Analysis of Leadership and Clinical Governance in Healthcare Settings

This report delves into the crucial aspects of leadership and clinical governance within the nursing profession, using a case study to illustrate key concepts. It explores the role of registered nurses as leaders, differentiating between leadership and management, and emphasizing their involvement in quality improvement and change management. The report also outlines the principles and processes of clinical risk management, highlighting the accountability of nurses in clinical governance. Furthermore, it covers essential knowledge and capabilities for the profession, including communication modes and digital literacy, as well as the application of critical thinking and problem-solving skills. The report underscores the importance of these elements in ensuring high-quality patient care and achieving organizational goals within healthcare settings. The case study of Christopher Hammett is used to show the importance of leadership and communication. The report also covers the concepts of clinical risk management, and the application of digital literacy.

Leadership and Clinical Governance
(Nursing)

Table of Contents
INTRODUCTION...........................................................................................................................1
ULO1 Role of registered nurse as a leader.............................................................................1
ULO2 Differentiate between leadership and management....................................................2
ULO3 Role of nurse in improvement of quality and change management............................2
ULO4 Principle and processes of clinical risk management and its application...................3
ULO5 Accountability of the registered nurse in clinical governance....................................3
GLO1 Specific knowledge and capabilities for the stated profession....................................4
GLO2 Use of different communication modes......................................................................4
GLO3 Application of Digital literacy to find, use and dissemination information.................5
GLO4 Evaluating information using critical and analytical thinking and judgment.............5
GLO5 Creating solutions to authentic problems....................................................................6
GLO6 Self management.........................................................................................................6
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8

INTRODUCTION
Leadership is an action which is attained by the leader to give, direct and lead the team
members. The concept of leadership is required in each and every field for the successful
company operations. On another hand, clinical operations are the method which helps the
organisations like NHS to enhance their services for the maintenance of care standards. Whereas,
the concept of clinical governance is initiated with a motive to develop the mechanism so that the
patients can get improved quality services (Brennan and Flynn, 2013). However, the stated
concept requires effective leadership for the implementation of the requisite changes and
alterations. It will allow the health care organisations to get a clear vision concerning all the
levels. The present document is based on the case study of deceased person name Christopher
Hammett. He died due to certain errors raised from the part of medical and nursing care. As a
result, this report will consider the same case and explain the role of the nurse as a leader in the
healthcare organisations.
ULO1 Role of registered nurse as a leader
In nursing care, the concept of leadership plays an essential role because the patients can get
proper attainment with the help of nurses. The roles of the registered nurses as leaders may vary
according to the structure and size of the firm. However, a registered nurse can perform his or
her duties are equivalent to the competent manager and the leader. The registered nurse is needed
to carry out the role related with visionary leadership (Porter-O'Grady and Malloch, 2011). This
allows the nurse to manage the operations related to the different patients. In the case of
Christopher Hammett(CH), he consulted with an orthopaedic surgeon for back pain. Further, his
health was good enough when he was admitted to the private hospital where the medical staff did
not find after the working hours. Initially, the oxygen saturation of the patient was maintained at
99 percent. Further, he was transferred to PACU. This has resulted in lowering down the
saturation level of the oxygen.
In context to above, the present anaesthetist assumed that due to reversible upper airway
obstruction, the level of oxygen saturation has tended to low. As a result, they supported his jaw
and inserted an oropharyngeal airway. The staff who was present there kept on changing their
oxygen mask. This has affected the saturation level of Mr CH which was not properly recorded
by the staff. When the level was recorded, it was mentioned at the stable level. Here, the nurse
assumed due to the use of morphine; the oxygen level is getting influenced. Therefore, being a
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registered nurse, it was their duty to properly analyse the condition of the patient instead of
assuming the things. This has resulted in the death of the stated patient (Bretschneider, Eckhardt
and et.al., 2010).
ULO2 Differentiate between leadership and management
Leadership and management are the two most crucial terms which are mainly used in the
organisations. The two concepts are quite distinct from each other but somewhere they are
connected collectively. However, leadership is the attribute of a leader by which the team
members are get influenced to attain the assigned tasks and duties. On the contrary to this,
management is the process by which the things are being managed in an effective manner. The
two terms are required and can be seen in all the fields like corporate, hospitality sports and
medical (Huber, 2013). Howsoever, the organisation like NHS and cancer research centres also
adapts this concept in this working environment. In the health sector, leadership is used to
influence the nurses and another staff for taking care of the patients. On another side,
management is used for the management of several activities in the health care organisations.
