Essay: Rationale and Impact of Australian NSQHS Standards

This essay provides a comprehensive analysis of the Australian National Safety and Quality Health Service (NSQHS) Standards. It begins with an executive summary and an introduction that outlines the purpose, scope, and context of the standards. The essay then delves into a detailed discussion of the rationale behind the development of the NSQHS Standards, emphasizing their role in improving healthcare quality and patient safety within Australia. The discussion section further examines specific standards, including Clinical Governance, Partnering with Consumers, Preventing and Controlling Healthcare-Associated Infections, Comprehensive Care, and Recognizing and Responding to Acute Deterioration. Each standard is explained, highlighting its purpose, criteria, and impact on patient care. The essay concludes by reaffirming the significance of the NSQHS Standards in enhancing the quality of healthcare services for patients and health workers. The essay utilizes APA 6th referencing format and includes a table of contents for easy navigation.

Running head : Australian national safety and quality health service standards
AUSTRALIAN NATIONAL SAFETY AND QUALITY HEALTH SERVICE
STANDARDS
Name of the Student
Name of the University
Author Note

1AUSTRALIAN NATIONAL SAFETY AND QUALITY HEALTH SERVICE
STANDARDS
Executive Summary
National Safety and Quality Health Services Standards are regarded as the parameter of the
health facility to the patients and their family. Every individual related to the health sector are
associated with these standards. Hospital authority, health workers, nurses, consumers and
stakeholders are included in this initiative by Australian jurisdiction and Health commission.
There are eight standard such as; “Clinical Standards”, “Partnering with Consumers”,
“Preventing and Controlling Healthcare-Associated Infection”, “Medication Safety”,
“Comprehensive Care”, “Communicating for the Safety”, “Blood Management”,
“Recognising, and Responding to Acute Deterioration”. Main purpose of these standards are
to provide superior quality health service with appropriate amount of safety to the patients.
The study aims to focus on the rationale of the standards and to understand how these
standards help Australian healthcare sector to enhance the quality of the facility. The report
focuses on the importance of clinical governance standard and the associated articles with
each standard with the reference of its importance in the workforce management. The report
also shows how “Partnering with Consumers” helps the patients to communicate with nurses
and the doctors. Nurses and the health workers manage to prevent the infections and
transmission of diseases among the patients and the standard called “Preventing and
Controlling Healthcare Associated Infections” evaluates their performance by an evidence-
based guidelines. “Comprehensive care standard” helps the health professionals to handle and
taking care of patients in an appropriate manner and prevent the damages related to patients’
health. Recognising and responding to the symptoms of the patients are the primary
responsibility of the health workers and standard eight explains all the responding systems
and the processes, which are maintained by the health workers and nurses. The study
concludes with a sense of affirmation that the Australian Safety and Quality Health Services
Standards are useful for patients and help the health workers to enhance the facility.

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Table of Contents
Introduction................................................................................................................................3
Discussion..................................................................................................................................4
Rationale of the Standards.....................................................................................................4
“Clinical Governance Standard”............................................................................................5
“Partnering with the consumers”...........................................................................................6
“Preventing and Controlling Healthcare Associated Infections”...........................................8
Comprehensive Care Standard...............................................................................................9
“Recognising and Responding the Acute Deterioration Standard”.....................................11
Conclusion................................................................................................................................12
References................................................................................................................................14

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Introduction
The Australian National Safety and Quality Health Service (NSQHS) Standards
developed by the Commission of safety and Quality for Health Care by the concern of
Government of Australia, in association with Australian Jurisdiction, states and territorial
authorities, hospital authorities and the patient caregivers. The patients, private sectors
professionals, clinical experts were also in the association for implementation of the standard.
The standard aims to provide better treatment or service and to reduce healthcare-related
risks. The standards act as the quality and safety parameter for the patients and their families.
However, the health sector professionals consider the standards as the feedback mechanisms
as these standards evaluate every section of health facilities. The Commission on Safety and
Quality implements the standards as a vital part of Australian Health Service Safety and
Quality Accreditation Scheme. The accreditation and the health services are evaluated as per
the NSQHS standards (Ritchie et al., 2018). The standards ensure the quality of patient care
and the high-quality medical facilities to the patients and improvement mechanisms help in
medical service to analyse the reasonable and progressive goals.
The commission first implemented the standard by receiving 92 written submission in
November 2009. The commission published the second revised edition addressing the
significant gaps recognised in the first edition of the standards. The second edition has a more
precise and specific approach to the eight standards with 148 actions, whereas the first of the
standard contained ten standards with 256 actions. Eight standards of National Safety and
Quality Health Services contains; Clinical Standards, Partnering with Consumers,
Preventing and Controlling Healthcare-Associated Infection; Comprehensive Care ,
Recognising and Responding to Acute Deterioration Medication Safety, Blood Management,
Communicating for the Safety, . This report aims to evaluate and to understand the

