Leading and Managing Nursing Care Assignment Sample

Introduction Of Leading and Managing Nursing Care

This assessment is present in critical commentary and a brief discussion on the importance of team working, effective management, leadership, and delegation in multidisciplinary team members within nursing. Followed by these relevant leadership and management theories have been compared to understand their relationship to the nursing practice within NHS UK while working within multidisciplinary teams (MTDs). Additionally, roles of leadership in quality and service improvement within the healthcare system especially, within multidisciplinary teams have been discussed to understand its relevance in ensuring patient safety and quality of care. The theoretical concept of team dynamics has also been assessed along with the possible challenges to meet the desired team dynamics goal while working with MTDs. Along with that, the concept of delegation as part of a leadership and management tool which effectively supports MTD working in nursing has been evaluated while highlighting the challenges of delegation. Followed by this, the use of information technology and information-sharing systems within healthcare to ensure leadership innovation has been evaluated. Based on the evaluation, existing gaps in clinical practice which require service improvement through innovation were identified. In Part 2 of the assessment, a brief reflection on the situation from placement has been presented by underpinning the importance of team working in healthcare. The role of nurses and other members in MTD to ensure patient safety and quality care has been reflected. Reflection on gained experience also presented to briefly explain how tasks were delegated during the first year of placement and nursing associate. What could have been done differently to improve delegation has also been described briefly. Besides, the reflection section also summarised how delegation activities influenced patient safety and overall quality of care service. Finally, a self-development checklist and brief action plan with SMART goals have been provided in the appendix section which might be effective to achieve self-development goals.

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Part 1-

Context-

Leadership in nursing helps to navigate the constant evolution of the healthcare system by motivating team members, monitoring productivity and ensuring patient safety as well as patient satisfaction (Ombudsman, 2019). Therefore, effective leadership in nursing helps to ensure a productive and safe work culture, high employee morale, higher patient-safety as well a high retention rate. On the other hand, management in healthcare refers to the particular process of planning, organising, leading, directing and motivating team members which helps to maintain best-practice within healthcare organisations at the time of delivering care services to patients (Kraus et al. 2021). Hence, it can be stated that effective management within healthcare ensures effective administration of the care system and other medical facilities by improving overall operation.

Additionally, teamwork in nursing practice generally aims to coordinate care systems through effective communication with other fellow memes, clinicians, healthcare staff, and administrators (Nursingworld, 2023). Besides, it is required to mention that teamwork within healthcare facilities involves patients and family members as part of teamwork because it plays an important role in improving care decisions. Moreover, it can be said that apparently and empathetically communicating with patients and their family members, nurses working within MDTs can ensure patient safety and quality care. Delegation in nursing particularly involves the assignment of particular performance activities of patient care to unlicensed assistive personnel (UAP) based on the overarching principles and strategies while retaining accountability for the outcome (Health.org.uk, 2022). In this regard, it is required to mention that registered nurses have legal liability to each patient, hence RNs need to ensure all assignments are delegated appropriately (Royal College of Nursing, 2023). However, it is seen that to improve management and teamwork in nursing, NHS England provides high-quality service to maximise resource use and meet growing demands (NHS UK, 2023). For instance, clinical managers lead multidisciplinary teams of healthcare professionals across the UK to ensure high-quality patient care (NHS UK, 2023).

Discussion-

Importance of leadership and management in nursing

This section of the discussion is evaluating the importance of leadership and management in nursing practice especially within a multidisciplinary team. In this regard, studies have highlighted that medical leadership and management strategy within nursing help to ensure engagement and maintain productivity by ensuring patient safety (Endeshaw, 2021). Apart from that, it is found that an effective management strategy helps to ensure the accurate utilisation of human resources within healthcare organisations. After analysing the Care Quality Commission's report it is found that the NHS focuses on carrying out management processes based on the prevailing safety culture to maintain high-quality social care across England (Cqc.org.uk, 2018). Besides, this report has highlighted that leadership and governance strategy has a direct impact on the patient safety and governance system particularly in workload distribution (Cqc.org.uk, 2018). However, it is found that NHS England does not have a consistent safety governance strategy which is leading to high death rates of patients (Cqc.org.uk, 2018). This indicates that the leadership and management approach of NHS England lacks clear direction thus, the trust is not being able to address issues in governance (Cqc.org.uk, 2018).

Exploring relevant leadership and management theories and their relevance within multidisciplinary teams (MTDs) to nursing practice-

The multidisciplinary team of nursing practice requires effective management and leadership strategy to maintain collaboration within the team. In a similar context, it is found that the effectiveness of clinical decision-making depends on management efficiency as well as on leadership practice (Nisar et al. 2021). For instance, it is noted that the transformational leadership strategy is largely implemented to ensure collaboration in nursing because it focuses on influencing the team while motivating group members to accomplish vision and goals (Nisar et al. 2021). Additionally, it is noted that the transformational leadership style is based on empathy, collaboration, accountability, resilience and communication which helps to increase healthcare effectiveness and ensure patient safety (Sousa et al. 2019). This indicates that the desired level of patient satisfaction can be achieved by implementing a transformational leadership style in MTDs. Another evidence study has witnessed that transformational leadership strategy shares the highest correlation with job satisfaction of healthcare staff and improved care service (Wang et al. 2021). In contrast, it is found that laissez-faire and passive-avoidant leadership style has a negative correlation with the job satisfaction label of healthcare staff (Akdere and Egan, 2020). In the case of NHS England, it is found that the trust has limited ability to drive and monitor progress throughout the healthcare system which is resulting in standardisation issues within MDTs and minimising care quality (Ombudsman, 2019).