Additionally, at the time of influencing the nurses and another staff for accomplishing work, the
leaders plays the essential role. The concepts of leadership assist the team to get influenced for
the achievement of organisational goals. Besides this, management brings stability in the
operations of an organisation. Therefore, it can be said that leadership and management are the
two important tools which are required in the organisation. Both the concept plays an essential
role in the attainment of the company objectives (McSHERRY, Pearce and et.al., 2012).
ULO3 Role of nurse in improvement of quality and change management
Nurses are the most important person in the hospital for the care of patients and their families.
They evolve considerable information concerning the strength and weakness of the heath care
organisations. For the successful operations of the hospitals, it is crucial to bring improvement
regarding quality. Nurses are the one who takes care of the patients and has the major focus on
the operations of the hospitals. For instance, they are responsible for the care of the patients
effectively (Weston, 2010). However, the top management adopts measures for the
improvements of quality are mainly followed by the lower staff. For example, If the higher
authority has implemented the software for the storage of patients data and information then it is
the duty of the nurses to make sure of the storage of patient data.
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In context to above, change management is another concept which is being focused on
the top level management in the hospitals. To provide improved services, the management needs
to focus on bringing changes. However, the nurses play an essential role in the adoption of
change management. The implemented alterations in the hospitals are followed by the lower staff
itself. This helps the management of the hospital to implement the strategic changes at
workplaces (Dwyer, 2011).
ULO4 Principle and processes of clinical risk management and its application
Clinical risk management is related to the enhancing the services quality in the health care
organisations. Here, the management identifies the current situation of the organisation and
analyse the risks which can harm the patients. To manage the clinical risk, there is four-step
process can be adopted by the management of the hospital. In the first step, the present situation
is analysed by which the actual risk is identified. Further, the managers need to assess the
severity and the frequency of the associated risk in the hospital (Bassett and Westmore, 2012). If
the frequency of risk is higher than the authorities needs to adapt the effective measures and vice
versa. Additionally, after analysing the frequency of risk the management requires focusing on
the reduction of risk with the implementation of the corrective measures. This will allow the
management to overcome the issues raised in the operations of the hospitality sector.
At last, the cost of risk must be analysed so that the organisation can focus on the corrective
measures to lower down the cost of risk. To apply the risk management techniques, the
management requires making a plan so that the whole picture can be analysed.
ULO5 Accountability of the registered nurse in clinical governance
For the registered nurse accountability is the major concerns in clinical governance. Whereas,
accountability can be explained as the responsibility of the actions. As per the modern concept of
the accountability, the nurses are the member of the profession. As per this concept, they are
responsible for certain roles and responsibilities towards the patients. However, judgements can
be made by them in different circumstances. They use their professional knowledge to make the
decisions concerning the patients. In clinical governance, the nurses are accountable for certain
responsibilities which help the patients to get proper care and treatment in the hospitals (Twigg
and McCullough, 2014). There are four 'principle' which form up a structure of professional
answer-ability deriving from various types of potency in nursing activity these are professional,
ethical, lawful and employment/contractual. All these principles help the registered nurse to
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perform their roles and duties in a way that the goals and objectives of the hospital can be
attained. As a result, the health sector organisations will be able to provide quality services to the
customers. This will result in attaining the goals and objectives in an effective manner. In
addition to this, the quality health services will result in the increase in a number of patients in
the concerned hospitals (Barden, Griffin and et.al., 2011).
GLO1 Specific knowledge and capabilities for the stated profession
For the stated profession, it requires having advanced knowledge of the principles and concepts.
Additionally, coherent and advanced knowledge of the underlying principles and concepts in one
or more disciplines and knowledge of research principles and methods. Cognitive and technical
skills to demonstrate a broad understanding of a body of knowledge and theoretical concepts
with advanced understanding in some areas (Levett-Jones and Bourgeois, 2010). In addition to
this, technical skills to design and use research in a project. Besides this, the application of
knowledge will demonstrate the application of knowledge and skills:
 With initiative and judgement in professional practice and scholarship
 To adapt knowledge and skills in diverse contexts
 To plan and execute project work and a piece of research and scholarship with some
independence (Top 11 Skills for Becoming a Successful Registered Nurse, 2017).
