An Analysis of the impact of Clinical Governancewithin my own specialist practice area of District Nursing.
...e components that are integral to its implementation viz : Quality, Standards, performance, managing risk and consumerism. Millar (2001) outlines in tablature form similar components with the addition of 1 extra standard Table 1. Component features of the clinical governance framework Ensuring that health professionals have the right education, training skills and competencies to deliver the care needed by patients; Ensuring that processes which improve the quality of care are in place throughout the organisation; Using techniques to anticipate and prevent potential problems; Using techniques which monitor and improve existing practice; Recognising and acting on poor performance -providing a framework which allows clinical staff to learn from mistakes; Facilitating the implementation of good practice. Clinical governance has been brought to the fore front of the governments mind as media interest escalated in an increase in the number of “NHS scandals”. The 29 babies that died after heart surgery at the Bristol Royal infirmary, led to the General medical council s enquiry (1998) in which three doctors were found guilty of serious professional misconduct, this was followed by a 14 million pound public enquiry published July (2001). The more recent conviction of Harold Shipman the Manchester GP convicted of serial murder of at least 15 of his patients, dealt a further blow to confidence in the medical profession and its systems of self governance (Rivett 2002). Hence the need for a concerted effort to restore patient confidence and raise the profile of effective policies that correct and pinpoint actual and potential health service deficits either clinically or corporately . What has been the impact on a local level of all this government activity in its quest for quality? , and can it be seen to be delivering its desired goal . Within the nursing context there has not been as much media attention, in relation to clinical or criminal negligence or mis judgement, but with clinical governance having as its underpinning ethos the idea of corporate governance, there has been a definite increase in my own area of clinical audit, and profiling , though the author has not been directly involved with these initiatives, the information regarding these initiatives has been briefly spoken of amongst the various team members. There is a greater emphasis on accurate record keeping and many other activities surrounding clinical governance issues . Training needs are being more rigorously monitored, within the area of statutory training in such areas as Card-io pulmonary resuscitation , Manual handling , child protection, patient risk assessments, record keeping e.t.c.. Many of the latter training needs are expected and required to be updated yearly, this is seen to apply to both corporate and clinical risk management. Professional development for nurses has always been encouraged within City and Hackney Primary care trust, before Clinical governance was being used as a tool for measuring and assessing quality. However management is instilling a need at each independent personal review to set objectives for staff personally and corporate training needs. There has been training given to the G grade nursing staff with the expectation that they will filter the required information to more junior staff who will set their own objectives, and will this in turn will be monitored by G grade personnel. Clinical Supervision has been held regularly within our own team by an outside facilitator, it has focused on many different aspects of our case load management and is hence a part of the clinical governance process in its quest for quality . It has been the impetus for opening up discussion that has made us look at ourselves and the way we practice . There have been some uncomfortable scenarios regarding difficult relationships that have needed to be talked over in a non...