The nurse unit managers are majorly responsible for monitoring patient care regularly, directing, supervising, and developing the nurse staff. The nurse unit managers have to report the information to the director of nursing to ensure delivery of effective and quality care to the patients with the skilled facility and ling-tern care (Boamah, 2018). The nurse unit manager has leadership and management knowledge that helps in clinical governance and patient safety as well at the ward level. The 3 main themes or key messages discussed here are communication, staff management, and effective run of operations/tasks inside the ward of the patient. The following factors are very important in leadership: encourage trust and cooperation, promote social justice and morality, enable collective learning, creating direction and alignment around strategies, organize and coordinate work efforts, and many others (Boamah et al., 2017). According to Goldsby et al. (2020), the main 5 leadership styles or theories that are followed by the nurses in Australia are – autocratic, transformational, democratic, servant, and laissez-faire theory.
The transformational theory is found to be very effective in the patient’s safety and clinical governance. If the nurse unit manager uses the knowledge of transformational theory then he/she can encourage the staff to collaborate and work effectively to achieve clinical goals that will help in achieving patient safety. Positive effects of transformational leadership result in patient-staff satisfaction, openness about errors, patient safety, positive nursing outcomes, staff well-being, and work-life balance. Such theories help in creating an environment that ensures the patient’s safety. This is because the nurse unit manager can respect the staff and patients, inspire confidence, and communicate through a shared vision that results in morale strengthening and improved patient health. According to Broome & Marshall (2017), the managers are honest, open-minded and develop a strong relationship with all with whom he/she works with like the patients, higher health authorities and other health professionals.
The nurse unit manager should have qualities like critical thinking, problem-solving, and knowledge about the healthcare sectors resulting in better and effective clinical governance with high levels of patient safety. The managers can be a nurse or a senior health care professional that can have his/her team with whom effective clinical governance will be executed. The nurse unit managers recruit those nurses who have high order thinking abilities and effectively communicate with co-workers and patients. This will ensure complete feedback from the patients and other health professionals regarding the plan of patient’s safety and will also provide us with new ideas presented by the participants (Lambooij et al., 2017).
The manager also ensures that the nurses and other health professionals are trained well during their respective training so that they develop professionalism with clinical governance (Broome & Marshall, 2017). An effective leader who can organize the plan and execute it effectively will help in the removal of various barriers and roadblocks. This leadership theory will gain staff satisfaction and in turn, reflect with a major positive impact on reducing the rate of patient care errors. Moreover, the leader with a transformational style will encourage patients and staff in the plan of change towards a new direction (Fischer, 2016). Another theory is a democratic leadership theory, according to Cope & Murray (2017), this always encourages the communication and inputs from the team that ultimately help a lot in decision making. It ensures that the team or members feel comfortable in speaking up and feel valued as well. A presence of a respectful and safe environment in the ward ensures not only patient safety but a strong relationship-bonding among the patient and the healthcare providers who ensure that the patient’s needs are met and respected.
For example, if a patient is old then feedback from such patents ensures the unit manager that health care providers are taking enough time to interact with him/her ensuring that effective clinical care is delivered by skilled staff. If the staff lacks in some areas then it is the responsibility of the unit manager to train them under respective highly skilled and qualified professionals. This will result in getting the knowledge of the clinical guidance as per the guidelines and standards. This will help in gaining the patient’s trust and delivering effective care. The higher organizations always value expertise, not the ranks of seniority, making this style beneficial in creating a safe and culturally effective environment that ensures a good plan of change in healthcare. All these factors in the end ensure that clinical governance is effective and maintained with high efficiency along with influence to promote patient safety at the ward level.
According to Kodama & Fukahori (2017), the management theories in nursing are theories x and y, systems theory, clinical management theory that has 3 sub-parts (scientific management, administrative management theory, bureaucratic management), and few others. These theories help the nurse unit manager in influencing and promoting the clinical governance and patient safety at the ward levels. The knowledge of classical management theory enables the nurse unit manager to ensure that the staff and other health professionals have proper types of equipment and tools. For example, the presence of alarms in the ward of those patients who forget about their medication intakes and who cannot call the medical care providers due to some medical reasons like dumb or difficulty in speaking. This knowledge also ensures that the hospital and the operations inside the ward run effectively influencing the clinical governance of the co-workers and the health professionals that ensure patient’s safety. According to Murray et al. (2018), the managers ensure that healthcare providers provide detailed supervision and instructions to each worker so that the tasks inside the ward are run scientifically and clinically.
The management in nursing emphasizes decision analysis, decision making, and control. The health professionals in health care should be trained so that they understand the task performance methods that yield maximum positive outcomes in patient’s improved health and safety status. A nurse unit manager with this knowledge has a strong hand in controlling, commanding, coordinating, organizing, and planning that helps in effective clinical governance. It ensures that there is a division of labor for specialization inside the wards and the health care providers are accountable for their roles and responsibilities (Kodama & Fukahori, 2017). It also influences clinical governance as it minimizes the chances of conflicts because there is the unity of command. The manager should teach the patient’s health care providers that there should be no sharp ended objects close to patients and the patent should also be taught about his/her treatment and care plans to reduce his/her anxiety. Moreover, it is the duty of the nurse unity staff manager to maintain the ratio of nurses that are assigned to the patients to ensure that clinical services are being made available to the patients (McKibben, 2017).
The hygiene and floor wetting issues should be kept under strict monitoring and the cleaning staff should be informed for the same to ensure the patient’s safety. Thereby, ensuring the patient’s safety and the unit manager is also involved in programs like safety and quality. The RN should also be taught to use the conflict management strategy to resolve the conflicts among other co-workers so that there are no such complex conditions in front of the patient that might disturb his/her health status. If the manager keeps a check of the nurse-patient ratio then there will be no workload burden on the nurses and they will in turn effectively deliver/perform their duties to achieve job and patient satisfaction. If there are proper collaboration and coordination among the staff members then risks can be reduced like in case of clinical emergency the anesthetic associates should be available 24/7 in the hospital so that they can immediately arrive in the ward at the time of emergency.
The following mind map shows that the nurse unit manager can influence the clinical governance and patient safety with knowledge of leadership and management.
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