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significance of some standards and critically analyse the rationale of those standards in the
health care sector of Australia (safetyandquality.gov.au, 2019).
Discussion
Rationale of the Standards
The NSQHS Standards are implemented in various sectors of the health care industry
for providing the best quality patient care and preventing any undesired consequences, which
affects the patient safety parameter. Among the eight standards, the first two standards are the
most significant, and these two are effective in the application of the remaining six standards
in medical industry. The standards contemplate the critical factors in the health care sectors.
The standards are designed in such a way that the patients can relate them with their
condition, and they can assess the facility given to them by the hospital authority. Various
implementation of the standards in different situations is proven effective and productive
also. Some important improvement can be recognised after the implementation of NSQHS in
2011; for example, a declination of bacteria Staphylococcus aureus was observed in patients
who were under the surveillance in between 2010 and 2014, and the declination was from
1.1% to 0.87% (James et al.,2019).
Another example is the decreasing rate of bloodstream infections among people from
2012 to 2014. The health organisations have become more cautious for preventing the
microbial infection among the patient. The organisations or the health sectors are focusing
more on the documentation and authentication of the medicinal drugs with medical history.
There is a constant reduction in RBC related issues in the patients from the middle of 2010 to
mid-2015. The statistics show that the decline has been shown approximately from 800000
units to 667000 units (Vellar, Mastroianni & Lambert, 2018). After the implementation of the
standards, a significant amount of declination can be found in the patients. According to the

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hospital reports, an impressive record can be observed in the cardiac sections or units as the
patient mortality rate has been reduced. Each of the standards contains the description,
purpose, criteria, and Explanatory notes on recommended actions related to the standard. The
details of the standards are comprehensive and easy to implement for the patients and their
families.
“Clinical Governance Standard”
The first standard of NSQHS is Clinical Governance Standard, which intends to
implement a high quality framework based on clinical governance. The standard ensures safe
and quality health care with continuous improvement with patient-centred care. There are
some criteria depend on patient safety and quality systems, governance with leadership and
culture, safe environment of healthy sector for the delivery of care, clinical performance and
effectiveness of treatment. The norms of the standard ensure the relationship and duties of
governing bodies, executives, health professionals, doctors, stakeholders with the patients and
the consumers of the health sectors. The primary purpose of the standard is to integrate the
frontline members of the hospital authorities such as manager and governing members of the
hospital to the medical officers and clinicians. As a result, the relation among every employee
can be improved and can assure a higher quality of service. Criteria related to governance,
leadership and culture are to imply the quality of health of the patients. The governing body
of the hospital maintains the first criterion of Clinical governance to satisfy the patient
aspiration regarding the facility. The set of priorities can be said as the strategic direction for
better health quality and parameters for the provided facilities (Jones & Killion, 2017). The
criteria also endorse the better organizational framework, management of the workforce. The
requirements also focus on the leadership of the organization to fulfil the expectation and
provide safety to the aboriginal and Torres island patients. It also shows how business
decision making can give protection and promise quality.