Role of leadership in quality and service improvement in healthcare-

Leaders play an important role to accomplish organisational goals within the healthcare setting by equipping staff with specific methods of skill development that eventually assist each individual to meet organisational goals by achieving individual goals as well (Sousa et al. 2019). The same study also highlighted that leadership is important to improve quality in healthcare settings because it assists to maintain team engagement levels explicitly. In a similar context, it is suggested that by building a management structure and aligning with the support system, healthcare staff working in MDTs can create a culture of innovation which can lead to effective problem-solving (Bardach et al. 2022). Increased innovation at the team level will automatically accelerate the quality of care by ensuring patient safety. However, leaders need to provide practical guidance to the multidisciplinary team to ensure quality improvement even in the post-implementation stage (Akdere and Egan, 2020). A successful QI approach can scale up quality in healthcare but leadership strategy, competency framework, and information management approaches need to be built as the foundation of the management system. Unless the team would not be able to provide care service due to the lack of direction. Most importantly, responsible leaders should have the ability to identify and prioritise tasks for service improvement and ensure patient safety.

Exploring theoretical concepts in team working within MTDs

Tuckman's model of team dynamics is widely being used to ensure collaboration within multidisciplinary teams as it helps team members to understand why challenges are emerging (Jones,2019). On the other hand, Kurt Lewin's group dynamic theory has mentioned that groups are dynamic and every involved person holds the power to influence individuals in a team (Endrejat and Burnes, 2022). In a word, leaders and subordinates can maintain team dynamics through influencing, forming, storming, norming and performing activities within MDTs in healthcare settings. Improved team dynamics automatically improve patient satisfaction and result in better organisational outcomes (Wagstaff and Quartiroli, 2023). Additionally, it is needed to highlight that the improvement of team dynamics, nurses and members of MDTs generally reflects improved engagement and professional accountability in the workplace. However, nurses involved in MDTs can face challenges to meet desirable team dynamics because of communication issues, lack of accountability and slow-decision-making possess (Leach, 2019). Besides, ineffective conflict negotiation strategies and lack of self-awareness among healthcare professionals are key challenges in the path of developing team dynamics. Hence, to develop a dynamic team, leaders within the healthcare sector should ensure effective conflict management strategy, and communication strategy as it ensures successful storming and norming which eventually guarantees high performance of MDTs. However, each involved healthcare professional should carry positive and collaborative attributes unless MDT in healthcare would not be able to meet a substantial organisational commitment.

Importance of role modelling in leadership and why it is important for networking skill development

This section of discussion is highlighting the importance of role modelling in leadership by considering the context of MDTs in the healthcare sector specifically, in nursing. In a similar context, Collins et al. (2020) said that nurse role models are the future of healthcare as they possess qualities to inspire, motivate and encourage healthcare staff to improve the quality of care service. Moreover, role modelling can increase the overall motivation and engagement level of nurses by regularly practising skill development. Another study has highlighted that role modelling in nursing helps individual nurses to facilitate, attain, maintain and promote high-quality care and accepts patients unconditionally (Orukwowu, 2022). On the other hand, a lack of role models in nursing can lead to fewer networking opportunities due to limited exposure to positive role models (Scammell et al. 2020). Moreover, by following the ethics and working strategies of role models in nursing, individuals can achieve the goal of professional development by increasing clinical competency. Automatically, increased clinical competency improves confluence among nurses and helps to influence and connect different people in the same work field. This indicates that role modelling has a critical influence on networking skill development in nursing as it assists through clinical competency improvement.

Exploring the concept of delegation as a leadership and management tool which supports effective MDT working

In this section of the discussion, different concepts of delegation as leadership and management tools within the multidisciplinary team have been evaluated based on literary evidence. Studies have highlighted that responsibility, accountability and authority are the three main elements of delegation which can be implemented as leadership and management tools as these hold the capability to increase effectiveness to support MDT in healthcare (Chilkuri et al. 2022). NMC codes for delegation for registered nurses mentioned that RNs must be accountable for their decisions while delegating tasks and duties to other individuals (Rcn.org.uk, 2023). Additionally, it is found that RNs only can delegate duties and tasks which are within another individual's competency. Adequate supervision and support to the delegated people ought to be provided to meet desirable outcomes (Rcn.org.uk, 2023). Moreover, each nurse involved in the MDT should ensure that the outcome of delegated tasks has met the required standards. One of the main challenges in delegating tasks within the healthcare sector is the lack of suitable training to perform specific interventions and the same issue has been observed within the NHS (Boulding and Hinrichs-Krapels, 2021). However, it is found that in NHS multidisciplinary team leaders ensure that support workers who are involved in the delegation process are going through ongoing development to ensure that their competence is maintained (England, NHS, 2023).

