NURS2006 Clinical Governance And Practice Improvement

Describe clinical governance and risk management in clinical practice and explain the need for this.

 

Describe the structures and processes of clinical governance in healthcare settings

 

Describe at a developing level how e-health information sharing can facilitate clinical governance and practice

 

Describe and discuss the implications of implementing unsafe nursing/health care

 

Explain the need for clinical practice improvement and the use of research to inform practice and quality improvement  identify and describe barriers to clinical practice

 

Improvement and develop strategies for overcoming these apply principles and tools to guide decision-making about clinical and professional practice and justify their own practice use various types of evidence to inform practice, including validated clinical practice guidelines

 

Critically assess evidence to evaluate its relevance, credibility and rigour to practice use appropriate communication strategies to plan, implement and evaluate care in an interprofessional context.

 

 

Answer:

Introduction:

The aim of the project always gives the proper idea of the project is all about?  The aim of the project must be specified accordingly to address a large section of the country. The aim of the project must attract the attention of all the medical staff to combat the deadly disease as early as possible. This diabetes care project needs to bring new opportunities to the medical staff as well the researcher to bayer healthcare disease. There are the various reasons behind diabetes. So the project gives the clear idea about the diabetes care (Buttigieg, Rathert & Eiff, 2015). If the aim of the project is not right, so the future solution for the disease cannot be met as per the requirement. It is very important to decide the right thing on the project.

The relevance of Clinical Governance to your project

The clinical governance of the project should comply with the national standards of nursing. The relevance of the diabetes resources should be maintained as per the need of the project. The components that are present in the clinical governance of the project states priorities of the diabetes care strategies should be made and prioritize should be set according to a perfect timeline. Planning of the assessment techniques of diabetes should be done properly which will help in making a proper action plan for the project. The implementation of the project should be done according to the action plan of diabetes care (Chambers, Boath & Rogers, 2007). The clinical aspects that are the assessment diagnosis and proper medication or treatment method should be done and it should be well documented so that it can be used for the future reference.  A proper plan should be made to implement the CPI tool in case of the patient suffering from diabetes in Australia. The roles are the responsibility of the diabetes caregivers should be clear and there should be no confusion regarding the delegation of work. The delegation of work should be done according to the strength of the personals present in the project.

Evidence that the issue/problem is worth solving:

The risk factors of diabetes are increasing day by day and are becoming one of the major problems in Australia. According to medical records in the nursing cares of the country the number of Diabetes patient in increasing at a rapid rate. Currently, it is one of the major reasons of death in the country. The patients are suffering from the type1 diabetes and the type2 diabetes.  According to the records almost 30 people in Western Australia is regularly diagnosed with Diabetes. Several risk factors are attached with the rising trend of diabetes care. The lifestyle of the Persons is changing which is having a huge impact on the health. Obesity is increasing among the diabetes affected patients which is enhancing the increase in diabetes. Evidence suggests that that 5.7 % of the total population affected by diabetes are under the age of sixteen. High obesity huge problem for the country (Dussart, 2009). This is becoming one of the major issues of the country. This issue needs to be looked into with matter of concern by the medical professionals. Renal system and cardiovascular system are affected by diabetes. Diabetes in the aged persons is causing a real problem in the ophthalmic system. Eye blindness in the people suffering from diabetes is very common in Australia. These issues can be resolved by the proper intervention of the nursing care. These issues are worth solving because the majority of the Australian people are suffering from these problems. By proper clinical nursing care assessment and nursing intervention, the issue can be resolved. It is seen diabetes among the aboriginals is 2- 4 times greater than the non-aboriginal persons. This is some of the evidence that suggests the Diabetes is one of the major issues of Australia and it should be resolved using proper clinical tools (Levesque, 2013).

Key Stakeholders:

During the planning of the projects, the key stakeholder of the project will be the concerned ministry of health in Australia and the local medical authorities who will be in charge of the training. It is very much obvious that the stakeholders play a very important role in the proper implementation of the project. In this case, the medical authority and the nurses which will be involved in the project should take a stake in the holistic development of the project (Phillips & Freeman, 2011). The people who are in charge of the project should be able to take clear stakes in the diabetes care project. The patient on whom the diabetes mitigation strategy will be implemented should have the important stakes. The patients should follow the guidance of the medical professional for the proper mitigation of the disease.  The stakeholders should perform key awareness activities during the project. The stakeholders should be able to take the responsibility for the implementation of the project which is a national problem for the country.  The medical professional should be able to take proper CPI tools for the assessment of the Diabetes. Blood biochemistry test is done to indicate the disease. This is, in short, some of the key stakeholders for the project (Smillie, 2013).