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Clinical leadership supports and understands the performance of the implemented
framework. Another criterion is based on patient safety and quality systems which ensure the
policies and the procedure of the health organization and measure and improve the quality
provided by the health organization. The criteria ensure the timely report of the performances
to the governing body and medical workforce, some native consumers and their local
community and other important health facility organizations. Management of risks for a
health service organization is also included in the criteria, and this identifies the risks related
to any documentation, data collection, plans. Next criterion for this standard is medical
performance and efficiency, which includes performance management, credentialing and
scope of clinical practice, safety and quality training, quality and safety measure of roles and
responsibilities, clinical evidence-based care, various medical exercise and consequences of a
health organization. The last criterion of the standard is about the safe environment of
delivery of care, which includes parameters relating to the safety measures of the situation.
Clinical governance is the standard, which focuses on the working frame and the connection
between the consumers and the members of the health organization.
“Partnering with the consumers”
Second necessary standard of NSQHS is Partnering with the consumers, which
considers patients as the partner of the hospital authorities. Consumers or the patients are the
prime factors of the health industry, so the standard allows the patients to show concern in
evaluating, planning, and designing of their treatment. The standard also has some criteria,
which enhance the development, implementation, and maintenance of the system. The factor
related to the standard supports the integration of clinical governance with the patient care
system and qualitative application for improving the entire system. The standard of
partnering with consumers focuses on the healthcare rights and related concerns which
ensures consistent supports of the Australian Charter of Healthcare rights and easy access to

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the rights and procedures for the patients (Banfield et al.,2018). Planning and sharing of the
decisions are also a part of the partnering in consumers standard. The criterion allows the
patients and their families for taking the decision for their condition with the concerned
health professionals. Health literacy is another criterion for the standard, which
communicates with the patient and the health professionals.
Various community people cannot understand the complexity of the health care sector
or organizations and face problems to take further decisions for their health condition.
Aboriginal and Torres island people are profoundly affected due to lack of health literacy and
Partnering with consumers standard helps them to understand health-related complications.
The standard depicts that clients are the partners in the planning and developing the decisions
of the health sectors. Partnering with the consumers or patients has several levels of the
practices such as at the level of the individual, at the level of service, at the level of service
department or program of care. The patients can have access to health services and evaluation
of the decisions taken by the organizations. Participation of consumer for the governance of
clinical methods, policymaking and planning can help them to avail the facility of the
hospital authorities (Bainbridge et al.,2013). The standard is to deliver the care, which based
on the association of patients and the health organization professionals. Families of aboriginal
or Torres island patients are not always aware of the health condition due to the
communication gap and lack of health literacy. Standard of partnering with consumer gives
them the scope to interact with the health organizers (Goeman et al., 2019). The standard help
to deliver a clear idea about the whole process to the patient and the family members. The
standard helps the patients to lower the cost per case and to reduce the duration of stay. The
leaders of the health care industry help in advancement, implementation and maintenance of
systems to collaborate with consumers or the patients.

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“Preventing and Controlling Healthcare Associated Infections”
Third standard of the NSQHS is to decrease the risks of patients or the affected people
by availing the preventable heath care related infections. Managing the infection and limiting
the development of antimicrobial measures through practical usage of antimicrobials is a part
of Associated Infection Standard. Primary intention of the Standard is to prevent the affected
from developing contamination of bacteria and effective management of microbial infections
by the help of evidence based strategies. Maximum health care related problems are due to
the infection and the preventable practices is to minimize the threat of transmission by
separating the patients and injecting the resistance of microbe (Rhodes et al., 2018) . There
are some criteria to fulfill the controlling and preventing of health care related infections
standard such as governance of the infection, prevention and controlling strategies,
management of patients or colonization, cleaning or disinfection and sterilization and
communication with patients and cares. The governance and quality improvement in
infection management regardless of the structure of the organization and the complexities
related to the services.
The infection prevention and the control strategies are practiced for reducing the
microbial contamination and minimizing the risk of the transmission. Health professionals or
nurses are directly associated to the criterion of the infection related prevention and control
system as they evaluated the patient’s condition and re-evaluate the risks related to clinical
risks . They examine whether the patient has communicable disease and try to prevent the
contamination with other patients (Russo et al.,2015). The nurses and doctors are bound to
maintain the hand hygiene program of the organization, which is a part of National Hand
Hygiene Initiative. Invasive medical devices are the advanced medical devices and
management of these machines are also included to the Guidelines for the Prevention and
Control of Infection in Healthcare of Australia. The regulation includes that the infections