 To contain some important skills such as organisational, stress management, good
communication, detail oriented, critical thinking, etc.
 Have a good knowledge regarding medicine, psychology, able to determine the needs of
service users, etc. (Ericksen, 2015).
GLO2 Use of different communication modes
In the case of Mr Hammett, nurses could use various communication modes to share the health
information and related updates with doctors and other health practitioners. The death of the patient
has also dependent over the miscommunication among the health care workers and selection of
wrong communication modes. To minimise the probability of occurrence of the following situations
in the future, there are different modes of communication can be used. These help in to inform,
motivate and the effect change. With the aid of communication skills, the clear ideas and
thoughts can be presented to the listener (Martin, McCormack and et.al., 2012). By using
effective communication skills, the ideas and principle will be effectually presented. With the
help of oral communication, the ideas and principles can be clearly explained to the listener. In
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addition to this, written communications assist in getting the information with the use of proper
language and format. This maintains the reliability of the information in a way that it helps in
communicate the right information to the other members. Along with this, interpersonal
communication mode can be taken into the consideration by the nurses of Pacific Private Hospital
to share the health update of Mr Hammett (Brennan and Flynn, 2013).
GLO3 Application of Digital literacy to find, use and dissemination information
Digital literacy means the knowledge, skills and behaviours used in a wide range of digital
devices. It contains laptops, smartphones, desktops, etc. In the case of Mr Hammett who has died
in Pacific Private Hospital because of several reasons such as errors series of errors albeit lack of care
on the part of the medical and nursing staff caring for him, aspiration pneumonia, etc. With the help
of application of different Digital literacy, nurses can find, use and dissemination of information
(Porter-O'Grady and Malloch, 2011). For example, by using the following concept, nurses can
able to understand how to use technologies to interact with the other staff members to information
about the health status of the patients to health care practitioners and maintain good
communication with them. With the help of this, they can record health update of service users in
every situation and analyse them to determine the variations in the health status of the patients
over the time. The generated information from Digital literacy can assist the nurses to share the
record and analysed data with other care workers of Pacific Private Hospital so that they can able to
take the right actions to improve the health condition of the patient ( Bretschneider, Eckhardt and
et.al., 2010).
GLO4 Evaluating information using critical and analytical thinking and judgment
With the application of critical and analytical thinking, it becomes easy to evaluate the
existing information in the right way. In the case study of Pacific Private Hospital, with the
application of the following concept, it has become easy to evaluate the issues by key points,
arguments and assumptions in the information. By doing this, it has assisted the nurses of a hospital
to determine what are the exact issues that have lead to the death of Mr Hammett. By this, a new
course of actions can be easily taken so that the same problems cannot repeat in the future with any
other patients (Huber, 2013). Along with this, by evaluating the already exist information using
critical and analytical thinking and judgment; it has determined the causes and effects, the
sequence of observational activities, similarities and differences in trends of patient health
observation, etc.
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GLO5 Creating solutions to authentic problems
By the given case study, it had determined that Christopher Hammett died as a result of a
series of errors albeit lack of care on the part of the medical and nursing staff caring for him when he
was a post-operative patient at the Pacific Private Hospital. Along with this, it has also found that
death was caused by aspiration pneumonia due to, or as a consequence of, coronary atherosclerosis
(McSHERRY, Pearce and et.al., 2012). To solve real and ill based problems, nurses of cited
organisation should adopt leadership professionals. It will help in developing a successful vision for
the organisation and develop collaborative nature between the nurses and other health care
professionals. This will allow solving the problems on a daily basis and providing direct guidance as
well as provide mentorship to other units nurse staff. Apart from this, with the use of leadership
approach, the nurses of cited hospital will show the responsibilities towards large-scale policy
planning, staff management, financial resource management, and business management functions
(Weston, 2010). Further, this will realise them to understand the core responsibilities such as
coordinating and supervising the delivery of health care. Besides this, with the proper education to
the nurse, Pacific Private Hospital, it becomes simple to find the solution of the problem.
