Strategies to Promote Patient Engagement and Reduce Clinical Risk

This essay discusses the importance of patient engagement in nursing and how it helps improve the quality and safety of patient care. It explores the strategies to promote patient engagement, such as effective communication and therapeutic relationships. The essay also highlights the role of informed consent in reducing clinical risk. Overall, it emphasizes the significance of patient engagement in improving patient outcomes and quality of care.

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Introduction
Patient’s engagement in the overall care plan is considered as one of the significant
aspect of the nursing profession and at helps to increase the overall quality of care (Domecq
et al. 2014). According to the Nursing and the Midwifery Board of Australia (NMBA)
(2018), it is the duty of the nursing professionals to engage in the therapeutic relationship
with the patients and thereby helping them to engage in the process of therapy plan. The
following essay aims to analyse how patients’ participation helps to increase the quality and
safety of patient’s care. The essay will discuss different aspects of the patient’s engagement
in healthcare and the manner in which it promotes positive health outcomes. The essay will
initiate with a personal reflection followed by a detailed illustration of the strategies which
the registered nurse to ensure patient participation and thereby reducing the chances of
clinical risk.
Description
During the time of my placement I was assigned to care for an older adult (Mr X) in
the domain of preventing the chances of the accidental fall. Mr X was a 70 year old man
suffering from dementia along with shiftiness in joint with poor eye sight. During by busy
shift timing, I fail to make time to indulge effective communication with Mr. X. Moreover, I
was less interested in interacting with older adults, in other words I was biased. Even when I
got scope to indulge him in the process of care, as he used to try to inform me many things, I
used to dodge his conversation saying that we are provide him the best therapy. Later my
ignorance made Mr. X completed opposed to care and he complained my mentor (registered
nurse) that he no longer wants to avail the therapy as he is highly satisfied. My mentor
understood the overall scenario and I was asked indulge in therapeutic relationship with the

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patients in order to deliver patient centred care. Eventually, Mr. X become cooperative and
his level of satisfaction in receiving the therapy increased.
Feelings
Initially the incident made me quite upset. I felt sorry for by biased attitude and my
inability to indulge in therapeutic relationship with client and procurement of patient centred
care. I went to my mentor (nurse leader or the registered nurse) in order to discuss about my
gap in practice. I was shattered and was suffering from lack of confidence and was unable to
concentrate on the task. My mentor explained me that my gap in communication with the
patient created barrier in the patient engagement and thereby decreasing the level of patient
satisfaction in the care process. I understood my fault and gradually tried to overcome my
bias and also felt the need to work on my interpersonal communication skills.
Evaluation
The negative part of the incident was patient’s sudden withdrawal from the therapy.
On evaluating my performance, the nurse leader guided me and helped to work on my inter-
personal communication skills. She also made me realize that every patient is same for the
nurses and we cannot have a biased or ignorant attitude just because the patient is an older
adult. She also highlighted that not engaging him in the therapy plan or not listening to his
concerns made him feel humiliated and thus decreased his satisfaction. I felt sorry about the
overall behaviour.
Analysis
Under this context it can be said that the nursing professional holds a significant part
in the process of the patient engagement and highlighting the exact needs of the patient.
Effective communication with the patient, and actively listening to their concerns, help to

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improve their level of satisfaction and trust. It is the duty of the bedside nurse to foster
interaction with the patient while respecting their needs (Radtke, 2013). I realised that patient
engagement is of prime importance in order to increase the provision and quality of care.
During my clinical placement, I deliberately ignored his concerns and this might have
resulted in clinical risk. However, I was lucky enough not to encounter the same as it that
care the conditions might have been fatal. However, my ignorance decreased patient
satisfaction and he attempted to withdraw from the therapy or care. Thus I think in order to
procure quality care during my professional practice; I will refine my effective
communication skills and will reduce my level of bias.
Conclusion
Thus from the above discussion, it can be concluded that patient engagement and
development of therapeutic relationship are two prime pillars for care delivery and improving
patient outcome.
Action plan
Going forward in order to promote my professional development, I will refine my
effective communication skills under the supervision of my nurse mentor. I will also take
help about the reflective practice in order to highlight my gaps and improve my critical
thinking skills.

