outcomes leads to the creation of sound culture on safety that is crucial for the improvement of healthcare programs. The patient safety culture contributes to the quality of healthcare services by ensuring the existence of a serene environment that is safety-conscious and capable of influencing structures and healthcare outcomes.
The safety culture helps Medicare professionals understand what is appropriate, bad, and wrong to establish and implement appropriate principles of behavior. It is necessary to understand that culture shapes behavior on the job and improves various outcomes of care. The whole concept helps improve both patients and family safety alongside the safety of the care provider.
The contribution of clinical nurse leadership to quality care provision
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