Leadership and Clinical Governance

Introduction to Leadership and Clinical Governance

Leadership is an action which is attained by the leader in order to give direct and lead the team members. The concept of leadership is required in each and every field for the successful company operations. On another hand, clinical operations are method which helps the organizations like NHS to enhance their services for the maintenance of care standards. Whereas, the concept of clinical governance is initiate with a motive to develop mechanism so that the patients can get improved quality services. However, the stated concept requires effective leadership for the implementation of the requisite changes and alterations. It will allow the health care organizations to get a clear vision with reference to all the levels. The present document is based on the case study of deceased person name Christopher Hammett. He died due to certain errors raised from the part of medical and nursing care. As a result, this report will consider the same case and explain the role of nurse as a leader in the health care organizations.

Role of registered nurse as a leader

In nursing care, the concept of leadership plays an essential role because the patients can get the proper with the help of nurses. The roles of the registered nurses as leaders may vary according to the structure and size of the firm. However, a registered nurse can perform his or her duties are equivalent to the competent manager and the leader. The registered nurse is needed to perform the role related with visionary leadership. This allows the nurse to manage the operations related with the different patients. In the case of Christopher Hammett(CH), he consulted to an orthopaedic surgeon for back pain. Further, his heath was good enough when he was admitted to the private hospital where the medical staff did not find after the working hours. Initially, the oxygen saturation of the patient was maintained at 99 percent. Further, he was transferred to PACU. This has resulted into lowering down the saturation level of the oxygen.

In context to above, the present anaesthetist assumed that due to reversible upper airway obstruction, the level of oxygen saturation has tended to low. As a result, they supported his jaw and inserted an oropharyngeal airway. The staff who was present there was keep on changing their oxygen mask. This has affected the saturation level of Mr. CH which was not properly recorded by the staff. When the level was recorded, it was mentioned as the stable level. Here, the nurse assumed due to use of morphine, the oxygen level is getting influenced. Therefore, being a registered nurse, it was their duty to properly analyse the condition of the patient instead of assuming the things. This has resulted in the death of the stated patient.

Differentiate between leadership and management

Leadership and management are the two most crucial terms which are mainly used in the organizations. The two concepts are quiet distinct from each other but somewhere they are connected collectively. However, leadership is the attribute of a leader by which the team members are get influenced in order to attain the assigned tasks and duties. On contrary to this, management is the process by which the things are being managed in an effective manner. The two terms are required and can be seen in all the fields like corporate, hospitality sports and medical. Howsoever, the organization like NHS and cancer research centres also adapts this concept in this working environment. In health sector, leadership is used to influence the nurses and another staff for taking care of the patients. On another side, management is used for the management of several activities in the health care organizations.

Additionally, at the time of influencing the nurses and another staff for accomplishing work, the leaders plays essential role. The concepts of leadership assist the team to get influenced for the achievement of organizational goals. Besides this, management brings stability in the operations of an organization. Therefore, it can be said that leadership and management are the two important tools which are required in the organization. Both the concept plays an essential role in the attainment of the company objectives.

Role of nurse in improvement of quality and change management

Nurses are the most important person in the hospital for the care of patients and their families. They evolve considerable information with reference to the strength and weakness of the heath care organizations. For the successful operations of the hospitals, it is crucial to bring improvement in terms of quality. Nurses are the one who takes care of the patients and has major focus on the operations of the hospitals. For an instance, they are responsible for the care of the patients effectively. However, the top management adopts measures for the improvements of quality are mainly followed by the lower staff. For example, If the higher authority has implemented the software for the storage of patients data and information then it is the duty of the nurses to make sure of the storage of patient data.

In context to above, change management is another concept which is being focused by the top level management in the hospitals. In order to provide improved services the management needs to focus on bringing changes. However, the nurses play an essential role in the adaption of change management. The implemented alterations in the hospitals are followed by the lower staff itself. This helps the management of the hospital to implement the strategic changes at workplaces.

