Professional Nursing: Leadership, Culture and Practice Engagement

This report delves into the multifaceted aspects of professional nursing, encompassing critical areas such as clinical governance, quality and safety, leadership and management, and organisational culture. It emphasizes the importance of consumer participation and shared decision-making in enhancing the quality of healthcare services, highlighting strategies like planning and development, and the benefits of informed patient involvement. The report explores the significance of prioritising quality and safety, as well as the application of effective leadership skills, including decision-making and resource management. It also underscores the characteristics of a learning-oriented organisational culture, promoting knowledge sharing and continuous professional development. The report provides practical insights into nursing practices at Bundaberg Base Hospital, focusing on how to integrate these principles to improve patient care and outcomes.

Engagement in
Professional Nursing

TABLE OF CONTENTS
Clinical Governance...............................................................................................................1
Quality and Safety .................................................................................................................2
Leadership and Management..................................................................................................3
Organisational Culture............................................................................................................5
Professional Practice..............................................................................................................6
REFERENCES................................................................................................................................7

Clinical Governance
Clinical governance is a systematic approach that assist in consistent improvement in the
quality of health services. There are several elements of this administration such as education,
training, clinical audit, R&D, etc. In addition to these, consumer participation is the tool which
enhances the quality of the services. Their participation helps in improving the understanding
and awareness of consumer perspective There are two ways in which consumers can actively
participate in shaping the health care bringing-
 Planning and development: Involving consumers in the planning and development of
the health care services will help in creating the services based on the different
perspectives. This development will assist the healthcare in meeting the broader and
varied demand of patients. Australia is the biggest example of the most successful
country in implementation and development of National health strategies and policies
(Regan, Laschinger and Wong, 2016).
 Shared decision-making: Active consumer participation in the decision-making results
in improved health outcomes. Healthcare homes are required to provide them with a
knowledge of self-management and quality information so they can choose the best
suited strategy for them. It has been studied in various studies that consumers should
become partners with the healthcare professionals, it will not only their right but also it
enhances the quality of care that is been provided. The major benefits of shared decision-
making involve improved knowledge, reduced decisional conflict and the involvement of
patients assists in their physical and emotional recovery by reducing their anxiety
(Kwedza, Larkins, Johnson and Zwar, 2017).
In addition, consumer participation can be gained by focused group, survey, feedback,
questionnaire, etc. This can assist in evaluation of the provided services and depending upon
which further improvements can be made.
Being a registered nurse in Bundaberg Base hospital it is my foremost duty to perform
effective actions that can improve the quality of the service that are being offered by the hospital.
I will perform a shared decision-making process in the treatment of patient. This thing will help
in understanding the perspective of patient and his/her family that will assist in effective
planning of the clinical functions. Besides this, before implementing any operation I will ensure
that the consumers are well aware and informed about that. This assurance is necessary so that
1

the strategies can be implemented effectively. However, all these steps can still not render the
evaluation of the performance or quality of the services that I offered to them and in order to
measure this I will take feedback from consumers (Nursing and Midwifery Board of Australia,
2017). Thus, in this way I will try to increase the consumer participation in the planning,
implementation and evaluation of the care. Besides this, I will ensure continuity of care from
shift to shift. For this I will prepare an interactive process in which I will involve staff and
patient’s allocation, updating the handover sheets, etc. Along with this, it is necessary to
communicate properly with the suffered persons to have the complete understanding of the
medical situations that are being faced by them. In order to achieve this, I will listen attentively
to them without interruption and also, I will ask open ended questions. Transparency is also
important to maintain to prevent any trust issues and thus, I will get the patients informed of the
decisions.
Quality and Safety
Quality in term of healthcare is associated with the best health outcomes whereas safety
is linked with the reduction of unnecessary risks (Halton and et. al., 2016). To understand these
terms in depth one can access the National health and Quality health service standards.
According to one of its modular, partnering with consumers is very necessary. This standard
describes that in order to implement safe and qualitative systems, entities should promote the
participation of consumers. This principle enables the creation of consumer-centred strategies
and this is only possible when they are involved in the developing and designing of quality
healthcare. There are several benefits of implementing this standard in the medical practices such
as decreased mortality, decreased re-admission rates, reduced length of stay, improved treatment
and so many.
In case if the practices are not adhered with these standards then there are possibilities
that patients may not like the services they are provided. This discontentment of consumer with
the quality of service will directly harm the image and productivity of the healthcare home
(Maxwell and Wright,2016). Further, according to the national rights it is necessary to involve
and inform patients about their entire medical discussion thus, depriving partnership with
consumer can lead to legal issues in the organisation. Besides this, disregarding this standard in
the clinical practices can directly impact the potential health outcomes such as mortality rate,
readmission rates, length of stay, acquired infection etc. Consumer partnering is the primarily
2

