Leadership and Clinical Governance

RUNNING HEAD: LEADERSHIP AND CLINICAL GOVERNANCE 1
Leadership and Clinical Governance
Student’s Name
Institutional Affiliation

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Leadership and Clinical Governance
Globally health facilities serve as a bottom line in the society. Nonetheless, health
facilities would fail to serve its purpose which is; to treat the injured and to take care of the
outbreak of diseases, if leadership and governance were absent. Leadership and clinical
governance ensure there is a safe consignment of health care services inclusive of enhancing the
quality of the services. The essay shall discuss the strategies required in the reduction of hospital-
acquired infections and the involvement of a professional clinical nurse in implementing the
strategies. This will be seen by discussing how the strategies shall be implemented, the obstacles
that could be encountered during the implementation, the facilitators of the implementation
process and finally the clinical governance that should be contemplated. Analysis of how the
strategies will reduce hospital-acquired infection shall be discussed providing existing evidence.
Primitively, educating the patients and the nurses the importance of hand hygiene would
greatly reduce hospital-acquired infections. Nosocomial infections are leading causes of
morbidity and mortality in most of the people reducing their length of stay and increasing cost of
care (Kaye, et al., 2014). Hands have been found to carry most harmful pathogens and infections
that can be transmitted easily through handshake, touching or holding important surgical
equipment or surfaces. Anderson states that contaminated surgical equipment can result to
prolonged hospitalization of death (DJ Anderson 2011). Mostly, nosocomial infections are
transmitted through cross infection via hands of health care personnel; nurses who do not
disinfect their hands after handling one patient or touching contaminated environmental surfaces
(Weber, D.J., et al., 2010). Nosocomial infections may be transmitted if a nurse handles a patient
suffering from an infectious skin disease and later handles the other without disinfecting the
hands. However, the nurse may hold syringes or other hospital equipment which may transmit

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infections to the patients if the nurse does not disinfect his or her hands. Educating on hand
hygiene can be implemented in various ways.
Lack of knowledge of the significance of hand hygiene by the patients and the nurses has
led to an increase in nosocomial infections. One way of educating about hand hygiene is by
educating student nurses on the importance of hand hygiene during clinical internships. Sundal
suggests that the performance of the student nurse on hand hygiene should assent during their
clinical placements. In addition, mentors are advised to encourage the students to improve their
performance in hand hygiene and should also provide regular feedback to students on their
performance (Sundal, J.S et al., 2017). In (“the importance of nurses hand hygiene” 2013) states
that Dr. Ignaz ordered his nurses to maintain their hand hygiene before handling maternity
patients since their fatality rate had increased. As a result the fatality rate reduced drastically. It is
therefore clear that hand hygiene beyond doubt saves lives. Using student nurses as hand hygiene
ambassador would also enhance the reduction rate of nosocomial infections.
Using student nurses as ambassadors in hand hygiene would be an efficient way since
they are aware of nurses’ roles and therefore will advise and educate accordingly. Moreover, this
program will also aid the student nurses in their clinical settings at all times and this will reduce
hospital-acquired infections. This method would be efficient since patients interact freely with
student nurses. Patients will carefully lend an ear to the nurses and follow the instructions in
maintaining hands hygiene this is possible since nurses play an important role in patient
education. Nurses in health facilities will also be in a position to switch to clean hands and
enhance reductions of infections since they would not wish to act differently with their minors as
it would disgrace them. Implementing this strategy will encounter some obstacles that may
hinder it from being a success.

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Some of the determinants that implementation would be successful are beliefs, attitude,
cognition, organization, and resources. Nurses have certain believes that Regular hand washing
their ability to perform tasks. For example, a patient suffering from a chronic disease is brought
into the facility and requires immediate attention; it would be precarious if the nurse took hand
washing as a priority. Nevertheless, some nurses only find the need of cleaning their hands after
encountering directly with the patients fluid or the equipment, or after the finish of patients care.
These beliefs have increased risks of contracting nosocomial infections. Nurses should be
educated against these beliefs and the risks accompanied by unhygienic hands.
Other barriers that reduce the effectiveness of the educating about hand hygiene include;
language barrier, high rate of nurses turn over in the hospitals, time spent training student nurses,
heavy clinical workload and the location of the facility (Barker, A.K, 2017). Many health
workers and student nurses argue that they lack the extra time that they could use in hand
washing while others say that there is a high workload that prevents them from engaging in hand
wash. Some patients rely mostly on their homeland language since understanding it best. It
would be difficult for nurses to explain the importance of hand hygiene in English. Moreover,
the Location of the facility is very significant since some climatic conditions favor the growth of
pathogens and therefore difficult to eradicate nosocomial infections even after maintaining hand
hygiene. Nevertheless, laziness and ignorance are the main barriers of implementing hand
hygiene followed by lack of water supply in the supply and the attitude of assuming that hands
are not dirty and infectious. Nurses have a perception that use of gloves are hygienic forgetting
that are carriers of microbial and hence need to change them after handling a patient. Non sterile
gloves are potential pathogen carrier in hospitals (Hughes, K.A., et al., 2013). Other factors
however are responsible for facilitating the implementation.