Principle and processes of clinical risk management and its application

Clinical risk management is related with the enhancing the services quality in the health care organizations. Here, the management identifies the current situation of the organization and analyse the risks which can harm the patients. In order to manage the clinical risk, there are four step process can be adopted by the management of hospital. In the first step, the present situation is analysed by which the actual risk is identified. Further, the managers need to assess the severity and the frequency of the associated risk in the hospital. If the frequency of risk is higher than the authorities needs to adapt the effective measures and vice versa. Additionally, after analysing the frequency of risk the management requires focusing on the reduction of risk with the implementation of the corrective measures. This will allow the management to overcome the issues raised in the operations of hospitality sector.

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At last, the cost of risk must be analysed so that the organization can focus on the corrective measures in order to lower down the cost of risk. In order to apply the risk management techniques, the management requires making a plan so that the whole picture can be analysed.

Accountability of the registered nurse in clinical governance

For the registered nurse accountability is the major concerns in clinical governance. Whereas, accountability can be explained as the responsibility of the actions. As per the modern concept of the accountability, the nurses are the member of the profession. As per this concept, they are responsible for certain roles and responsibilities towards the patients. However, judgements can be made by them in different circumstances. They use their professional knowledge in order to make the decisions with reference to the patients. In clinical governance, the nurses are accountable for certain responsibilities which help the patients to get proper care and treatment in the hospitals. There are four 'principle' which form up a structure of professional answer-ability deriving from various types of potency in nursing activity these are professional, ethical, lawful and employment/contractual. All these principle helps the registered nurse to perform their roles and duties in a way that the goals and objectives of the hospital can be attained. As a result, the health sector organizations will be able to provide quality services to the customers. This will result in attaining the goals and objectives in an effective manner. In addition to this, the quality health services will result in increase in number of patients in the concerned hospitals.

Specific knowledge and capabilities for the stated profession

For the stated profession, it requires to have advanced knowledge of the principles and concepts. Additionally, coherent and advanced knowledge of the underlying principles and concepts in one or more disciplines and knowledge of research principles and methods. cognitive and technical skills to demonstrate a broad understanding of a body of knowledge and theoretical concepts with advanced understanding in some areas. In addition to this, technical skills to design and use research in a project. Besides this, the application of knowledge will demonstrate the application of knowledge and skills:

  • With initiative and judgement in professional practice and/or scholarship
  • To adapt knowledge and skills in diverse contexts
  • To plan and execute project work and/or a piece of research and scholarship with some independence.
  • To contain some important skills such as organizational, stress management, good communication, detail oriented, critical thinking etc.
  • Have a good knowledge regarding medicine, psychology, able to determine the needs of service users etc.

Use of different communication modes

In the case of Mr Hammett, nurses could use various communication modes to share the health information and related updates with doctors and other health practitioners. The death of the patient has also dependent over the miscommunication among the health care workers and selection of wrong communication modes. To minimize the probability of occurrence of the following situations in the future, there are different modes of communication can be used. These help in to inform, motivate and the effect change. With the help of communication skills the clear ideas and thoughts can be presented to the listener. By using effective communication skills, the ideas and principle will be effectually presented. With the help of oral communication, the ideas and principles can be clearly explained to the listener. In addition to this, written communications assist in getting the information with the use of proper language and format. This maintains the reliability of the information in a way that it helps in communicate the right information to the other members. Along with this, interpersonal communication mode can be taken into the consideration by the nurses of Pacific Private Hospital to share the health update of Mr Hammett.

Application of Digital literacy to find, use and dissemination information

Digital literacy means the knowledge, skills and behaviours used in a wide range of digital devices. It contains laptops, smartphones, desktops etc. In the case of Mr Hammett who has died in Pacific Private Hospital because of several reasons such as errors series of errors albeit lack of care on the part of the medical and nursing staff caring for him, aspiration pneumonia etc. With the help of application of different Digital literacy, nurses can find, use and dissemination of information. For example, by using the following concept, nurses can able to understand how to use technologies to interact with the other staff members to information about the health status of the patients to health care practitioners and maintain a good communication with them. With the help of this, they can record health update of service users in every situation and analyze them to determine the variations in health status of the patients over the time. The generated information from Digital literacy can assists the nurses to share the record and analyzed data with other care workers of Pacific Private Hospital so that they can able to take the right actions to improve the health condition of the patient.

