• Internal Code :
  • Subject Code : NURS2002
  • University :
  • Subject Name : Nursing


Registered nurses are required to ensure quality and safe medical interventions that, in turn, results in the aversion or reduction of the issues that the patient might be going through. Professional Self-Care underpins Person-Centred Care (PCC). Nurses should seek to offer culturally-sensitive interventions that are geared towards not only providing a remedy for the problems the patients face but also offeringextensive care; that might extrapolate to providing essential care (Bodolica & Spraggon, 2019). Caitlyn ordered the rendering of medication-two paracetamol for a patient without applying the Clinical Reasoning Cycle (CRC) to collect cues and information on the patient’s biopsychosocial background. Moreover, analysis and evaluation of the outcomes wereconsidered before the rendering of service. The failure to effectively incorporate the Gibbs cycle of analysis on offering patient care results in problematic situations going forward; the medical interventions that are carried out during the point-of-care of the patient are rendered ineffective. The nurse should endeavournot only to create a rapport with the patient to facilitate interpersonal communication but also to use culturally-sensitive,and methods in offering the interventions.In turn, this encourages the patient to develop strength, avert anxiety, and improve coping(Khan &Usherwood, 2018).

Incident 1: Professional Self-Care Strategies

Patient-centred care is one of the underpinnings of offering essential care that is in tandem with health promotion. One of the most critical strategies that are commonly used is the initial creation of a rapport with the patient so that they can feel free, secure, and reduce their anxiety, given the environment that they find themselves. Maintaining an excellent interpersonal relationship with the patient offers a prerequisite for the full information gathering that has clinical significance in terms of affecting the intermittent decision(making criteria). As such, correct diagnosis and treatment are ensured, and this resultsina smooth and short recuperation period of the patient.In the long-run patient-provider relationship plays a huge role in the improvement of general health care (Khan &Usherwood, 2019).

Health promotion is the inherent improvement in productivity by offering extensible essential health care for purposes of improving the quality and safety of nursing interventions. One of the patients that Caitlyn dealt with was having medical adherence issues and drug abuse. Health promotion, in this case, is warranted given the undesired clinical effects of the problems mentioned above. Medical adherence is one of the primary factors that affect the recuperation period as well as the efficacy of the administered drugs. In this case, the nurse should have offered informational and educational content to increase the patient awareness on the adverse effects of medication adherence and the chances of readmission, which has cost implications for both the entities involved. Given that another patient was also undergoing additional issues, offering lifestyle education would have played a marginal role in improving the quality and safety of care (Daundasekara et al., 2020). Therefore, it is vital to observe medical adherence, not forgetting lifestyle education if significant progress is to be madeon the patients.

Incident 2: Clinical Governance

Clinical governance constitutes the underpinnings of persistent improvements and quality in rendering care especially in Australia. Clinical governance in this case is based on the pillars of trust and processes that deliver the systems and services,according to Panteghini& Rogers (2019). Thus, this part of the paper will analyse the provided case study with reference from the clinical governance standpoint. Risk management is one of the most essential aspects of clinical governance. The management of the hospital should ensure that the team groups perform following the prescribed rules and regulations. In the long run, the management should ensure that strategic human resource management is applied for effective clinical governance (Rendalls et al., 2019).

Also, an environment where the employees work without fear of being reprimanded leads to effective error reporting and logging,which in turn leads to a reduced future occurrence of undesirable clinical outcomes. The nurses did not take any precautions so that potential risks associated with errors in diagnosis and assessments are averted. Therefore, this shows that the possible effects of the mistakes made by the armature nurses could culminate inexacerbationof the patient’s condition or activation of other environmental stimuli that could further worsen the patient’s situation, given that the incidents occurred at the respiratory ward. Although risk management strategies are widely advocated for health governance, the effectiveness of the approach is still yet to be accurately determined (Pasqualetti et al., 2019). In practice, there are systematic challenges pertaining to the governance strategies of risk management(Hanberger& Lindgren, 2019). Risk management strategiesare critical in clinical governance as they hugely affect the outcome of the treatment.

