Assuring Quality And Safety Of Care Assignment Sample

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Introduction Of Assuring Quality And Safety Of Care

Many NHS Trusts are assessing the quality of care being delivered and putting new measures in place to increase the standard of treatment as a result of the introduction of clinical governance. The goal of this report is to analyse and investigate the execution of a practise change effort in a clinical environment of primary care within an NHS trust. COVID-19 Mandatory Testing is the change that is being recommended. This is because 9 members of staff including kitchen staff and housekeeping tested positive for COVID-19 which resulted in 22 residents testing positive too. Consequently, the care home was put under lockdown with no visitation allowed and also resulting in the home being short-staffed. Staff and staff management, one part of clinical governance, can be related to this transformation because it was thought that this was an area that needed improvement.

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“Nursing Associate” is playing a vital role in a healthcare nursing team. Nursing Associates are working with healthcare support registered nurses and workers for delivering high-quality patient care and safety to patients. It has also been considered as stepping stone to becoming a Registered Nurse. Besides, “Trainee Nursing Associate” is helping to bridge the gap in patient care between Registered Nurses and Healthcare Support Workers. This specific study has shed light on the analysis of “Nursing Associates” and “Trainee Nursing Associates” on improving patient care and providing safe care to patients to improve their health status. Moreover, both of them are helpful for improving the patient care quality and health status of patients.

Rationale

COVID-19 was declared a pandemic in 2020 as it travelled quickly around the globe and took numerous lives along with it (WHO, 2021). This made it mandatory for everyone to get tested so as to slow down its transmission to other parts of the body and in so doing, treat it. These problems are solved via early diagnosis and a multidisciplinary team approach. The treating physician's knowledge of the underlying pathophysiology, familiarity with well-described treatment options, and awareness that a planned, multidisciplinary group approach (Chmielewska-Muciek et al., 2021) would best achieve the point of appendage rescue are all crucial factors to take into account when it comes to the COVID-19 mandatory testing.

Role of Nursing Associate and Trainee Nursing Associate to manage care safety and quality

Nursing Associates are helping to improve and monitor the quality of patient care that has been received by patients. Moreover, they are identifying all risks regarding patient safety and taking actions for managing patient safety. According to the statement of Muir, (2020), it has been stated that a Nursing Associate is considered as a team member in a nursing team and they are providing high-quality care to patients for improving their health status and care services. Basically, Nursing Associates have been trained for working with people in every age and also working in various kinds of settings. It has been intended that all new roles can support all registered nurses with the help of enabling patients for focusing on more complex and clinical duties. The nursing associates are maintaining the “Codes of NMC” and they are able to deliver care with respect, compassion, and kindness (Nmc, 2023). Moreover, they are avoiding all individuals to make assumptions and identify diversity, and making choices.

The “Trainee Nursing Associates” are playing a crucial role in terms of managing and improving patient care and the health status of patients in a healthcare setting. As per the words of Thurgate and Griggs, (2023), it has been observed that “Trainee Nursing Associates” are recording and performing clinical observation which includes temperature, blood pressure, pulse, and respiration rate. Sharing information and discussing ideas with registered nurses is considered as another role of TNA in a healthcare setting. As a result, it is helpful for all TNA to provide high-quality and safe patient care to improve the health status of patients. Based on the NMC codes, TNA is assuring patients to provide treatment, medication, and care without any kind of delay. Moreover, they are also giving respect and upholding every individual's human right (Williams, 2022). Thus, it can be stated that both NA and TNA are responsible in order to provide high-quality and safe patient care to improve the health status of patients and combat the negative consequences of the outbreak of the Covid 19 pandemic. In the NMC there are main four themes and they are, "Practice effectively", "Priorities people, “Practice effectively” and “Promote professionalism and trust”. An institute can improve its healthcare service by following these four main themes.

Role of NA to manage infection and transmission of disease

Sharing information and discussing ideas with registered nurses is considered as another role of “Trainee Nursing Associates” in a healthcare setting. As a result, it is helpful for all “Trainee Nursing Associates” to provide high-quality and safe patient care to improve the health status of patients. Based on the “Nursing and Midwifery Council codes”, “Trainee Nursing Associates” is assuring patients to provide treatment, medication, and care without any kind of delay. Moreover, they are also giving respect and upholding every individual's human rights (Nmc, 2023). An “Infection Control” nurse has been considered as registered nurse or RN. They are also implementing best practices in order to halt the virus spread and bacteria spread for delivering high-quality care and treatment to patients to improve their health status (Wray and Kitson, 2023). Moreover, it is helpful for them to combat infectious diseases and lead a healthy and normal lifestyle.

Collaboration and team work related to quality and safety of care is usually paramount. In the implementation of change in practice, all-hands-on-deck is usually the right approach(Santangelo et al., 2018).To produce better results, the practice is making use of the shared decision-making model, according to Department of Health, (2022). Treichler & Spaulding, (2018) indicated that when two or more professionals cooperate to make difficult decisions for a patient, this is referred to as a shared decision-making process. To put it another way, Chong et al., (2013) was of the view that in order to reach a diagnosis, a group of health care professionals comes together to share their expertise and experience in understanding the medical issue.As noted by Graskemper, (2016), not only is a team of specialists involved in this process, but the individual is also given the chance to voice their opinions, understandings, and pReferences in addition to those of their family and other members of their support network.

