NRSG7377 Transition To Contemporary Nursing and Clinical Leadership Report 2 Sample
“The safety and quality of the care provided in Australia’s health system is of utmost importance to all patients, their families, and carers. A safe and high- quality health system provides the most appropriate and best-value care, while keeping patients safe from preventable harm” (AIHW, 2024). The professional nurse plays a vital role in the quality improvement of health care services. However, nurses cannot make these improvements in isolation. They must include other professionals and ancillary personnel in their initiatives. Total quality commitment and change initiatives also must include all levels of an organisation structure.
You are a graduate registered nurse working on a surgical ward in a large metropolitan hospital. As an emerging clinical leader, you have been asked by your Nurse Unit Manager to propose a quality improvement initiative to address one (1) of the following patient safety risk concerns:
1. Communication errors are one of the leading causes of medical errors — this translates to poor patient outcomes, longer hospital stays, and increased costs (Tiwary, Rimal, Paudyal, Sidgel, and Basnyat, 2019).
2. Human error form a significant portion of preventable mishaps in healthcare (Sameera, Bindra, and Rath, 2021). Errors are multifactorial and even a competent individual can commit an error. Human errors pose a threat to patient and organisational safety.
Use the Quality Improvement Proposal template provided and respond to the following through your proposal:
1. Identify the patient safety risk concern that you would like to address in a change initiative. Provide a purpose, background, two (2) specific and achievable objectives and evaluation of change concepts, inclusive of (2) specific evaluation practices for your change initiative proposal. Use current literature to support your proposal. (500 words)
2. Stakeholder engagement is a pivotal aspect of quality improvement. Identify the main stakeholders whom you need to engage in your change initiative proposal and critically discuss communication strategies with the stakeholders. (350 words)
3. Identify the leadership style that you will adopt in this innovation for change. Analyse how the two (2) specific attributes of this leadership style would benefit and guide success of this quality improvement proposal. (300 words)
4. Identify two (2) possible barriers to change, one (1) individual and one (1) organizational that you could encounter when implementing change. Critically discuss using current literature. (350 words)
Solution
1. Introduction
1.1. Purpose of the Proposal for Change
Communication errors remain one of the most common causes for medical error fatalities affecting patient safety and outcomes in a pronounced fashion. Quick, precise communication is critical to coordinated and efficient patient care in a high-pressure environment such as the surgical ward (Australian Institute of Health and Welfare, 2022). In the worst case, misunderstanding and not passing on crucial information can result in medication errors, wrong diagnoses or treatments as well as other bad events (Sameera et al. 2021.p.330). The primary aim for university assignment help of this proposal is to resolve gaps in communication among health care providers on the surgical ward by instituting interventions specifically meant to decrease errors and improve patient safety. They also are concentrating on patient handovers and interdisciplinary communication.
1.2. Background
Communication errors are the most commonly stated causes of medical mistakes globally (Tiwary et al. 2019.p.7). Miscommunication accounts for thousands of preventable medical errors per year and leads to prolongation of hospitalization, poorer patient outcomes as well overall an increased cost on the healthcare system (Australian Institute of Health & Welfare 2024). The high stakes, fast-pace of care in the surgical environment makes communication critical. Information must flow fluidly across the transitions between pre-operative, intra- operative and postoperative phases so that every care team member has a complete picture of patient symptoms or conditions as well as what has been done to treat them and prevent risks.
Patient’s handover has been identified as a specific context where breakdown in communication takes place, especially during transitions between shifts and among several healthcare professionals caring for the same patient (Aase & Waring, 2020.p.103228). The problem also is magnified with hierarchical barriers, overtasked capacity, and underutilization of communication solutions. Tackling these obstacles in the surgical ward setting is necessary to increase patient safety and reduce adverse events related to communication misunderstanding.
1.3. Objectives
• Objective 1
Use the SBAR (situation, background, assessment and recommendation) format in all patient handovers. SBAR is a tool that provides a standard way for doctors and health care professionals to communicate information about the patient (Mohamed et al. 2023.p.39). Automate repetitive documentation tasks to ensure that all the shifts for a hand over and within team communication is in accordance with defined process of structured approach thereby minimizing chances of leaving out any important information.
• Objective 2
Conduct interdisciplinary team training in communication practices. This training will create a culture of safety by aligning the nursing team and surgeons, anesthesiologists, allied health professionals for collaborative effort (Drossman et al. 2021.p.1674). The training promotes a culture of transparency and collaboration.