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Strategies to promote patient engagement and to reduce the clinical risk
Clinical risk management is another important aspect of the nursing professionals.
Clinical risk management deals with improving the quality of care of the patient while
ensuring safety in the health care practise. According to the National Safety and Quality
Health Standards by the Australian Commission on Safety and Quality in Healthcare (2012),
Standard 2 (partnering with consumers standards) and Standard 6 (communicating safety
standard) are two important aspect of the effective management of the clinical risk.
Partnering with the consumers standards is defined by the concept of the clinical governance
which help to increase the level of the patient’s participation in the care plan. The
communicating safety standard helps to avoid the nursing error during the change of shift
nurses. The communication safety standard, emphasize on the importance of the effective
communication skills to highlight patient’s exact needs and drafting of the patient’s centred
care (Briner, Manser & Kessler, 2013).
The study conducted by Hannaford et al. (2013) highlighted that use of the effective
communication with the patients also help to avoid the clinical risk. Hannaford et al. (2013)
highlighted effective communication during the transfer of the clinical handover during the
time of the change of shift nurses help to avoid the chances of the medication error and
thereby helping to overcome the chances of the clinical risk. The systematic review
conducted by Hamine et al. (2015) revealed that effective communication of the nursing
professionals with the patients help to uncover any past aspect of health or drug allergies or
hereditary predisposition and thereby helping to avoid risk and improving the quality of care.
Elkin et al. (2014) are of the opinion that increasing the participation of the patient in
the decision-making process is one of the important aspect of the procuring patient-centred
care and as per the nursing professional code of conduct. The systematic review conducted by

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Domecq et al. (2014) have highlighted that effective involvement of the patient in the
decision making process helps to avoid the chances of the clinical risk and at the same time
increase the therapy adherence. The study conducted by Powers et al. (2017) among diabetic
patient highlighted that engaging patients in the decision-making process helps to increase the
patient’s knowledge in the disease progression and thereby helping to improve on the
diabetes self-management skills and at the same time reduces the chance of clinical risk like
injecting higher dosage of insulin or non-adherence of anti-diabetic diet.
Nursing leaders also holds the prime responsibility in reducing the clinical risk. The
nurse leaders by guiding the newly recruited nurses in effective communication skills, helps
them to develop therapeutic relationship with patient and promoting shared decision making
process (Wallis and Kennedy, 2013). The research conducted by Kelly, Wicker and Gerkin
(2014) on the nursing leaderships highlighted that training and effective leadership provided
by the nurse leaders to the newly recruited nurses help to reduce the chances of the clinical
error due to lack of experience.
Quality improvement also helps in reducing the risk of the clinical errors. Important
aspect of the quality improvement is engaging patients in the process of giving informed
consent. Nishimura et al. (2013) stated that informed consent enables their nursing
professionals to give the patients a detailed aspect of care along with the project outcomes,
highlighting all the pros and cons of the treatment. This helps to increase the patient’s trust
and the level of patient’s satisfaction and creating provision for patient engagement in care
(clinical governance). Cole, Wellard and Mummery (2014) are of the opinion the concept of
the informed consent helps to define the ethical principle of autonomy, advocacy, dignity and
respect. By giving the patient the sole right to give consent for his or treatment helps to abide
by the ethical principle of autonomy and at the same time, make student feel empowered. The
while designing of the informed consent, patient cultural, spiritual and religious preferences

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are given preferences and thereby helping to uplift the concept of dignity and respect
(Judkins-Cohn et al., 2013)
Stewart, C. (2014) stated that transforming the scope of the continuous professionals’
development to professional learning helps to increase the depth of the knowledge of the
nursing professionals and thereby helping to reduce the chances of the clinical risk in
practice. The review of the literature conducted by Jayatilleke and Mackie (2013) highlighted
that reflective practice is a part of the continuous professional development for the nursing
professionals. Reflective practice helps to increase the critical thinking skills of the nurses
and thus helping to procure quality care.
Thus it can be said that it order to decrease the chances of the clinical risk and
increase the level of the patient’s participation in the care plan two of the effective
approaches are establishment of the therapeutic relationship with the patient by the execution
of the effective communication skills and informed consent.

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References
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