tool that is used to prevent and effective manage the different illness of patients. In the present
time, it is very essential for hospitals to possess personalised care to the patients depending upon
their perspectives and requirement (Thomas, McIntosh, Lamar and Allen, 2017). Wrong and
inappropriate treatment not only impact upon the consumer satisfaction but also increase the
mortality rate. Thus, organisations should provide consumer-centred care and it is only possible
by consumer partnering. Sticking to these practices will help in proper communication of
patients with the healthcare professional which will help in identifying all the issues that are
being faced by the consumers and thus, effective implementation of the strategies will take place.
Being a registered nurse in Bundaberg Base hospital I will ensure consumer partnering so
that I can bring the effectiveness in the operations. In this way, I will involve them in all the
decision-making procedures and medical discussions. This action will maintain transparency.
Further, this engagement will help in gaining their demands which will assist in drawing
functions. Besides this, I will conduct feedback sessions after providing my health care services
to the patients. These feedback, survey and training conduction will provide me with lacking
points so that I can further improve them by enhancing my nursing practices. Besides this, hand
hygiene is necessary to have better control on the infections. For this I will render the patients
with a study of importance of keeping hand hygiene to avoid ill-health. I will indicate patients
for hand wash with soap and water when their hands will be visibly dirty, after they use
restroom, before and after having food (McSherry and Pearce, 2017).
Leadership and Management
Leadership and management are although two different terms but are highly related with
each other. The overall process comprises of setting a vision and then directing it by considering
the principles or standards (Cooper, 2017). In context to nurses, there are several leadership
skills such as prioritising health safety and quality, time management, decision-making, self-
awareness, social awareness, relationship management, etc. Out of them the major are the
prioritising quality and safety and decision-making, which are explained further: Prioritising quality and safety- It is the foremost duty of a nurse to prioritise the quality
and the safety of the health services that are being provided to the patients. There are
numerous strategies and tools that can assists in gaining this skill such as person-centred
care, teamwork and collaboration, etc. The significance of this strategy includes various
factors from patient and organisation point of view (Mancuso, 2016) In context to patient,
3

this is necessary as it assures the safety and quality of the health services. By adopting the
quality of care tool, healthcare professionals can increase the standards of comfort. Also,
person-centred care is essential to meet the needs of different patients. On the other hand,
this tactic will help organisation in gaining satisfaction and trust of consumers on their
services and hence, increased productivity.
 Decision-making- Being a nurse, it is very necessary to possess the decision-making
skill. This ability is essential for carrying out further operations. Besides this, this is the
basis of entire planning. All the activities are discussed while taking any clinical decision.
This method helps in gaining a layout following which all other operations can be carried
out (Kantanen, Kaunonen, Helminen, and Suominen, 2017). The patients will be involved
in decision-making process either directly or indirectly. Healthcare professionals can
either involve them in the medical discussions related to the patients or by taking their
suggestions to implement them in the decisions.
Apart from this, the healthcare leaders are also required to focus on the success of the
organisation(s) in which they work. To do so, they must be effective in: Planning by actively
contributing to plans to achieve service goals. Managing resources by knowing what resources
are available and using their influence to ensure that resources are used efficiently and safely,
and reflect the diversity of needs. Also, managing people by providing direction, reviewing
performance, motivating others, and promoting equality and diversity. Further, performance
should be managing by holding themselves and others accountable for service outcomes.
Both the skills are effective and mandatory in implementing nursing practices. As per my
point of view I would like to strengthen the prioritisation of the quality and safety of the services.
It is because failure in achieving this skill leads to severe problems in treatment of patients. In
order to achieve this, I will involve the consumers in decision-making to ensure the quality of
services for them. The quality of service can also be improved by taking assistance of several
tools such as feedback, survey, questionnaire, focused group, etc. This tactic will help in
evaluating my weaknesses and strengths. Further, the focused group can help in boosting my
knowledge on quality of health services (Sawan, Jeon, Fois and Chen, 2016). Besides this, the
safety in services can be attained by following clinical reasoning cycle as this will enable
effective planning of entire operations.
4