CPI Tool:

Diabetes is a very common issue all around Australia. Around 15% of the Australian is suffering from diabetes. It is differentiated into type1 diabetes and types 2 diabetes. Diabetes can be prevented and treated through effective healthcare practices. The new IDF clinical practice has proposed some recommendations regarding the diabetes acre treatment. The tools as mentioned by the diabetes care treatment is as follows :

· Screening: Screening is a process that is used to undertake the length of variability and complicated symptoms. It is found that the people aging from 40 to 45 are prone to be affected by the syndromes of diabetes. Several risk factors are associated with diabetes like cardiovascular disease, high blood pressure, and hypertension. A blood test is a key tool for screening. It helps to understand the level of sugar and situation of blood. However, the blood test is unable to locate the associated risk factors for diabetes (Carpenito-Moyet, 2006). The broader aspect of screening is done through population-based and is able to locate all the associated risk factors regarding diabetes, The most applicable screening process is a glucose fasting procedure. The fasting procedure is capable to locate whether the person is affected by type 2 diabetes or not. PP test is conducted to identify the symptoms of type 1 diabetes. Thus, type1 and type2 diabetic symptoms can be located properly through the sequential screening tests.

· Glucose control; in the diabetes care, the caregivers must use glucose control tools for the effective treatment of diabetes care.  The risk of chronic kidney disease is associated with the fluctuation level of glucose.  The target of the Australian caregivers is to limit the glucose level of the patients within the HbA1c level. Urine test, blood sugar test,  and GVD testing are the appropriate testing procedure to control and locate the glucose and its preventive measures based on the test reports

· Monitoring: Glucose control is another tool for diabetes acre treatment. The glucose control can be particularly identified in both insulin and non-insulin taker Australians. In both the cases, monitoring is important. As per the Australian medical guideline, the blood glucose target must be equivalent to the HnA1c level. The Australian caregivers must notice the fluctuation of the level of glucose properly for the effective outcome (Haugen & Musser, 2012).

· Education: A proper education is required for effective diabetes care.  The Australian diabetes caregivers must maintain the NICE guidelines to get a proper education regarding the diabetes prevention.  This is an evidence program that would focus on ethical treatment procedure for diabetes care. Moreover, the program would teach the medical practitioners of Australia on the effective use of skills, knowledge, and curriculums for effective diabetes care treatment. The application of the knowledge gathered from the NICE program would make the medical practitioners capable to locate and identify diabetes and start treatment according to the proper measure (Haugen & Musser, 2012).

· Diet control:  The Australian medical practitioners must advise the patients for diabetes control. Fresh vegetables, fruits, and sufficient water must be advised to them for an effective outcome. Moreover, a regular physical exercise is required to control the level of sugar in the blood. The daily caloric limit should be within 800 calls to 1200cal. A regular burn of 500 to 600 calorie can be advised to the people who are suffering from diabetes.

· Insulin therapy: Insulin therapy is a most prominent treatment for the people suffering from diabetes. The medical practitioners must advise the patients to take the insulin’s based on the symptoms and level of diabetes. Most of the insulin algorithm sustains in 10 unit or 0.2units/kg. Thus, the patient must be advised to take I insulin at least once or twice in a week in normal; case. However, the patients suffering from high level of diabetes must be advised to take the intake of insulin close to 10 times a month (Mantzoros, 2007).

Summary of proposed interventions:

The intervention starts with the screening process. This process is a most authentic process to locate the level of diabetes. This includes a blood test and test of glucose level. Moreover, the PP test and empty glucose test are also two methods for a screening tool to locale the diabetes level. Glucose must be controlled by the advice of the medical practitioner. The medical caregivers of Australia must be aware top limit the glucose level of the patient within the level of HbA1C. The medical caregivers must monitor the level of blood sugar and diabetes of the patients (McGill, 2016). The symptoms must be noted down for the further treatment and must advise them for healthy practices The healthcare givers of Australia must advise the diabetes patient for a healthy diet and physical exercises and food calorie must limit within 800 to 1000cal; one. Hence, insulin treatment is the best treatment for the diabetes care treatment for a successful outcome.

