Contemporary Nursing Practice Issues: Organisational Culture And Professional Practice

Clinical Governance and Patient Engagement

Question:

Discuss About The Organisational Culture Professional Practice?

Nursing practice is both rewarding and challenging at the same time. Apart from retrenchment, they are to confront a number of challenges that might make their practice within the setting difficult. Registered nurses are to address contemporary practice issues while carrying out their practice within a clinical setting. The primary domains in which such issue arise encompass clinical governance, quality and safety, leadership and management, organisational culture and professional practice. Clinical governance highlights the role of consumer participation in the improvement of service delivery by considering the need of the patients and their perspectives (Giger, 2016). It is crucial that safety of patient and quality of care are two basic aspects of the process of improving care in addition to the reduction of harm. Leadership skills have been long connected with competency levels of professionals irrespective of their domain. A registered nurse is expected to be responsible for own professional development through continual learning. A nurse is prone to suffer stress and burnout from a diverse range of source and must apply self-care strategies for combating the same (Potter et al., 2016).  The present paper addresses the above highlighted contemporary nursing issues in a detailed manner. It is divided into five sections, each pertaining to one domain. The paper requires the author to reflect upon own experiences and support the opinion with evidence from existing literature.

Shippee et al., (2015) have drawn the attention of healthcare researchers on the importance of engaging patients, that is healthcare consumers for better care delivery. As per the authors, it is in the hands of patients to mould up the manner in which care is delivered and influence the quality of care in a direct manner. The rationale behind this is that they are recognised as one of the important stakeholders in a care setting that is patient-driven. As highlighted by Greene et al., (2015) a healthcare professional contributes to such engagement of consumers by multifaceted approaches. The first method by which a patient can be engaged in service delivery is to receive input from them about how they would want to outline their care plan. A professional might emphasis on the cultural and social aspects of the patient while caring for him. The second method for engaging patients in to service delivery would be to receive suggestions and recommendations on the care delivery system on the whole after they have been discharged from the care setting. This would encompass highlighting their satisfaction level and any arising challenges and issues that when looked after would bring about a change in the system of the organisation (Bosio, 2014).

Preventing and Controlling Healthcare-Associated Infections

I, as a registered nurse, would enable engagement of patients in care service delivery by taking feedback from those who have been discharged from the care setting in the last one week. This would be done by contacting the patient over the telephone and communicating in a manner that would ensure that the patients report their true feelings and perceptions. A feedback form would be sent to them via email, and the same are to be reverted within a span of two days. The elements of the feedback form would encompass different aspects of patient satisfaction pertaining to care delivered while his stay at the hospital. Suggestions would be taken on how the services can be made better in the future (Black, 2016).

The National Safety and Quality Health Service (NSQHS) Standards has been outlined by the Australian Commission on Safety and Quality in Health Care (ACSQHC) that aims to foster and promote protection and safety of the patients getting services from a healthcare centre. There are ten standards described in the document, each focusing on diverse patient care issues (safetyandquality.gov.au, 2012). The present section would focus on the Standard three as outlined in the document. This standard emphasises on “Preventing and Controlling Healthcare Associated Infections”. The risks related to non-adherence of this standard is far-reaching. Healthcare-associated infection (HAI) is the infection suffered by a heath care consumer while he is receiving care services at a care unit. The eventual impact of such infections is mobility and increased chances of mortality. As opined by Mitchell and Ferguson (2016) Australian healthcare system has been facing major challenges in combating the financial burden of treating HAIs. It is a recognised safety issue concern as thousand of the patient every year in Australia report this issue.

A registered nurse has a prime role in adhering to strategies that minimise the burden on care settings to care for HAIs (Brouqui et al., 2017).  I ensure that I follow religiously the policies and guidelines set for prevention of HAIs within my setting. This would mainly focus on the different hand washing techniques and use of protective personal equipment. Washing techniques involve simple use of mild soap and water, or a stronger alcohol based antiseptic, based on the particular condition of the patient cared for. It is to be mentioned in this regard that hand washing technique has bene provided to reduce chances of HAIs to a considerable extent. Personal protective equipment includes wearing gloves and aprons while coming in direct contact with patients. Contamination of self would be prevented by this approach and chances would be less that I become the carrier of infectious agents (Russo et al., 2017).