Methodology

A successful implementation of change may be threatened by its complex nature and potential obstacles(Cork, 2005). In order to improve nursing practice, deliver high-quality care, and build a better system, Cummings et al., (2018) acknowledge that nurse leaders must drive the changes they see as required. To execute change in an organization, one would need to adhere to a change theory. Although numerous theorists have created theories of change processes, Lewin's theory is likely the most well-known, approachable, and straightforward of them all(Cork, 2005). In order to overcome some challenges, a change model might be helpful.

However different types of theories have been created to develop the nursing practice of an institute. According to the view of Butts & Rich, (2021), a healthcare institute care institute needs to follow a proper strategy to improve the health service. Proper leadership and a proper management system are extremely important to identify the issues which are related to the health care service. All the health care institutes also can take feedback from the patient to find out the requirements of the patient and to identify the current issues.

Role of NA to ensure patient safety

The view of the “NMC council” has been supported with the help of healthcare professionals who care with a passion for patient safety. Additionally, in the upcoming days of nursing workforce has been considered as a shred of evidence with the help of response for an extended engagement in “Health Education England” (Nmc, 2023). Moreover, those have been carried out since the last year by having with proper stakeholders from across the health and the social care. According to the statement of James and Bennett, (2022), it has been observed that Nursing Associates have been trained for working with people in every age and also working in various kinds of settings. It has been intended that all new roles can support all registered nurses with the help of enabling patients for focusing on more complex and clinical duties. According to the “Nursing and Midwifery Council” in England, all registered nurses are required to give respect and support to patients based on the individual's right for accepting treatment and refuse it (Nmc, 2023). Henceforth, it can be stated that NA and TNA are providing high-quality care and monitoring patients to improve their health status.

The foundation of Lewin's paradigm of normative change is teamwork, which includes all employees who will be influenced by the change (Bozak, 2003). Through a bottom-up strategy, this encourages their acceptance and implementation of change, and it also highlights the fact that accomplishing effective and long-lasting change requires the cooperation and engagement of the entire team, not just lone actors(Bozak, 2003). The plan-do-study-act (PDSA) cycle (see appendix 1) is one of the key approaches which was observed to be used in this change. According to Reed et al., (2016), it focuses on the central aspect of change, or the moment when principles and goals are put into action. The PDSA cycle involves planning how to test a change (Plan), carrying it out (Do), analysing the findings and learning from them (Study), and deciding what modifications to the test should be made (Act). Due to the monthly, if not weekly, barrage of new national and local improvement programmes, many doctors working in healthcare today faces change fatigue. Within quality and safety of care, teams can use these techniques quite effectively to achieve maximum results.

According to the "force field analysis" (FFA) of Lewin (1951), there are different types of guidelines [Refers to Appendix 2], to change the nursing procedure and to improve the nursing practice also. In this study, it has been seen that the "plan-do-study-act cycle which is also known as the PDSA cycle [Refer to Appendix 1] is an important approach to the changes in the nursing practice after the implementation of goal and action (Tappen, 2022) This cycle support developing a proper plan, observing a change and helping to identify the outcomes also.

However, a strategy that outlines the necessity is essential before any modification is taken into consideration. Lewin's (1951) force field analysis (FFA) guideline (see appendix 2), according to Baulcomb, (2003), establishes the difficulties of the change procedure, as well as how positive and opposing factors were included into the development and execution stages. Before putting a planned change into action, it is important to understand the driving and restraint forces. Cork, (2005) goes on to say that while executing any form of change, there are a lot of aspects that contribute to change, such as the driving notion, such as the desire to enhance workplace direction. On the other hand, resistance to change or low employee morale may operate as a restraint. Change may thus only occur when one force is greater than the other. Preferably, for optimistic change, the supporting forces must be greater than the limiting factors(Reed et al., 2016).

Comparison between NA and TNA

Nursing Associates are very familiar with patients and with the family members of the patients. As a result, it is helpful for all patients to share their emotions and feelings with healthcare professionals, and it is also helpful for healthcare professionals to understand patients' emotions and feelings (Stephens et al. 2021). Hence, it is helping to receive and provide proper care and treatment from healthcare settings. Apart from that, Trainee Nursing Associates are very professional which means they only do their job properly instead of understanding patients' feelings and emotions. As per the words of Bak et al.(2020), it has been stated that both the Nursing Associates and Trainee Nursing Associates promote health and prevent illness among patient's health. In addition, both of them are providing high-quality care and evaluating the effectiveness of the quality of patient care. Moreover, based on the codes of the “Nursing and Midwifery Council” in England, all registered nurses are required to give respect and support to patients based on the individual's right for accepting treatment and refuse (Nmc, 2023). They are also able to recognise patients' anxiousness and distress and giving responses politely and compassionately.