GLO6 Self-management
As per the given case study, it has found that Christopher Hammett had faced unresolved
back pain. For this, Dr Scott-Young performed an orthopaedic review on the patient. After few
months, the same health checks up done by the doctor and has suggested to Mr Hammett for L5- S1
disc replacement operation. After completion of the 35-minute operation, he has shifted to the Post
Anaesthetic Care Unit (PACU) (Dwyer, 2011). There were two registered nurses appointed for
patient care and its health observation. During his case, various observations had taken by the health
care practitioners to ensure the health of Mr Hammett. From the case analysis, it has identified that
there were reasons that were working behind the death of the patient. To overcome the weaknesses of
nurses, self-management becomes most important. For this, the first concept in this direction has
worked and learning independently. In this context, the management of Pacific Private Hospital
should arrange the proper training to them so that they can learn different practices to deal with the
patients and deliver them proper care. It will assist in the development of various skills in nurses so
that they can work independently in the hospital with less monitoring and guidance. Along with this,
self-management concept will allow them to take responsibility for personal actions if they notice no
improvement in the health of services. By this, nurses of Pacific Private Hospital can determine
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several courses of actions in the context of the well-being of patients (Bassett and Westmore,
2012).
CONCLUSION
From the above research, it can be concluded that in Pacific Private Hospital, Christopher
Hammett was referred by his general practitioner for unresolved back pain. Different health
observations and check-up were taken into the consideration by the doctors to determine the main
route cause of illness. After all these work, it was recommended to carry out a disc replacement
operation to the patient. A further operation, Mr Hammett was shifted to PACU where two nurses
were there to monitor their health. The less knowledge of operating the equipment and mistakes in
taking the health observation, finally the patient died in the hospital. By this case study, it has been
concluded that there have several reasons which have shown that nurses have needed proper training
and education to taking care of patients and operating the machines. By adopting the right leadership
and management styles, they have able to take the right decisions in clinical risk management and
apply it in healthcare domains.
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REFERENCES
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Westmore explore the importance of workplace culture and leadership. Nursing
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Brennan, N.M. and Flynn, M.A., 2013. Differentiating clinical governance, clinical management
and clinical practice. Clinical Governance: An International Journal. 18(2). pp.114-131.
Bretschneider, J., Eckhardt, I. and et.al., 2010. Strengthening the voice of the clinical nurse: The
design and implementation of a shared governance model. Nursing Administration
Quarterly. 34(1). pp.41-48.
Dwyer, D., 2011. Experiences of registered nurses as managers and leaders in residential aged
care facilities: a systematic review. International Journal of Evidence
‐Based
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Huber, D., 2013. Leadership and nursing care management. Elsevier Health Sciences.
Levett-Jones, T. and Bourgeois, S., 2010. The clinical placement: An essential guide for nursing
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Martin, J.S., McCormack, B. and et.al., 2012. Evaluation of a clinical leadership programme for
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McSHERRY, R.O.B.E.R.T., Pearce, P. and et.al., 2012. The pivotal role of nurse managers,
leaders and educators in enabling excellence in nursing care. Journal of Nursing
Management. 20(1). pp.7-19.
Porter-O'Grady, T. and Malloch, K., 2011. Quantum leadership: Advancing innovation,
transforming health care. Burlington, MA: Jones & Bartlett Learning.
Twigg, D. and McCullough, K., 2014. Nurse retention: a review of strategies to create and
enhance positive practice environments in clinical settings. International Journal of
Nursing Studies. 51(1). pp.85-92.
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Weston, M.J., 2010. Strategies for enhancing autonomy and control over nursing practice. Online
J Issues Nurs. 15(1).
Online
Ericksen, K., 2015. 5 Professional Nursing Skills You Need to Launch Your Career. [Online].
Available through: <http://www.rasmussen.edu/degrees/nursing/blog/five-professional-
nursing-skills-to-land-a-job/>. [Accessed on 5th January 2017].
Top 11 Skills for Becoming a Successful Registered Nurse. 2017. [Online]. Available through:
<http://www.topregisterednurse.com/registered-nurse-skills/ >. [Accessed on 5th January
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