Leadership and Technological Advancement

The central element of nursing skills is perhaps leadership, as stated by Wheatley et al., (2017). Leadership is the process, or rather progression made by a healthcare professional to guide other within the clinical context to work for a common goal. This goal for a nurse would be to achieve best results pertaining to patient outcomes. From the analysis put forward by Cherry and Jacob (2016) two discreet leadership skills that draw attention and that nurses must integrate into their practice are firstly a global mindset or perspective and secondly an adequate knowledge of advanced technology. A nurse needs to work in a diverse workplace as a patient come in from different ethnic and cultural background. It is therefore crucial for a nurse to embrace the diversity and become culturally competent.  A global viewpoint while delivering care enables nurses to respond in an appropriate manner to the trends of care and become adapted to working at a national level. A nurse must also be updated to the implementation of advanced technology in care delivery. Technologies play a primitive role in the daily patient interactions and collection of adequate patient data. As a nurse, one must be keeping himself abreast of such technologies so that others can be guided towards a better care delivery process.

Among the above mentioned leadership skills, the one that would I would consider to be integrated in my practice is working knowledge of advanced technology. This skills would help me to operate a robust care service. For enhancing this skills I can undertake research and gain knowledge on technological advancements such as clinical decision support (CDS) system and Electronic health records (EHRs) (Grohar-Murray et al., 2016). By doing so I would be armed with the desirable technical knowledge that would stand me in a strong foundation for the coming future. The technical knowledge can also be gained by undergoing a course on the same from a reputed organisation of the local area.

Continual learning for developing skills and competencies is a key part of professional development for registered nurses across domains. Nurses are to foster a learning culture under conditions that promote safer practice delivery. For ensuring a learning cultural emerges, nurses are to demonstrate leadership skills at every stage of practice. Learning culture in an organisation promotes such learning that aids in the reduction of the burden of the same organisation in relation to care approach (Gagnon et al., 2015). A nurse is to be provided with motivation and encouragement to enhance their knowledge by allocating resources for research. Funding of research is the right step organisations can take for the same purpose. New paradigm is witnessed that for an organisation to be sustainable in this highly competitive world; it needs to promote learning of it professionals. Learning professionals are therefore more in demand (Afzali et al., 2014). To be abreast of the changing technology and science, dynamics of change and complexity can be combated by suitable learning. A nurse can only grow in his field if he decides to engage in continual learning.

Professional Development and Learning Culture

My contribution as a registered nurses towards the culture of learning would bring about a change in the organisation. I consider engaging myself in research, both primary and secondary within my scope of practice. The research is done based on a PICOT format that would address any patient issue. The resources are to be provided by the organisation since it is to be benefited from the outcomes. The second method would be to receive constructive feedback from my peers and seniors who would enable me to highlight areas of improvement that I would need to address. This can be done on a regular basis and for a particular period. Criticism and subsequent recommendations would help me to analysis the experiences I have had in the past. The inference drawn from this would be scrutinised to improve similar experiences in future (Nieswiadomy & Bailey, 2017).

Role conflict in relation to nursing practice, as highlighted by Zaccagnini and White (2015) is the arising conflict within a clinical setting whereby an individual is expected to demonstrate certain attributes of his role that might help overall with other roles other than the primary role he is playing. There is an increasing demand to show competency in multiple skills from one or more domains. Such issues are common in almost all care organisations, and depending on the nature of the conflict the impact is adverse. Masters (2015) pinpoint that role conflict needs to be avoided at any cost since the impact is deleterious. The direct results are high occupational stress for nurses, lower efficiency and high staff turnover. Role conflict is a key reason for decreased performance even if there is a capability to deliver the best. In organisations where there is an inappropriate staffing structure, role conflict can be found at all stages.

Nurses are often subjected to situations that lead to role conflict, and eventually stress and extreme cases of burnout. Retention of such employees is really difficult. Nurses must consider applying self-care techniques so that they can combat challenges faced on a regular basis (Fong, 2016). Taking breaks in between long shift hours would prove to be quite effective for me in relieving the stress and burden of work. Since work is monotonous and stressful, I believe that taking breaks to give rest to the body is essential. Physical stress is quite harmful to nurses, lowering their performance in the long run. I also have informal relationships within the workplace. This is a good method for coping up wit the emotional stress suffered at work. Keeping away from frustrations and boosting up of morale is possible with informal interactions with peers. 

Avoiding Role Conflict

Conclusion

Nurses practising at the modern era are prone to face numerous challenges that they are to overcome at any given point of time. Response to these issues rests upon the ability of nurses to relate to literature and apply evidence based strategies. To respond to the change taking place within the setting, it is imperative that nurses carry out a reflection on their own practice and examine thoroughly their implications. Propositions for nursing requirements are to be given special attention in this regard. Global diversity, evidence-based practice, leadership, clinical governance, patient safety, organisational culture and transition to practice are the chief areas that draw the attention of practitioners in the present era. Challenges are a part of work life for nurses, but they should not be made the driving factors behind poor performance. When dealt properly, the challenges can be overcome within a short span of time. The nurse must acknowledge their experiences and carry out further research to give rise to what would be the package of combating stressors and demands

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