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Introduction

Clinical governance, a framework introduced in England in 1997, has been pivotal in enhancing healthcare quality. It mandates that NHS organisations are responsible for continuously improving the quality of services and upholding high standards of care by cultivating an environment conducive to excellence in clinical care (Macfarlane, 2019). This framework gained widespread recognition in the UK and was a model for numerous nations, including Australia (Ghavamabad et al., 2021). The Australian Commission on Safety and Quality in Healthcare (ACSQHC) took a pioneering role in implementing clinical governance through the creation of the National Safety and Quality Health Service Standards (NSQHS) (ACSQHC, 2021). Drawing from a case study during a clinical placement, this essay critically assesses the impact of clinical governance on nursing care delivery. It also explores how the NSQHS standards are instrumental in assisting nurses to adhere to governance principles. Moreover, it underscores the importance of a safe and supportive healthcare environment in achieving optimal outcomes for patients and healthcare professionals.

Concept of clinical governance and clinical placement

Healthcare organisations use clinical governance as a systematic framework to ensure and continuously enhance the quality and safety of patient treatment. It covers various initiatives to advance clinical efficacy, patient safety, and excellence in healthcare services (Mcfarlane, 2019). Clinical governance is essential to contemporary healthcare systems as it holds healthcare professionals responsible and emphasises innovation and continual improvement. The culture of responsibility and quality improvement it fosters in healthcare organisations makes clinical governance essential. Clinical governance prevents medical errors, enhances patient outcomes, and improves patient experience (Kaini, 2019). It combines several elements, including clinical audit, risk management, training and education, patient feedback, and clinical efficacy, to guarantee high-quality, safe, and patient-centred healthcare services (Michael & Loh, 2023).

I saw how clinical governance concepts positively impacted nursing care when preventing hospital-acquired infections during a clinical placement in a hospital. One instance was the introduction of stringent guidelines for putting on and taking off personal protective equipment (PPE). To reduce the danger of contamination, nurses were expected to follow precise instructions when donning and taking off PPE. Regular training sessions and audits served to emphasise the significance of this protocol. This strategy considerably decreased the risk of hospital-acquired infections by ensuring that nurses followed the best infection control measures (Infection Control Guidelines Advisory Committee, 2019). Another crucial component of infection control in the hospital was mask fit testing. The use of masks that fit well and create an airtight seal was ensured by applying clinical governance standards. Regular fit testing was done, and nurses received instructions on how to use masks properly. Respiratory infections were less likely to occur by taking preventative measures and safeguarding patients and healthcare professionals (Xu et al., 2021).

Clinical governance also strictly regulated the use of hand hygiene techniques. Before and after patient encounters, nurses must follow stringent hand hygiene guidelines, which include washing hands with soap and water or using hand sanitiser (Australian Government, 2019). The hospital's dedication to these procedures was apparent from the supplies for good hand hygiene that were easily accessible, and the frequent reminders posted all over the place. The hospital's attention to patient safety and high-quality care was shown by its adherence to hand hygiene, which also decreased the incidence of infections. Lastly, clinical governance was critical in ensuring the nursing staff delivered high-quality treatment while reducing the risk of hospital-acquired infections (Australian Government, 2019).

Impact of standards (NSQHS) in Australian setting

The National Safety and Quality Health Service (NSQHS) Standards are a crucial foundation in the Australian healthcare system intended to ensure safe, high-quality healthcare services. These standards are critical tools for nurses to attain governance compliance in the Australian setting, and they are inextricably linked to the provision of nursing care, as demonstrated by my clinical experience in hospital-acquired infection prevention (ACSQHC, 2021). In the overall setting of my clinical case, Standard 3 was critical. It targets infection control directly, a critical obligation for nurses in hospital settings. This standard instructs nurses on best practices for controlling and avoiding healthcare-associated infections, including hand hygiene, PPE use, and environmental cleaning. By adhering to this guideline, nurses ensure that they follow evidence-based infection control practices, dramatically lowering the possibility of hospital-acquired infections(ACSQHC, 2021).

Standard 1 establishes the framework for clinical governance in healthcare organisations. It focuses on the significance of leadership, consumer interaction, and continual quality improvement. As essential healthcare team members, nurses engage fully in these procedures (ACSQHC, 2021). In my professional experience, I saw how clinical governance frameworks created an accountability and improvement culture. Nursing staff were urged to provide feedback and report events, which resulted in meaningful modifications to infection control measures and other parts of patient care. Drug administration is a fundamental nursing job, and Standard 4 focuses on reducing drug errors and increasing medication safety. This standard specifies best practices for pharmaceutical management, such as labelling, storage, and administration. Compliance with this criterion ensures that nurses are well-equipped to administer medications accurately and safely, improving patient safety and quality care (ACSQHC, 2021).

