NURS2006 Clinical Practice Improvement Assignment


Added on  2020-06-06

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Clinical Practice Improvement Project ReportProject Title:Improve Clinical Handover among RN’s and EN’s by providing education by educational programmes.Project Aim:On the basis of SMART goal aim can be described as:Specific: Provision of education and training regarding that help in Clinical Handover in Registered Nurses and Enrolled Nurses.Measurable: In first two weeks basic information regarding Clinical handover will be provided to EN’s and RN’s, then in next sixweeks education regarding appropriate Clinical Handover is provided to nurses. Attainable: Education programme first will be initiated by the provision of basic education regarding clinical handover than withspecific process of clinical handover.Relevant: it is the best way to improve the practice of clinical handover among EN’s and RN’s.Time bound: The aim can be achieved in the duration of 8 weeks.Relevance of Clinical Governance to your projectAccording to Schneider et al. (2010, p.16) clinical governance is an effective approach that helps in maintaining and improvingthe appropriate quality of care that is provided to patients in health care setups. It also helps in analysing whether adequateclinical standards are maintained during provision of care to patients. According to Department of Health and Human Services(2012, p. 5) clinical governance have 4 pillars. 1.Collaboration leadership 2.Aligned incentives3.Clinical programmes4.Effective training and educational programmeThis assignment elaborate with fourth pillar of clinical governance that includes the use of effective se4ssions and educationalprogrammes for improvement in clinical handover among registered nurses and enrolled nurses neglecting the main and major problems or difficulty and clinical action of the patient and can also leads the organization safetyto practice at high threat, clinical team might get concerned, hassled, dishonour, regret which possibly leading them to havemental distress due to errors in different scope of practices like communication and listening in handover that cause negativeaffect on the wellbeing of the patient. In the procedure of creation of the plan and its development education must be deliveredto nurses in order to practise safe and high quality of practice of bedside handover with the available specific technical

development in order to cause no damage to patient’s health. According to the Nursing and Midwifery Board of Australia (2009p.3), staff should enhance their knowledge and skills by practising and joining time to time specialised developmentprogrammes moreover, Safe bedside Handover practice will reduce the errors and help to attain better outcomes of the patient’s.Evidence that the issue / problem is worth solving:Pringle, Collins & Santry (2013, p. 648) states that bedside handover consists of specific and appropriate exchangeresponsibilities and jobs of the patient which is given by one nurse to another nurse from end of the shift to another nurse whichis starting the shift. The main reason for the appropriate bedside handover is, that it consists of medical information aboutparticular patients and procedures for the proper continuation of care.Manias et al. (2016, p. 89reason for bedside handover is that the nurses and patient can see each other as result both can know each other for the furtherclinical process like treatment, benefits, needs, clinical investigation, evaluation and plan of care. As communication plays animportant part in the handover, communication error contributes about 70% of failure to patient care (2013, p. 653). These kind of practices can be lethal and can risk the life of the patients if done effortlessly through the handoverbetween clinical, social and personal insurance staff. Improper transition of Clinical handover from one shift to another shiftsometimes leads to loss of information regarding patients. As these handovers consists of important information regardingvarious test and diagnosis that are performed on the patients and their results. It also includes necessary information regardingongoing medication and test that are still needed to be performed. In some cases these handovers also contain specificinformation regarding vital sign and results of blood test and urine tests. In order to overcome these complications in thehealthcare settings proper transfer of clinical handover is necessary (Australian Commission on Safety and Quality in HealthCare, 2010, p.4).Key Stakeholders:Nurses, doctors, carer, hospital administration team and patients are the main Key stake holders in the clinical governance.Nurses- the main responsibility of nurse manager or supervisor is to arrange the programme and manage it in proper manner aswell as they are responsible for funding and deliver training to other care givers and provide other study material. On the otherhand, registered nurses and enrolled nurses will acquired and practise new learning in order to perform a safe and appropriatebedside handover.Hospital Administration Team: The management team of particular health care setting is responsible for providing the budget forthe preparation and significant necessary material for the training.Doctors: It helps in improvement of effective communication among staff of different shifts and the appropriate shift manger

along with the medical team and patients in order provide effective care to the patients.Patients: Patients contribution and opinion, recommendation, doubts assist to recognise the zone of enhancement and theoutline of the plan and in the last the consequence will be assessed on the basis of their approval or feedback. CPI Tool:According to the School of Nursing and Midwifery (2016), PDSA cycle and PEPPA framework are the two standard tool for CPIprocesses. The most common used tool with the efficient, quick and easy to learn PDSA cycle will be used in this projectencourages team work and efficient positive changes in the existing health care process that result in favourable outcome withthe use of Plan-Do-Study-Act. Due to this particular reason, this this CIP tool has been chosen for the assignment Roulleau and Trabold 2013, p 338). PDSA process obeys four vital round phases of education method: plan, do, study and actto adapt to the variations which is meant to develop the focuses of the plan (Taylor et al. 2014, p.288). (2017, pp. 24-28) the initial phase of PDSA is initiated by recognition of the questions that arises with the improper transition ofclinical handoverthat further includes purpose of the evaluation of the impression and significant the potential explanations orsolution. The following phase is “Do” which is applying the planned solution on the small scale and on the third cycle “study” it isthe evaluation of the process which is done on the small scale and the result is compared with the previous data whether thereis any improvement or what need to be modify. Whether It can be implemented on the large scale whole lot of study is beendone. Analysis of the data will help to identify where change. The third one is analysis where its measurement and assessmentof the result to discover the rationality of the predictable variations. The final phase is the act which includes the completeimplication of process map. The earliest stage that is to plot a aim to give understanding and practice handover procedure toolintermediate the health care workers and practice the guidelines and procedures that include informative series like videos (Coury et al. 2017, p.28). The strategy is to develop methods for bedside handover after the practice of changed handover. Thenext “DO” stage supports to arrange program to get into play. A unit of applicants will give a feedback as the protocol of theplan, in which will include gathering of both qualitative and quantitative information by skilful staff in the clinical area to getcorrect outcome.The third stage is the changes bought in the plan or process after through the feedback of the patients and staff and the last andthe final one is the last stage is the act which assists the team of the project to choose if the set strategy is effectual to thecontributors and if it needs upgrading in alteration of plan for the investigation (Johnson et al. 2016, p. 261).Another important tool that can be used is HFMEA which was developed by VA’s National Centre for patient safety and iscommonly known as Health Failure Modes and effects analysis. This tools is effectively used for the risk assessment by thehealthcare team and professionals. This CIP tool is consists of 5 important steps which includes: the first step is to define andrecognise the problem, second step is to assemble the whole health care team that will help in addressing the particularproblem, third step is the most important step that includes the formation of a specific process map or plan for the particular

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