Various barriers are attached to the implementation of the campaign for diabetes. Around 13% of the Australian is suffering from diabetes. Diabetes is the combination of many diseases. The people of the country are not able to learn something new about diabetes. Most of Australia is not aware of diabetes. In the patients with diabetes, the level of glucose is very high. One of the common symptoms are the feel tiredness all the time, feeling thirsty all the time, and weight loss. There is the existence of various types of diabetes in Australian people (Miller, 2011). They consume more sugar than the other countrymen. Apart from that, most of the women are suffering from sexual oriented diseases that are deeply attached with ineffective diabetes care management.. By relating to that, the women are very much prone to diabetes. It is found by the doctor that the body of the women possesses more sugar than the male counterpart in Australia. Apart from that in recent times, the Australian witnessing the attacks on the women. So, for this reason, it can be mentioned that the women spend the night sleepless. Sleepless nights may lead the chances of diabetes. Apart from that, the mental tension, depression are liable for infected with diabetes. Some of the major organization is making the awareness campaign for diabetes. But overall the entire picture of diabetes has not been changed since the time. For this reason, the ignorance of the people about the disease can be mentioned as well as the most of the people in Australia are not willing to maintain the proper diet for improving diabetes (Saudek & Margolis, 2011).

Evaluation of the project:

To evaluate the entire situation of diabetes in Australia it can be mentioned that the people of Australia would not be able to maintain a proper diet to control the level of sugar.. The proper action, as well as the previously taken actions, may decrease the ratio of diabetes for the Australian people. The government, as well as some of the NGO, need to come forward to cure the disease. The proper nursing treatment, as well as the knowledge of diabetes, can be cured as fast as possible. Some of the organization has taken the initiative of making the awareness program for the people of Australia about diabetes. Most of the time it is found that the people of 30 are suffering from diabetes. The projects on diabetes only need to attract the attention of the government officials to cure the disease. Besides that, they need to make an awareness campaign for the people of Australia (Parks, 2009). The aim of the evaluation of the project mainly determines the necessities of the proper guidance as well as the direction to curb the disease. The purpose of the evaluation of the project needs to attract the attention of the government official. Apart from that, the evaluation may detect the right and wrong way of dealing with this serious issue. The evaluation of the project may need to be addressed properly (Wright & Hill, 2003). The evaluation of the project always gives the exact idea as well as the expected guidelines about the disease. The Australian government must provide extra care to the diabetes affected patients for a healthy outcome. 