Both aims are specifically aimed at reducing the risk associated with patient safety by improving communication and ensuring all health professionals have the right information to deliver care of high standard.
1.4. Evaluation of Change
• Evaluation 1
This will involve a detailed pre- and post-audit of patient safety incident reports stating communication incidents. This initiative will be preceded by gathering of the baseline data on incidents related to miscommunication occurring before its implementation (Hettinger et al. 2020.p.585). Following six months of using the SBAR framework and providing team training, a repeat audit needs to be conducted to determine whether there has been significant improvement in these events.
• Evaluation 2
Feedback from staff using surveys and focus groups regarding the helpfulness of what worked to reduce suicides will be gathered. Qualitative methods will be used to determine overall experiences, perceived communication improvements or areas in need of improvement (Wong et al. 2020.p.15). This feedback can shape the initiative to a great extent.
In a nutshell, these evaluation aspects are another element of a change initiative that produces empirical results illustrating the effectiveness and highlighting room for improvements.
2. Stakeholder Communication
2.1. Identification of Major Stakeholders
The success of Quality Improvement initiative requires an effective stakeholder engagement (Litton et al. 2020.p.315). The proposed interventions must be directed towards different stakeholders in an organization operating within a surgical ward, various other departments. These individuals must be engaged to implement such initiatives.
• Nursing staff
Ward nursing staffs have a key role in patient handovers and day to day communication (Hesselink et al. 2024.p.103797). They are important target users to consider when implementing the SBAR framework and communication training.
• Surgeons and anesthesiologists
During surgery, surgeons and anesthesiologists decide vital matters regarding the care of patients (Douglas et al. 2021.p.472). They must participate to ensure clear and complete communication between those handover anesthetic in the pre- and post-operative phases.
• Allied healthcare professionals
Patient care after surgery often includes allied healthcare professionals (e.g., pharmacists, physiotherapists). They play a critical role in the communication loop to ensure care plans are coordinated (Stevens et al. 2021.p.1075).
• Nurse Unit Manager (NUM)
The Nurse Unit Manager (NUM) and hospital management are key stakeholders in the allocation of resources, support and regulatory oversight for implementing the change project.
• Patients and their families
Patients and their family members are greatly influenced by communication approaches.
2.2. Engagement and Communication with the Stakeholders
It is utmost significant to ensure that all stakeholders are informed (Litton et al. 2020.p.312). In order to engage stakeholders, it is very important that the objectives and benefits of this initiative are clearly communicated.
• Regular meetings
It is essential to include all the fundamental stakeholders. It is a place to know about the shared goals address issues and adapt strategies when needed
• Workshops and training sessions
It is necessary to learn about the SBAR communication tool (Mulfiyanti & Satriana, 2022.p.378). The same will help in addressing work culture by promoting teamwork among diverse professional groups. It is expected that open communication about the system will shape the overall process.
• Feedback Loops
It will be significant to promote ongoing input from all staff using polls, focus groups and casual conversation. It allows stakeholders to feel that they are being listened and play a role in ensuring initiative will succeed.
3. Leadership Style
3.1. Specific Leadership Style
Transformational leadership style
The task of managing this quality improvement will be under transformational leadership approach. Transformational leaders inspire and motivate through shared vision, inclusivity of others, creating antecedents that support positive change. In a healthcare environment this type of leadership is ideal to improve patient care outcomes and optimize innovation because it empowers, collaborates, & invests in professional growth (Yusuf & Irwan, 2021.p.4).
3.2. Attributes of the Leadership Style That Will Promote Success
• Inspirational motivation
It refers to telling an inspiring story to attain shared vision, and provides the focus that gets the employees committed. When the positive outcomes of communication improvement are explicit, staff will know they can contribute to its success. It created a shared purpose and excitement, which is necessary for change.
• Individualized consideration
The art of giving individual attention to the subordinates comprises of enhancing their skills and unique needs. This customized support will work to overcome any resistance that some staff may feel toward change by coaching, encouraging and training them in the areas they find difficult (Côté et al. 2020.p.e390). These traits contribute to creating an environment based on teamwork and motivation among its members seeking better communication practices in redefining patient safety.
4. Barriers to Change
4.1. Organizational Barrier
The unavailability of resources, specifically time and staff shortages is one key organizational barrier to the adoption this quality improvement initiatives. Introducing new communication tools and cross-professional training is time-consuming and may be challenging to fit in an busy surgical ward (Milton, 2022). There is evidence to suggest that resource constraints are a significant hindrance for effectively implementing of care delivery changes within health services.