Evaluating information using critical and analytical thinking and judgment

With the application of critical and analytical thinking, it becomes easy to evaluate the existing information in the right way. In the case study of Pacific Private Hospital, with the application of the following concept, it has become easy to evaluate the issues on the basis of key points, arguments and assumptions in the information. By doing this, it has assisted the nurses of hospital to determine what are the exactly issues that has lead to death of Mr Hammett. On the basis of this, new course of actions can be easily taken so that the same problems cannot repeat in the future with any other patients. Along with this, by evaluating the already exist information using critical and analytical thinking and judgment; it has determined the causes and effects, the sequence of observational activities, similarities and differences in trends of patient health observation etc.

Creating solutions to authentic problems

On the basis of the given case study, it has determined that Christopher Hammett died as a result of a series of errors albeit lack of care on the part of the medical and nursing staff caring for him when he was a post operative patient at the Pacific Private Hospital. Along with this, it has also found that death was caused by aspiration pneumonia due to, or as a consequence of, coronary atherosclerosis. To solve real and ill based problems, nurses of cited organization should adopt leadership professionals. It will help in developing a successful vision for the organization and develop collaborative nature between the nurses and other health care professionals. This will allow solving the problems on daily basis and providing direct guidance as well as provide mentorship to other units nurse staff. Apart from this, with the use of leadership approach, the nurses of cited hospital will shows the responsibilities towards large-scale policy planning, staff management, financial resource management, and business management functions. Further, this will realize them to understand the core responsibilities such as coordinating and supervising the delivery of health care. Beside this, with proper education to the nurse, Pacific Private Hospital, it becomes simple to find the solution of the problem.

Self management

As per the given case study, it has found that Christopher Hammett had faced unresolved back pain. For this, Dr Scott-Young performed an orthopaedic review on patient. After few months, the same health check up done by the doctor and has suggested to Mr Hammett for L5- S1 disc replacement operation. After completion of 35 minute operation, he has shifted to the Post Anaesthetic Care Unit (PACU). There were two registered nurses appointed for patient care and its health observation. During his case, various observations had taken by the health care practitioners to ensure the health of Mr Hammett. From the case analysis, it has identified that there were reasons that working behind the death of patient. To overcome the weaknesses of nurses, self management becomes most important. For this, the first concept in this direction has working and learning independently. In this context, the management of Pacific Private Hospital should arrange the proper training to them so that they can learn different practices to deal with the patients and deliver them proper care. It will assist in development of various skills in nurses so that they can work independently in the hospital with less monitoring and guidance. Along with this, self management concept will allow them to take responsibility for personal actions if they notice no improvement in health of services. On the basis of this, nurses of Pacific Private Hospital can determine several courses of actions in the context of well-being of patients.


From the above research, it can be concluded that in Pacific Private Hospital, Christopher Hammett was referred by his general practitioner for unresolved back pain. Different health observations and check-up were taken into the consideration by the doctors to determine the main route cause of illness. After all these work, it was recommended to carry out a disc replacement operation to the patient. Further operation, Mr Hammett was shifted to PACU where two nurses were there to monitor their health. The less knowledge of operating the equipments and mistakes in taking the health observation, finally the patient was died in the hospital. On the basis of this case study, it has been concluded that there have several reasons which has shown that nurses have needed proper training and education to taking care of patients and operating the machines. By adopting the right leadership and management styles, they have able to take the right decisions in clinical risk management and apply it in healthcare domains.


  • Barden, A.M., Griffin, M.T.Q. and et.al., 2011. Shared governance and empowerment in registered nurses working in a hospital setting.Nursing administration quarterly.
  • Bassett, S. and Westmore, K., 2012. How nurse leaders can foster a climate of good governance: In the first of a four-part series on corporate responsibility, Sally Bassett and Kathryn Westmore explore the importance of workplace culture and leadership.Nursing Management.
  • Brennan, N.M. and Flynn, M.A., 2013. Differentiating clinical governance, clinical management and clinical practice.Clinical Governance: An International Journal.
  • Bretschneider, J., Eckhardt, I. and et.al., 2010. Strengthening the voice of the clinical nurse: The design and implementation of a shared governance model.Nursing Administration Quarterly.
  • Dwyer, D., 2011. Experiences of registered nurses as managers and leaders in residential aged care facilities: a systematic review.International Journal of Evidence‐Based Healthcare.
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