Patient safety is the core of Standard 5. It emphasises precise patient identification and matching operations to patients. Nurses are critical in patient identification accuracy during healthcare interactions (ACSQHC, 2021). Standardised patient identification methods were visible during my clinical placement, lowering the chance of errors in patient care and enhancing patient safety. Effective communication among healthcare personnel is critical to ensure patient care continuity and safety (Sheehan et al., 2021). Nurses are routinely involved in clinical handovers as patients are transferred between units or shifts. Standard 6 compliance requires the use of defined handover methods and tools. These standardised handover procedures, in my experience, improved communication and patient safety by lowering the likelihood of information gaps and inaccuracies during care (ACSQHC, 2021).

Nurses play a pivotal role in preventing and managing infections. Standard 8 provides guidelines for assessing patient risk and implementing preventive measures (ACSQHC, 2021). Compliance with this standard ensured that my nursing care was aligned with the best infection prevention and management practices.

Importance of safety culture

A robust safety culture within a healthcare organisation is the foundation for delivering high-quality patient care while ensuring staff well-being. Safety culture encompasses the collective values, attitudes, and behaviours of healthcare professionals, leadership, and the organisation concerning patient safety (Lu et al., 2022). It is an environment where open communication, error reporting, and continuous improvement are encouraged, and its impacts on patient outcomes and staff are profound (Kilcullen et al., 2022). Foremost among the advantages of a strong safety culture is its ability to reduce medical errors. In an environment where staff feel comfortable reporting errors and near misses without fear of reprisal, errors are more likely to be promptly addressed (Rodziewicz & Hipskind, 2020). This reporting culture emphasises learning from mistakes and identifying system weaknesses rather than assigning blame. By pinpointing the root causes of errors, healthcare organisations can swiftly implement preventive measures to reduce the recurrence of similar mistakes. This directly benefits patient safety by minimising harmful medical errors, thus improving patient outcomes (Singh et al., 2022).

Open and effective communication is another crucial element of a safety culture. It promotes better collaboration among healthcare teams, ensuring that critical information is shared promptly and accurately (Kwame & Petrucka, 2021). Enhanced communication leads to better patient care by allowing healthcare providers to identify and address potential issues before they become patient safety risks. When information flows freely, each team member is well-informed, enabling well-coordinated care that optimises patient outcomes (Agency for Healthcare Research and Quality, 2021). Moreover, a culture of safety contributes to increased patient satisfaction. Patients who perceive a strong safety culture within a healthcare facility are more satisfied and confident in their care (Noviyanti et al., 2021).

The knowledge that their healthcare providers prioritise safety instils trust in the healthcare system, enhancing the overall patient experience. This increased trust encourages patient engagement, compliance with treatment plans, and a willingness to seek care when needed, all of which contribute to improved patient outcomes (Hannawa et al., 2022). Additionally, a safety-focused environment promotes better adherence to established protocols. The staff members are likelier to follow protocols and guidelines consistently. This consistency reduces practice variations and ensures patients receive standardised, high-quality care (Morikane et al., 2021).

Conversely, a poor safety culture can harm patient outcomes and staff well-being. In such an environment, staff may hesitate to report errors or voice concerns, leading to increased medical errors. When errors are underreported due to fear of reprisal, they may go unaddressed, potentially causing harm to patients (Lu et al., 2022). The lack of transparency and accountability can foster a culture where errors are overlooked, compromising patient safety. Employee burnout is another typical result of a poor safety culture (World Health Organisation, 2021). Staff may feel unsupported, underappreciated, and overburdened by the stress and frustration of their jobs in such an environment (Garcia et al., 2019). Burnout can lower staff morale and have a detrimental influence on patient care. This can also lead to mistakes, lapses in decision-making, and lower quality of treatment, compromising patient outcomes (Garcia et al., 2019).

Lastly, an insufficient safety culture also leads to low employee engagement. Staff employees may get disengaged from their work if they believe their complaints should be taken urgently or their perspective should be respected. This disengagement further jeopardises patient outcomes, as a lack of passion and excitement for the position can lead to subpar performance (Scott et al., 2022). Finally, a lack of safety culture undermines patient confidence in the healthcare system. Patients who sense a lack of dedication to safety may be hesitant to seek care, feeling that their health will not be prioritised (Layne et al., 2019).

Conclusion

In summary, a robust culture of safety is a fundamental pillar in healthcare organisations, essential for delivering high-quality patient care and safeguarding the well-being of healthcare professionals. This culture, characterised by open communication, error reporting, and continuous improvement, brings numerous advantages that directly impact patient outcomes. It significantly reduces medical errors by promoting the prompt identification of mistakes and system weaknesses, thus enhancing patient safety and results. Effective communication within a safety culture enhances collaboration among healthcare teams, ensuring the timely sharing of critical information for optimised patient care. Patients who perceive a strong safety culture are more satisfied, engaged, and confident in their care, ultimately leading to improved outcomes. Conversely, a poor safety culture can lead to increased medical errors, staff burnout, reduced staff engagement, and diminished patient trust, all of which compromise patient care and outcomes. Therefore, nurturing and upholding a safety culture remains a top priority in healthcare organizations to benefit patients and healthcare professionals.

References

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