This barrier can be prevented by engaging hospital administration, scheduling times to perform EHR training and providing additional coverage for trained staff. If this could be achieved, the implementation process would have a higher chance to succeed and best communication practices can live on in an organization.
4.2. Individual Barrier
One Individual Barrier to change is employee's resistance with new “communication means”, especially for those employees whom used customary practices. Resistance may arise due to unfamiliarity of the new methods, fear for additional workload or simply aversion towards change. Resistance to change is a common phenomenon which can pose as an obstacle in the quality improvement process (Talwar et al. 2023.p.114135).
Clear communication around the benefits of using advanced interactive tools is essential. The staff may need individual help if they are struggling to adapt. A change of attitude can also help reduce resistance and require input from staff by encouraging them to provide feedback, involve in decision-making processes etc.
5. Conclusion
This Quality Improvement Proposal aims to develop holistic approach in reducing communication errors within surgical ward aiming overall patient safety. Incorporating the SBAR framework, inter-professional training and effective stakeholder engagement, this initiative focus on decreasing errors related to communication failure. In addition, it aims to cultivate a normalized/ legalized), open climate of dialogue and cooperation. The success and sustainability of changes are also promoted by adopting transformational leadership with the proactive management approach.
Reference list
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Australian Institute of Health and Welfare (2024) Health care safety and quality, Retrieved from: https://www.aihw.gov.au/reports/health-care-quality-performance/health-care-safety-and-quality AIHW, [Retrieved on 12 October 2024]
Côté, A., Beogo, I., Abasse, K. S., Laberge, M., Dogba, M. J., & Dallaire, C. (2020). The clinical microsystems approach: Does it really work? A systematic review of organizational theories of health care practices. Journal of the American Pharmacists Association, 60(6), e388-e410. Retrieved from: https://doi.org/10.1016/j.japh.2020.06.013 [Retrieved on 11 October 2024]
Douglas, R. N., Stephens, L. S., Posner, K. L., Davies, J. M., Mincer, S. L., Burden, A. R., & Domino, K. B. (2021). Communication failures contributing to patient injury in anaesthesia malpractice claims?. British Journal of Anaesthesia, 127(3), 470-478. Retrieved from: https://doi.org/10.1016/j.bja.2021.05.030 [Retrieved on 12 October 2024]
Drossman, D. A., Chang, L., Deutsch, J. K., Ford, A. C., Halpert, A., Kroenke, K., ... & Sperber, A. (2021). A review of the evidence and recommendations on communication skills and the patient–provider relationship: a Rome foundation working team report. Gastroenterology, 161(5), 1670-1688. Retrieved from https://doi.org/10.1053/j.gastro.2021.07.037: [Retrieved on 12 October 2024]
Hesselink, G., Bins, S., Bonte, I., Westerhof, B., Hoek, N., van Strien, J., ... & Zegers, M. (2024). Improving patient care transitions from the intensive care unit to the ward by learning from everyday practice. A multicenter qualitative study. Intensive and Critical Care Nursing, 85, 103797. Retrieved from: https://doi.org/10.1016/j.iccn.2024.103797 [Retrieved on 12 October 2024]
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Litton, E., Guidet, B., & De Lange, D. (2020). National registries: Lessons learnt from quality improvement initiatives in intensive care. Journal of Critical Care, 60, 311-318. Retrieved from: https://doi.org/10.1016/j.jcrc.2020.08.012 [Retrieved on 12 October 2024]
Milton, J. (2022). Interprofessional Teamwork in the Emergency Department-Communicating for Patient Safety. Retrieved from: https://gupea.ub.gu.se/handle/2077/70945 [Retrieved on 11 October 2024]
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Mulfiyanti, D., & Satriana, A. (2022). The Correlation between the use of the SBAR Effective Communication Method and the Handover Implementation of Nurses on Patient Safety. International Journal of Public Health Excellence (IJPHE), 2(1), 376-380. Retrieved from: [Retrieved on 12 October 2024]
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Talwar, S., Dhir, A., Islam, N., Kaur, P., & Almusharraf, A. (2023). Resistance of multiple stakeholders to e-health innovations: Integration of fundamental insights and guiding research paths. Journal of Business Research, 166, 114135. Retrieved from: https://doi.org/10.1016/j.jbusres.2023.114135 [Retrieved on 11 October 2024]
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