Caitlynis not entirely qualified to administer medicine to the patients, given that she is still a second-year student of nursing. The ward she is assigned to is the respiratory ward; the possibility of worsening conditions of patients with sensitive environmental stimuli like asthma is high. She administers drugs toone of the patients without applying the process of clinical reasoning by first considering the patients’ biopsychosocial determinants of their respective activities of living and how they might determine current and future medications.

Professionals need to be protected from occupational hazards that may occur during rendering service (Preisz, 2019). The activities that Caitlyn conducted were inherently flawed such that the preceding medical interventions could not render effective remedy given the fundamental problem solving and decision-making chain of CRC, and the application of Gibbs cycle was broken. Additionally, the nurse continued to offer patient medicine without a medical order, and this is poor decision-making that has a potential forperilous outcomes (Looi, Allison, &Bastiampillai, 2019).

From a management perspective, given the size of the hospital, there is a need for the setting up of qualified personnel that renders quality service to the patients. The trainees are only supposed to be allocated work via delegation. The delegation, in this case, works best when the parameters and the desired outcomes are set beforehand. Structuring personnel this way allows for efficient error reporting and identification. A working environment where the employees are permitted to make erroneous decisions without facing the consequences is not desirable. Nurses have regulatedprofessionals who are recognized by the law as having responsibility for their actions (Standing, 2020).In contemporary society, emerging trends such as the use of Decision Support Systems (DSS) is one of the emerging trends on clinical governance given the overall improvement of efficiency and reduction of errors by augmenting the normal hospital management process (Birindelli, &Panteghini, 2019; Reddy et al., 2020).


In conclusion, the advent of increased use of Health Technology Assessment (HTA) reports used to provide the effectiveness of the implemented strategies. It is so because itdetermines the direct and indirect effects of technology in solving the problems at hand. In this case, there were no present medical orders for the patient who could not speak English but had pain. The nurse only realized this through her daughter in law but not the actual patient. Effective pain management strategies depend on the physical examination of the patient and the direct response from the subject. In this case, the nurse was only offered the information by a colleague-not necessarily form the same team group. The importance of teamwork and interprofessional collaboration is critical in ensuring that the patient cues, analysis, evaluation, and assessment information are shared across the team group. As such, this will eradicate possible informational asymmetries that generally occur in patient-provider scenarios.


Birindelli, S., &Panteghini, M. (2019). Clinical governance should be a priority when care delivery systems are disrupted. Archives of Pathology & Laboratory Medicine, 143(9), 1046-1046.

Hanberger, A., & Lindgren, L. (2019). Evaluation systems in local eldercare governance. Journal of Social Work, 19(2), 233-252.

Khan, N., &Usherwood, T. (2019). ‘We are not invincible’: a qualitative study of self-care practices by Australian general practice registrars. Australian Journal of Primary Health, 25(4), 380-386.

Looi, J. C., Allison, S., &Bastiampillai, T. (2019). Commonwealth of common mental health: the need for a comprehensive overhaul of corporate governance in mental healthcare in Australia. Australasian Psychiatry, 1039856219891657.

Panteghini, M., & Rogers, B. B. (2019). Clinical governance should be a priority when care delivery systems are disrupted/in reply. Archives of Pathology & Laboratory Medicine, 143(9), 1046-1046.

Preisz, A. (2019). Fast and slow thinking; and the problem of conflating clinical reasoning and ethical deliberation in acute decision‐making. Journal of Paediatrics and Child Health, 55(6), 621-624.

Rendalls, S., Spigelman, A. D., Goodwin, C., & Daniel, N. (2019). Health service engagement with consumers and community in Australia for issue. International Journal of Health Governance.

Standing, M. (2020). Clinical judgement and decision making in nursing:Learning matters. Melbourne, Vic: SAGE.

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