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related to advanced machines such as urinary catheter, air pressure injection, sub dermal
implants, keyhole surgery and others should be taken care by the nurses or health workers.
The guidelines for prevention and control infection are included the regulation for preventing
environmental risks related to infection or transmission such as; cleaning and disinfection of
the environment and training related to the appropriate use of the specialized protective
equipment. The reprocessing or reused devices are also considered under the prevention and
controlling health care preventing standard. The devices such as surgical forceps,
stethoscopes, and endoscopes should be disinfected before use on a patient’s body. It can be
said that checking of those devices before applying is another prime responsibilities of
nurses.
Comprehensive Care Standard
NSQHS has another important standard known as Comprehensive Care Standard,
which includes articles regarding clinical governance and quality enhancement, minimising
the patient harm, delivering comprehensive care ,developing the complete care plan. The
standard ensures comprehensive care from the nurses and the health workers. According to
the standard, the nurses should provide continuous care patient and collaboration with them
as a team. Clinical governance and the quality improvement are the integrated part of the
comprehensive care and include the parameters such as partnering with consumers, designing
of the system to deliver comprehensive care, collaboration and teamwork with the patients
and integration of clinical governance. The standard also comprises an article called
developing comprehensive care. Development of comprehensive care focuses on the planning
and developing the comprehensive care, analysis of risk, clinical evaluation for the

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betterment of patient care (Woolfenden et al.,2017). Nurses are associated with the planning
and developing the comprehensive care plan with the help of clinicians or doctors. Analysing
and screening the risk are also other responsibilities of the nurses as the analysis or screening
is dependent on the issues regarding the physical and mental condition of the patient.
The risks should be analysed with the reference of the clinical history of the patient
and respective documentation. Doctors are responsible for the clinical assessment and taking
decisions regarding the health conditions of the patients, but the nurses usually make
decisions related to the development and maintenance of the clinical plan. The standard
ensures that the patients should have safe and comprehensive care from the nurses. Nurses
should have a transparent partnership and comprehensive approach to the patients and their
families. Patients with the end of life care treatment are an integrated part of comprehensive
health care as they generally admit to the hospitals for a long time. Nurses have key
responsibilities for minimising patient harm. There are various types of patient damages such
as pressure injuries, falls, poor nutrition or malnutrition and dehydration, self–harm or
suicides, aggression and violence, harms related to restrictive practices and nurses should
prevent the risks of these patient harms. Nurses can avoid injuries of pressure as these occur
during the exercises of skin inspection and application of injection ( Padula, Chen &
Santamaria, 2019). Fall management is one of the most significant concerns in the health care
industry. Patients from any age group can face the problems regarding fall and effect of falls
are different for individuals. The Australian Health Commission implement the evidence-
based guideline for preventing falls in the older age people (Redley & Raggatt ,2017).
Restrictive practices such as seclusion and restrained can be restricted by the health
professionals by providing mental support and comfortable environment. The patient with
suicidal tendencies and unpredictable behaviour (violence and aggression) needs physical
safety and psychological support, which can be provided by the nurses. Nurses help patients

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suffering from dementia and delirium to reduce related harms by providing cognitive
impairment (Pryor & Clarke, 2017). It can be said that the comprehensive care standard
ensures a direct connection between nurses and patients.
“Recognising and Responding the Acute Deterioration Standard”
“Recognising and Responding the Acute Deterioration Standard”, is the last standard
or the eighth standard of National Safety and Quality Health Service Standard of Australia,
which includes the regulations to prevent clinical and physiological abnormalities in patients.
Some psychological causes can lead to the death and deterioration of the patient’s health, and
the standard considers psychological vulnerabilities as deterioration. The standard maintains
the National Consensus Statement for “Essential elements for recognising and responding to
acute physiological deterioration” proposed by the Australian Commission on Safety and
Quality of Healthcare (Davies et al. 2014). The statement includes safe and active responses
to of the damages patient’s condition regardless of any age group in critical health facilities.
The standard is applicable to every kind of patients such as medical, surgical,
psychological and pregnant patients (Massey, Chaboyer & Anderson, 2017). The Australian
Health Commission regulates the standard based on national statements. According to the
standard, nursing management is also related to the patients of Delirium or other
psychological disorder. Acute deterioration can be detected by the physiological changes and
lack of efficiency of the health workers. The deterioration can be prevented by the knowledge
of the system, awareness of the mental and physical symptoms, and analysing the signal and
signs of patients’ body properly. Responding to the patient is an essential responsibility of
nurses, which has been discussed in this standard. Nurses can prevent risks due to lack of
response and recognition of patients’ symptoms by the escalation of care as this can detect
the early symptoms by prohibiting the progression of deterioration. Critically ill patients or