Organisational Culture
Organisation culture is a system of shared beliefs and values that controls the behaviour
of people within an organisation. When learning adds to this culture, it increases the knowledge,
competence and performance (Grealish and Henderson, 2016). The defining characteristics of
learning culture are as follows: In an organisation that follows a learning culture, information is
not kept confidential rather it is shared. Further, they are readily accessible for both the high-
level authorities and other employees. The high priorities for a learning entity are the training
and acquisition. Besides this, such entities focus on constant learning that can enhance the entire
performance. It is the most important characteristics that define the learning. This concept allows
people to understand various things. This is the place from where the idea of learning has been
generated. Personal mastery the individual's deepening of vision that helps in focusing on his/her
energies. Personal mastery is the commitment of an employee to the process of learning. It also
creates a health competition between the workers of organisation which will boost the entire
performance of the entity by the development of each and every individual.
Mental Models are deep-rooted assumptions that influence the understanding of outer
environment. Further, it also covers the actions of different people on their perspectives of outer
world. Learning helps in building an idea that can inspire organisations for thousands of years.
This type of development is necessary in motivating the employees to learn (Hodge, Campbell
and Tobar, 2016) The integration of individual learning results in team learning. It is the most
effective method for the workers to grow and to develop problem solving ability.
Being a nurse of Bundaberg Base hospital, it is essential for me to promote a learning
culture in my organisation. To enhance my knowledge of nursing, I can learn by sharing the
information from other healthcare professionals. Group discussion is always being a great tool to
acquire more knowledge within less time. Also, I should attend all the training programmes that
are conducted either by the organisations or government to amplify my learning. In addition to
this, I will stay updated with the new medication methods that are been discovered and will
implement them in my nursing practice. For this, I will search for the new methods using internet
and reports of other entities. As I believe in team learning I will consistently interact with the
colleagues and other staff of the hospital to share the knowledge.
5

Professional Practice
Role ambiguity is a situation that occurs when people are unclear about their expectation
with a certain role. These roles are essentially need to be clarified. It becomes more severe when
it comes to then nursing practice. Nurse are required to be clear with all their function as life of
many people are associated with their confusion from the role (Talley, 2016). Higher the role
ambiguity sensed by a nurse, lesser will be her/his commitment with the organisation. The role
ambiguity from the side of a nurse directly impact upon the health of patient. If nurses or
midwives will unclear about their expected work role then entire treatment of patients may needs
to suffer. This situation occurs when the information is not clear or communication is lacking. In
this way, the nurses will not be aware of the exact data and does cannot implement operations on
the patient. There are several reasons that result in ambiguity of the work. The major among
them is poor learning of nursing practices. Also, the ineffectiveness’s of absence of learning
culture in the organisations leads to role ambiguity. In addition to this, this condition puts dual
pressure on some employees (Poitras, Chouinard, Fortin and Gallagher, 2016). If some nurse or
healthcare professional is having unclarity of the task then it is moved to some other person for
completion which creates more work pressure on him/her. Besides, this lack of specificity leads
to role strain that highly influence nurses to leave the organisation. This turnover will directly
impact on the overall performance of the hospital and hence, entities should work on conducting
some training that can clarify the different roles of healthcare staff.
In order to stay away from role ambiguity, I will try to implement some strategies that
will facilitate me in staying emotionally and physically well. Firstly, I will ensure proper
communication with high level professionals and patients. The interaction with the patient will
assist me in getting the clear idea of their situation and besides this, discussion with the
healthcare professionals will help me in achieving better understanding of the treatment. In
addition to this, communication helps in revealing all the issues that are being faced by the
patients. Besides this, appropriate knowledge of nursing practices is also necessary in dealing the
situation of ambiguity. This can be gained by studying various books and journals on relevant
practices. However, practical knowledge is must in every sector thus high practice is required
(Cooper, 2017).
6