	PERFORMANCE STANDARD
CATEGORY & WEIGHTING	Excellent Work	Good Work	Passing Work	Unsatisfactory work
Project Aim and Evidence the issue is worth solving 20%	Aim succinct & clearly defined. All evidence relevant & rigorous. Shows a very high level of insight & relevance to the issue.       (17-20) o	Aim well defined. Some irrelevant information but most evidence relevant & rigorous. Shows a very good level of insight & relevance to the issue.   (13-16.5) o	Aim stated with some ambiguity. Some evidence relevant and rigorous, Acceptable level of insight. Quite a lot of irrelevant information is present. Maybe overlong/ too brief   (10-12.5) o	Aim not clearly stated Most evidence is not relevant or rigorous. Poor level of insight & relevance to the issue. A significant amount of irrelevant/ missing information.  (0–9.5) o
The relevance of Clinical Governance to your project   10%	Succinct and highly relevant discussion of the relevant pillar of clinical governance related to the chosen clinical issue.                               (9-10) o	Succinct and mostly relevant discussion of the relevant pillar of clinical governance related to the chosen clinical issue.       (7-8.5) o	An adequate discussion of the relevant pillar of clinical governance related to the chosen clinical issue. Some parts not relevant Overlong / too brief may be missing relevant information. (5-6.5) o	Inadequate discussion of the relevant pillar of clinical governance related to the chosen clinical issue. Overlong / too brief may be missing a significant amount of relevant information (0-4.5) o
Key Stakeholders 5%	Identifies most relevant key stakeholders. Discusses clearly how they could be involved in the project. Succinctly and expertly written. Very high level of insight into the role of stakeholders.   (4.5 – 5) o	Identifies some relevant key stakeholders and adequately discusses how they could be involved in the project. Very well written. Good level of insight into the role of stakeholders.     (3.5-4.25) o	Identifies a few relevant key stakeholders. Mentions briefly how they could be involved. Quite well written but contains some irrelevant information, or minor information is missing. An adequate level of insight into the stakeholder role. (2.5 – 3.25- ) o	Contains irrelevant information, or major information is missing. Inappropriate or no key stakeholders are identified Poor insight into the stakeholder role.       (0-2) o
Clinical Practice Improvement Tool 20%	Describes a relevant CPI tool Very clearly discusses how it could be used to address the aim and implement the interventions. Succinctly and expertly written with no omissions of relevant information.   (17-20) o	Describes a relevant CPI tool Discusses quite clearly how the tool could be used to address the aim and implement the interventions. Well written but may contain some irrelevant information, or some minor information is missing    (13-16.5) o	Describes a relevant CPI tool and adequately discusses how the tool could be used to address the aim and implement the interventions. Not succinct contains irrelevant information,  significant information is missing (10-12.5) o	A relevant CPI tool is not identified. There is no adequate discussion of how the tool could be used to meet the aim or implement the interventions. Contains irrelevant information or some major information is missing.  (0–9.5) o
Summary of proposed interventions 20%	All relevant interventions are discussed very well. Project outline is very clear and the relevance to clinical practice is very high.           (17-20) o	Most relevant interventions discussed quite well. Project outline is clear & relevance to clinical practice is good. Contains some irrelevant information, minor information may be missing.    (13-16.5) o	Acceptable level of relevant interventions discussed. Project outline mostly clear, although it may be unclear how the project would actually be implemented in clinical practice due to irrelevant/missing info   (10-12.5) o	Some elements missing or incomplete. May contain large amounts of irrelevant information. Project poorly described and it is unclear what the project actually entails or its relevance to clinical practice.      (0–9.5) o
Barriers to Implementation 15%	Identifies most potential barriers to implementation & clinical change. Discusses in depth how these barriers could be overcome or minimized.       (13-15) o	Identifies some potential barriers to implementation & clinical change. Discusses how these barriers could be overcome or minimized.       (10-12.5) o	Identifies a few potential barriers to implementation & clinical change. Discusses how barriers could be overcome or minimized. Minor omissions and/or some irrelevant information present   (7.5-9.5) o	Relevant barriers not identified. Poor or no discussion about how they could be overcome or minimized. Major omissions, much of the information provided is irrelevant/unrelated to the CPI goal. (0-7) o
Evaluation of the project 10%	A succinct discussion of an excellent and achievable plan for how the intervention/s could be evaluated.         (9-10) o	A succinct discussion of a very good and mostly achievable plan for how the intervention/s could be evaluated.         (7-8.5) o	Discussion of an adequate plan for how the intervention/s could be evaluated. Some parts not relevant or achievable Overlong / too brief may be missing relevant information.   (5-6.5) o	Plan absent or not well described. Most or all of the plan is not relevant or achievable Overlong / too brief may be missing a significant amount of relevant information   (0-4.5) o
Name of Marker
Grade		Overall Comments

 

References

Buttigieg, S., Rathert, C., & Eiff, W. (2015). International best practices in health care management. Bingley, U.K.: Emerald.

Carpenito-Moyet, L. (2006). Nursing diagnosis. Philadelphia: Lippincott Williams & Wilkins.

Chambers, R., Boath, E., & Rogers, D. (2007). Clinical effectiveness and clinical governance made easy. [Stoke on Trent, Staffordshire]: Staffordshire University.

Dussart, F. (2009). Diabetes and relatedness in an Aboriginal settlement in Central Australia. Canadian Journal Of Diabetes, 33(3), 281.

Haugen, D., & Musser, S. (2012). Health care. Farmington Hills, MI: Greenhaven Press.

Hunnicutt, S. (2010). Universal health care. Detroit: Greenhaven Press.

Levesque, C. (2013). Diabetes. Philadelphia, Pa.: Elsevier.

Mantzoros, C. (2007). Obesity and diabetes. Totowa, NJ: Humana Press.

McGill, M. (2016). Diabetes care in Australia. Diabetes Research And Clinical Practice, 120, S3.

Miller, D. (2011). Health care. Detroit, Mich.: Lucent Books.

Parks, P. (2009). Health care. San Diego, CA: ReferencePoint Press.

Phillips, R., & Freeman, R. (2011). Stakeholders. Cheltenham U.K.: Edward Elgar Publishing Ltd.

Saudek, C., & Margolis, S. (2011). Diabetes. Baltimore, MD: Johns Hopkins Medicine.

Smillie, I. (2013). Stakeholders. Taylor and Francis.

Wright, J., & Hill, P. (2003). Clinical governance. Edinburgh: Churchill Livingstone.