Identifying digital data, IT and information sharing within healthcare to ensure quality care and patient safety as well as effective MDT working

Digital data and information technology support the development of advanced record systems within the healthcare sector and make information sharing easy (Boulding and Hinrichs-Krapels, 2021). Therefore, it can be said that the information system acts as a bridge between technology and people in the chosen sector and helps to increase the effectiveness of team working. It is found that NHS England has established an advanced information management system to ensure safe and compassionate care to each patient and to develop team-level collaboration (England NHS, 2023). Hence, it can be stated that decision-making technology and people are an important part of the ongoing technological evaluation of NHS England because it is enabling the trust to improve the quality of care ensuring patient safety. Apart from that, the use of advanced communication technology helps the NHS trust to improve the communication of patients with healthcare staff which is eventually increasing the effectiveness of multidisciplinary team working (England NHS, 2023). This particular strategy is enabling this trust to work more efficiently with local MDT by improving service efficiency and decision-making. It is expected that the successful digital transformation of the information system might enable the team to improve the diagnosis and treatment system by accelerating information flow within MDTs. Instead of these, NHS England reported the data breach to the Information Commissioners which is known as Capita cyber incident (England NHS, 2023). For instance, Capita informed the NHS that documents provided by the NHS contain limited optometry information for two patients.

Identifying the gap in clinical practice or healthcare which needs service improvement through innovative practice

Based on the above evaluation, it can be stated that the NHS needs to improve its digital data management strategy to minimise the likelihood of data breaks. Additionally, the patient's sensitive information protection system requires improvement to ensure imposing laws and regulations. Besides, the confidentiality of sensitive data is required to be protected within the NHS by strengthening the confidentiality policy. Another report has highlighted that the MDT of the NHS cannot drive and monitor progress due to the lack of patient-safety alerts among a few staff (Ombudsman, 2019). Due to the issues in systematic identification within the multidisciplinary team of the NHS, in 2017 the trust failed to identify girls and women who were taking valproate drugs (England NHS, 2023). Besides, it is found that the MDT of National Health Services of England relies on each other instead of an information sharing system, which is a potential gap behind the limited information flow and inadequate data management. This indicates that an ineffective patient-data monitoring system is behind the ineffective patient-safety system within NHS England. Besides, it is found that inconsistent prioritisation at the board level is another area where the trust needs to maintain focus to prevent 82% occurrence of Never Events and improve the safety of 59% of planned events (Cqc.org.uk, 2018). Followed by the report, it can be said that to ensure innovation in service improvement NHS England should guarantee safe operation along with continuous technological improvement while proactively identifying risks.

Part 2- Reflection

Reflecting on the situation made me realise the importance of team working in healthcare

Considering my experience of working as a nursing associate during the first year I came to know that team working helps to improve productivity in the healthcare sector and improves the quality of the care system. However, communication is one of the main issues within the multidisciplinary team in the healthcare sector as people come from different cultural and national backgrounds. In this regard, I need to mention that I also faced issues communicating with members who are working with me as part of the multidisciplinary team but the collaborative and visionary approach of the team leader helped to resolve the issue. In other words, I can say that only because of the collaborative attitude of team members, did I get to know how teamwork is important to ensure patient safety and to increase the effectiveness of decision-making. Moreover, I have realised that a collaborative leadership approach and transparent communication help to develop a safety culture within healthcare organisations and oblige to address critical issues.

Reflecting on my experience when one task was delegated to me during the first year in my role as a Nursing Associate

Initially, when the team leader delegated tasks to me in the first year, I faced a range of issues as the ethics of delegation were not clear to me. For instance, I was not able to review errors in the decision-making approach as a delegate but other personnel involved in the team guided me to deliberately understand the challenge behind it. Eventually, this helped me to understand how team members can help to strengthen the decision-making skill of a nursing associate in the stage of delegation.

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Conclusion-

Summary

At the end of the evaluation, it is found that gaps in leadership and decision-making are minimising the quality of care within the NHS. Similarly, it is noted that team working, delegation, role modelling and delegation can be used as leadership tools within MDTs especially in nursing. However, the authority is aiming to leverage a range of advanced technologies to accelerate decision-making and improve collaboration through transparent communication. Though, it is found that monitoring of progress is necessary throughout the delegation process unless it can lead to ineffective decision-making and low quality of healthcare service which may lead to decreased patient safety.

Recommendations

Recommendation 1

• It can be recommended that establishing a clear direction for the leadership and management strategy besides, the improved access to training opportunities in NHS England can improve the efficiency of overall healthcare operations.

Recommendation 2

• Minimising dependency on individual delegates and promoting teamwork, accuracy as well as collaboration in task implementation action can be improved.

Recommendation 3

• The full record of training needs to be kept to ensure the effectiveness of training before and after delegating tasks to persons. Additionally, support workers' competencies need to be assessed before and after training to ensure the effectiveness of delegation.

Reference list

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