REFERENCES
Books and Journals
Cooper, E. (2017). Quality and Safety Education for Nurses Implementation: Is It Sustainable?
Nurse Educator.42(5S). S8-S11.
Currie, J. & et.al., (2017). Implementation of a clinical governance framework to 17 combat
service support brigades, Australian army. International Journal of Health Governance.
22(1). 15-24.
Grealish, L., & Henderson, A. (2016). Investing in organisational culture: nursing students’
experience of organisational learning culture in aged care settings following a program of
cultural development. Contemporary nurse.52(5). 569-575.
Halton, K. & et.al., (2016). Using a clinical governance framework to identify barriers to
infection control practice. Infection, Disease & Health.21(3). 143-144.
Hodge, M. B., Campbell, P., & Tobar, K. (2016). Engaging Nurses in the Development and
Implementation of a Professional Practice Model Through Nursing Salons. Journal of
Nursing Administration.46(9). 425-427.
Kantanen, K., Kaunonen, M., Helminen, M., & Suominen, T. (2017). Leadership and
management competencies of head nurses and directors of nursing in Finnish social and
health care. Journal of Research in Nursing.22(3). 228-244.
Kwedza, R. K., Larkins, S., Johnson, J. K., & Zwar, N. (2017). Perspectives of rural and remote
primary healthcare services on the meaning and goals of clinical governance. Australian
Journal of Primary Health.
Mancuso, L. (2016). Guest editorial: Building a foundation for Global Nursing Leadership.
Journal of nursing management.24(8), 981-982.
Maxwell, K. L., & Wright, V. H. (2016). Evaluating the Effectiveness of Two Teaching
Strategies to Improve Nursing Students’ Knowledge, Skills, and Attitudes About Quality
Improvement and Patient Safety. Nursing education perspectives.37(5). 291-292.
McSherry, R., & Pearce, P. (2017). Measuring healthcare workers perceptions of what constitutes
a compassionate organisational culture and working environment: Findings from a
quantitative feasibility survey. Journal of Nursing Management.
Poitras, M. E., Chouinard, M. C., Fortin, M., & Gallagher, F. (2016). How to report professional
practice in nursing? A scoping reviews. BMC nursing,15(1), 31.
Regan, S., Laschinger, H. K., & Wong, C. A. (2016). The influence of empowerment, authentic
leadership, and professional practice environments on nurses perceived inter
professional collaboration. Journal of nursing management. 24(1).
Sawan, M., Jeon, Y. H., Fois, R. A., & Chen, T. F. (2016). Investigating the role of outer layers
of organisational culture in the use of psychotropic medicines in Australian Nursing
Homes. Research in Social and Administrative Pharmacy.12(5). e25.
7

Talley, L. B. (2016). Collaborative Partnerships: Raising the Professional Practice of Nursing.
Journal of Nursing Administration.46(6). 291-292.
Thomas, C. M., McIntosh, C. E., Lamar, R. A., & Allen, R. L. (2017). Sleep deprivation in
nursing students: The negative impact for quality and safety. Journal of Nursing
Education and Practice.7(5). 87.
Online
Nursing and Midwifery Board of Australia, 2017 [Online] Available Through:
<http://www.nursingmidwiferyboard.gov.au/> [Accessed On 30th August].
8