Introduction 

The current study takes into consideration two important aspects of professional nursing which are clinical governance and maintaining effective quality and safety standards.

Clinical governance

The clinical governance is the amalgamation of integrated systems, processes, effective leadership and cultural sensitivity which are the pivotal in providing   quality healthcare services. As mentioned by, effective clinical governance practices helps in implementing a person centred approach. The key systems and practices are required to provide safe care within an acute healthcare setup.  The guidelines as mentioned under the rules for clinical governance states that all the nurses and the midwives should take an active part in the patient safety processes. The guidelines also mentions that the all the incident s of clinical accidents need to be reported actively, as it helps in focussing upon the safety loopholes. As mentioned by Cleary and Duke (2017), it helps in supporting the organizational and community priorities by implementing some of the effective practices such a patient centred approach,  practice of informed decision making etc. Some of the most important aspects as mentioned within the clinical governance guidelines are that the patient issues need to be escalated to the managers. As reported by Maier (2015), a number of incidences of breach of ethical and legal guidelines have been reported in an acute healthcare setup. Hence, provision of effective training to the healthcare professionals regarding the clinical guidelines and practices including the reporting standards could prevent the occurrence of any untoward incidents within an acute healthcare setup.

Some of the responsibilities and roles of nurses and midwives as stated under clinical governance are actively taking part in the development of an organizational culture which promotes patient safety. Additionally, encouraging, mentoring and guiding colleagues in the delivery of high quality and safe healthcare practices fall under the guidelines as stated under clinical governance (Knight, Kenny & Endacott, 2015).

The clinical governance practices could be further discussed in the light of the Djerriwarah health services or the Bacchus Marsh healthcare service. In 2015, large number of medical casualties at the Bacchus Marsh hospital came to notice.  This led the department of health and human services Victoria take a number of actions including review of hospital safety and quality assurance. The matter had been notified to the department of health and human services by the Consualtive Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM). An independent review by senior obstetrician was conducted which proved that in seven of the eleven cases clinical deficiencies were required. Some of the effective measure which were taken by the hospital over here were appropriate risk mitigation along with open disclosure to the respective families who had suffered the casualties. Therefore, based on the case above two particular loopholes have been found out within clinical practice and risk management. It was found that the healthcare staff failed to meet the National Safety and Quality healthcare standards. Additionally, the response of the department’s regional office was not most effective or appropriate (Gardner, Gardner, Coyer, 2016).

Quality and safety 

Quality and safety are very important for the management of risk within an acute healthcare setup. For the purpose of which an effective risk management protocol needs to be undertaken. The risk management is further based upon a number of strategies which are crucial in meeting the quality healthcare services. Some of these are benchmarking of the practice protocols which are based upon following of effective clinical practice and guidelines. As mentioned by Phillips et al. (2017), following effective documentation procedures could help in keeping a check over the occurrences of untoward incidences.  Therefore, sufficient training needs to be provided to the healthcare professionals regarding following effective documentation techniques. In this respect, it was found that the responses of the regional health offices to the complaints raised by the patient who suffered the casualties in the Bacchus March hospital were not effectively addressed. It was found from the inspection conducted within the hospital that the accreditation standards were not met fully.

As suggested by Usher (2017), the implementation of internal auditing as a standard protocol would have been effective in keeping a tab on the systems and processes. The systems part also includes the infrastructural setup within the acute healthcare setup which is plays a pivotal role in the maintaining of the quality health services. The quality and safety in healthcare could be divided into a number of objectives such as improving diagnostics, reducing the number of hospital acquired infections, increasing patient and family engagement, implementing safety tools and measures. As mentioned by Masters (2016), diagnostic error is an unrecognised threat to patient safety. The errors could arise to a number of conditions such as provision of effective safety training to the healthcare staffs as it could reduce the number of hospital acquired infections. As reported by Hewitt, Tower and Latimer (2015), a public private partnership could be beneficial in meeting with the infrastructural and process gaps which are crucial in maintaining the quality of care. One of the most important criteria in meeting with quality healthcare services is increasing patient engagement.  This aspect has been further supported by the practice of informed decision making which ensures that all the major decisions in healthcare service delivery are taken in due consultation with the patient population. Some of the tools which could be followed over here are the Consumer Assessment of Healthcare Providers and Systems (CAHPS). It consists of a number of questions which are presented in the form of a survey. Based upon the responses provided by the healthcare staffs effective monitoring protocols could be implemented.

References 

Cleary, S., & Duke, M. (2017). Clinical governance breakdown: Australian cases of wilful blindness and whistleblowing. Nursing ethics, 0969733017731917. Retrieved  from : https://doi.org/10.1177/0969733017731917

Gardner, A., Gardner, G., Coyer, F., & Gosby, H. (2016). Educating for health service reform: clinical learning, governance and capability–a case study protocol. BMC nursing, 15(1), 32. Retrieved  from : https://doi.org/10.1186/s12912-016-0152-8

Hewitt, J., Tower, M., & Latimer, S. (2015). An education intervention to improve nursing students’ understanding of medication safety. Nurse education in practice, 15(1), 17-21. Retrieved  from :  https://doi.org/10.1016/j.nepr.2014.11.001

Knight, K. M., Kenny, A., & Endacott, R. (2015). Gaps in governance: protective mechanisms used by nurse leaders when policy and practice are misaligned. BMC health services research, 15(1), 145. Retrieved  from : https://doi.org/10.1186/s12913-015-0827-y

Maier, C. B. (2015). The role of governance in implementing task-shifting from physicians to nurses in advanced roles in Europe, US, Canada, New Zealand and Australia. Health Policy, 119(12), 1627-1635. Retrieved  from : https://doi.org/10.1016/j.healthpol.2015.09.002

Masters, K. (2016). Integrating quality and safety education into clinical nursing education through a dedicated education unit. Nurse education in practice, 17, 153-160. Retrieved  from : https://doi.org/10.1016/j.nepr.2015.12.002

Phillips, C., Hall, S., Pearce, C., Travaglia, J., Lusignan, S. D., Love, T., & Kijakovic, M. (2017). Improving quality through clinical governance in primary health care. Retrieved  from : https://openresearch-repository.anu.edu.au/handle/1885/119232

Usher, K., Woods, C., Parmenter, G., Hutchinson, M., Mannix, J., Power, T., … & Jackson, D. (2017). Self-reported confidence in patient safety knowledge among Australian undergraduate nursing students: a multi-site cross-sectional survey study. International journal of nursing studies, 71, 89-96. Retrieved  from : https://doi.org/10.1016/j.ijnurstu.2017.03.006