The study here describes in detail that the role of both groups is significantly important in their place. The "Nursing Associates" are the most important part and they play a vital role in the healthcare centers (Colomer-Pérez et al. 2019). The maximum contribution in teaching, managing and maintaining the healthcare norms are taught by the "Nurse associates" to the "Trainee Nursing Associates". This also includes the monitoring of the activities of the "Trainee Nurses", and even the "Nursing Associates contribute to evaluating and planning the critical cases in the healthcare centers (Griffiths et al. 2019). Whereas on the other hand, the part of "Trainee associates" also refers to the mixture of knowledge, new ideas of applications and planning of the healthcare centers (Rafferty et al. 2019). Even sometimes they prove to be more efficient in playing their role. Similarly, these activities and the skilling up of their performances are guided by the "Nursing Associates" within the healthcare services in proving care to the patients.

Results/Outcome

In this study, it has been seen that a total of 9 staff has tested positive and which has caused the spreading of the disease among more than 22 residents also. As a result, the test for covid 19 becomes mandatory for all and it has been seen that some patient who had COVID-19 symptoms has shown false negative results also(Chong et al., 2013).

The findings demonstrate how addressing an outbreak early could stop it from getting out of hand. The board information may help with enhancing wellbeing administrations and provide evidence-based changes, leading to greater health and more effective use of healthcare resources. Both patients and staff should keep in mind safety precautions for their contemplation plans to reduce the possibility of the disease recurrence once the it heals.

Discussion and Analysis

In this study, it has been seen that different guidance of MNCs, Trainee Nursing Associations and the Nursing association are extremely important to improve the nursing practice Alshahrani, (2022). In this study, it has been seen that proper leadership and healthcare service chain are extremely important to provide proper healthcare service to the patient. In this study, it has been seen that a "Trainee Nursing Associate" (TNA) need to follow all the guidance which has been published by the NMCs and also needs to work in social care settings (Heinen et al. 2019).

Instead of the traditional command and control staff supervision technique, to improve the motivation, morale, and output of their team members, a transformational leader uses effective communication(Samuel et al., 2018). Another important problem is trust, which results from a shared understanding that the change won't hurt the personnel but rather to improve conditions and curtail the COVID-19 outbreak at the hospital. Therefore, the change agent will need to be able to motivate the workforce through effective communication. A leader has to have strong emotional intelligence, according to Ellis, (2021). This makes it feasible to recognise and positively manage the staff's emotions in order to get the greatest results. Gilmore-Bykovskyi and Bowers, (2013) goes on to state that it enforces the change agent's problem-solving and decision-making abilities, helping workers to become more at ease, less stressed, and receptive to change.

Encouragement is used to make the alternatives to the status quo more visible. Al-Dossaryet al., (2014) also continues by stating that this may be considered to be fairly difficult and can have components of being confrontational. The process starts with an information exchange, which enables the MDT to talk with the service user about the best alternatives and any potential benefits or risks associated with those options(Lichtner et al., 2016). In order for the employees to utilise and build the pack consistently, the change agent needed to inform them of the COVID-19 mandatory testing and make clear what was expected of them. According to Foley, (2016), this will offer the staff confidence that they are acting ethically and that their practise is successful and long-lasting.

Scope and Limitations of the Study

The scope of the study determines the role played by both groups in providing care to their patients. The vital role played by the "Nursing associates" in the healthcare system helps the "Trainee Nursing Associates" in bridging the gaps that the healthcare system had aimed to. The study focused on bringing out the facts and the main roles of both groups and how they are different (Colomer-Pérez et al. 2019). The limitations of the study are the lack of information from the healthcare centres. For the authenticity of the research, the study requires time so that all the points can be highlighted and can be produced with proper knowledge and information.

Conclusion

Although some people may be hesitant to change, others may welcome it and feel empowered. Change is a crucial dynamic in healthy growth and development. Communication is a recurring element that has emerged throughout the here may change process. By allowing individuals who will be affected by the change to speak up, excellent communication skills enable obstacles and opposition to be removed. In this study, it has been seen that change in the nursing practice can improve the healthcare service chain. The leaders of every healthcare institute need to communicate properly with all employees to identify the issues which are related to the healthcare service. Different NMCs code is extremely important to increase the quality of the nursing practice. It has been observed that at the time of the COVID-19, outbreak total of 9 patients have been identified as covid positive. After this, this disease spread to 22 others. The entire study has summarised that both Nursing Associates and Trainee Nursing Associates are playing a crucial role to provide high-quality healthcare and patient safety. Moreover, after maintaining the NMC codes are helpful in providing the best care and treatment to patients to assist them in leading a normal and healthy lifestyle. Hence, it can be concluded that both NA and TNA are responsible in order to provide high-quality and safe patient care to improve the health status of patients and combat the negative consequences of infectious diseases.

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Websites

  • Nmc, (2023). The Code. Retrieved on 19th May 2023. Retrieved from: https://www.nmc.org.uk/standards/code/
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