(5B) 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. Please this is a final year essay and is required 90% please if i could make upto 80% please.
Please this is the second essay am summitting the same topic but for my friend , please i will apricate it if it will be different writer to avoid writing the same thing for both of us. Also if the research could be done around UK Scotland. Thanks
Perspectives of Adult Health on the Importance of Clinical Governance and Quality Improvement Agenda
Student’s Name
Institutional Affiliation
Perspectives of Adult Health on the Importance of Clinical Governance and Quality Improvement Agenda
Adult health is becoming a challenge to stakeholders in healthcare bearing the consistent demographic changes in contemporary healthcare services. With advancements in healthcare quality, more people are growing older. The portion of the population with people aged 75 years or above is increasing consistently. At that age, individuals demand more healthcare attention. As such, older people will be frequent visitors to healthcare facilities soon. Such dramatic change demands changes in clinical governance. Activities within the custody of clinical governance that include patient safety must be revitalized to match the increasing need for enhanced efficiency in adult health. This paper explores the perspectives of adult health on the importance of clinical governance and quality improvement agenda. The paper bases its input on the case of a frail patient, aged 84, with a history of falls, who was admitted via Accident and Emergency with respiratory problems for which he was treated with Intermittent Positive Pressure Ventilation but later died following patient safety concerns. Exploring the perspectives of adult health is vital to understanding the inputs of risk assessments in complex care environments, the contribution of clinical nurse leadership to quality care provision, and understanding the patient safety culture with their inputs in contemporary care settings.
The Process of Risk Assessments in Complex Environments
A human health risk assessment is a prospect that healthcare organizations must conduct to ascertain the safety of their personnel and patients. It is the process to estimate the probability and nature of adverse health effects to individuals who may be exposed to occurrences in clinical settings (Snell, 2016). In complex clinical settings, it is upon the clinical governance to ensure that all risks are assessed and addressed appropriately should they occur. Assessing risks encompasses all the key performance indicators in an organization. That is, a healthcare facility must ensure that all its key components and departments are accommodated in the risk assessment activities. In a complex healthcare organization with multiple departments and personnel, the risk assessment task requires insightful analyses.
Risk assessment is a detailed 4-step process that requires an emphasis on every step to achieve the necessary success. The first step in the process is planning. Every aspect of human risk assessment must begin with research and proper planning (Specchia, Poscia, & Volpe, 2015). Every organization is structured differently. Hence, one risk assessment protocol cannot apply to two different organizations even if they operate in the same industry. It is in the planning process that the organization attempts to answer questions concerning what or where the risk is embedded, the environmental hazard concern, the origin of the hazard, the exposed stakeholders, and the possible impacts of the hazard attacks (Bujold, Pluye, & Légaré, 2017). From this planning process, organizations understand how many risks they face in their operational environment and how individual risks should be mitigated.
The case provides multiple incidences of lack of planning in risk assessment. From the elements of the case, the patient was admitted to the facility with the expectation that the facility had the resources to care for such a patient (Specchia, Poscia, & Volpe, 2015). Falls are a concern to most healthcare organizations. Hence, facilities attempt to devise avenues and structures to limit falls. In the case of the facility, not much effort had been put to manage falls. The case implies that a structure was built at the realization that the patient would need it. With the changing demographic prospects in healthcare, the least a facility can do in its risk assessment is ensuring that it is prepared for health challenges that face older individuals such as falling (Bujold, Pluye, & Légaré, 2017). To that effect, the healthcare facility in the case did not conduct its risk assessment adequately to accommodate all its stakeholders.
The second phase of risk assessment is hazard identification. In this phase, the facility examines whether a stressor has the potential to cause harm to individuals and in what circumstances (Specchia, Poscia, & Volpe, 2015). It is in hazard assessment that the facility determines whether an adverse health effect can occur and affect humans. While assessing the possible health hazards in a facility, emphasis must be put on the possible mode of action for every incident. In this case, the hazard was poor structures that could trigger patient falls. The falls can cause injuries or deaths to patients. In such a case, a good hazard assessment strategy would instill the mitigation of falls (Snell, 2016). That would include the installation of appropriate beds and the implementation of a monitoring strategy that is likely to address any possible occurrences. The healthcare facility in the case did not address hazard assessment. That is marked by the fall of the patient and the eventual injury.
The third element of risk assessment in a complex healthcare facility is a dose-response assessment. A dose-response relationship is a description of how the severity of adverse health effects is related to the amount of condition of exposure. That is, the assessment must explore how the risks increase with the escalation of other factors. For instance, if falls are a dose, the assessor must explore the impacts of a particular response to that dose. Patient falls are a problem that majorly faces older individuals. The increase in the number of older individuals in clinical settings implies a corresponding increase in the risk of falls (Snell, 2016). To a healthcare facility, an appropriate response would be the development of structures that respond to the possible doses at a particular time frame. Notably, the facility in the case barely explored the dose of patient falls in its settings. The outcomes are injuries that would have been mitigated had the dose-response relationship been assessed effectively.
The last step in risk assessment is risk characterization. In practice, all components of risk assessment must be assessed on the extra risk of health problems in the exposed population. Risk characterization implies the classification of risks in order of seriousness (Snell, 2016). A risk characterization occurs with an analysis of uncertainties, limitations, assumptions, and key findings. It is through risk characterization that organizations can execute integrative risk analyses. An efficient risk characterization occurs with the proper completion of the first three steps in risk assessment. An organization that fails in the first steps automatically fails in risk characterization.
Complex organizations must conduct a comprehensive risk assessment to curb some of the risks that they face. The analyses must accommodate all the primary key performance indicators. Risk assessment should also focus on the current operations as well as activities of the future. To most organizations, risk assessment can be a complex process (Snell, 2016). That is because it requires cultural, structural, and resource inputs to implement a proper risk assessment tool in a complex organization. Most organizations, to that effect, overlook the possible risks in hope that they will not occur. While risk assessment can be a costly and time-consuming process, it is something that even complex organizations must conduct because the adverse outcomes can be injurious or fatal to stakeholders as evident in the case.
Patient Safety Culture
Patient safety is fast becoming a component of organizational culture. Culture implies the values and beliefs that guide decisions and activities within an organization. Cultural prospects interact with the system’s structures and control mechanisms to produce consistent behavioral norms. Culture defines what is important and what is held to be true in an organizational setting (Snell, 2016). Culture influences patient safety by encompassing accepted practices in a clinical setting. Culture also influences patient safety indirectly by acting as a barrier or a fueling factor to the implementation of behaviors that promote patient safety. Understanding influencers and components of culture create an environment for easy safety assessment and the development of strategies that are likely to enhance patient outcomes. Healthcare facilities rely on their cultures to create the ultimate safety strategies for their patients.
Culture is multidimensional and bears various features that individually affect patient safety. The first feature is an informed culture. Healthcare organizations operate in a highly dynamic operational environment (Khoshakhlagh, Khatooni, & Akbarzadeh, 2019). Whenever changes occur around an organization, they should be accompanied by appropriate responses within the organization. In the feature of informed culture, the healthcare facility ensures that it collects relevant safety information, analyzes the information, and disseminates it for proper usage. An informed culture creates the motivation to understand changes (Snell, 2016). In the case provided, the healthcare facility lacked the tenets of informed culture. An informed organization would understand that the demographic c...