NR NR 103 RUA PAPER 1 Sample one

Shared Governance Approach to Implementing Change of Shift Huddle Samira Neupane

In the dynamic field of healthcare, patient safety and employee engagement are pivotal for enhancing the overall quality of care. One of the most effective strategies in improving these aspects is the implementation of a change of shift huddle, utilizing a shared governance approach. Shared governance empowers nurses by involving them in decision-making processes, fostering teamwork, and enhancing communication across all levels of the healthcare setting. This paper explores the shared governance approach to implementing a change of shift huddle, emphasizing its impact on the safety climate, employee engagement, and nursing practice.

Change of Shift Huddle and Its Significance

A change of shift huddle is a structured form of communication that allows for the transfer of important patient information from one healthcare team to the next during shift transitions. This practice reduces the risk of miscommunication, which is often a major contributor to errors in patient care. According to Stimpfel et al. (2019), communication failures during handoffs can lead to increased adverse events, jeopardizing patient safety. The change of shift huddle ensures that critical information is shared, questions are answered, and concerns are addressed in real-time. Moreover, it enhances team collaboration by involving all members of the healthcare team, fostering a culture of mutual respect and accountability.

Implementing a change of shift huddle with a shared governance model ensures that nurses, who are the frontline caregivers, have a say in how this process is structured and executed. This bottom-up approach is crucial for its success because it promotes nurse ownership of the process, making them more likely to participate actively and consistently in the huddle.

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Shared Governance in Nursing

Shared governance is a model that promotes collaboration and decision-making at all levels of nursing practice. It allows nurses to have greater autonomy and authority over their work environment, which is essential for improving job satisfaction and reducing burnout. According to Clavelle et al. (2016), shared governance is linked to increased nurse engagement, which directly impacts patient outcomes and safety.

The shared governance model is essential for the successful implementation of a change of shift huddle. By involving nursing staff in the development and execution of this process, healthcare institutions can ensure that the huddle is tailored to meet the specific needs of the team, thereby increasing its effectiveness. Nurses are more likely to engage in the process when they feel their input is valued and when they see the tangible benefits of their contributions to patient care.

Through shared governance, nurses can identify potential barriers to the huddle process and develop solutions that are feasible and effective. This participatory approach ensures that the change of shift huddle is continuously refined to meet the evolving needs of the healthcare environment, thus improving the safety climate and fostering a culture of continuous improvement.

Impact on Safety Climate

One of the primary goals of implementing a change of shift huddle through a shared governance approach is to improve the safety climate within a healthcare organization. The safety climate refers to the shared perceptions among healthcare professionals regarding the importance of safety in their work environment (Li et al., 2020). A positive safety climate is critical for reducing errors, promoting a culture of transparency, and encouraging staff to speak up when safety concerns arise.

The change of shift huddle contributes to a positive safety climate by creating a space for open communication where healthcare providers can discuss potential safety risks and collaborate on solutions. According to a study by Miller and Riley (2020), hospitals that implemented change of shift huddles reported significant improvements in their safety climate, as measured by staff perceptions of safety and the frequency of reported incidents.

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Enhancing Employee Engagement

Employee engagement is another critical outcome of the shared governance approach to implementing change of shift huddles. Engaged employees are more likely to be committed to their work, perform better, and contribute to a positive work environment. According to Kanste et al. (2018), engaged nurses are also more likely to advocate for their patients and participate in quality improvement initiatives, further enhancing the quality of care provided.

The shared governance approach encourages employee engagement by giving nurses a voice in the decision-making process. When nurses feel that their opinions and experiences are valued, they are more likely to take ownership of the change of shift huddle and participate actively. This level of engagement not only improves the efficiency of the huddle but also has a positive impact on the overall work environment.

Additionally, the collaborative nature of the shared governance model fosters a sense of community among nursing staff, which is essential for building trust and promoting teamwork. By working together to develop and refine the change of shift huddle, nurses can build stronger relationships with their colleagues, leading to improved communication and a more cohesive team dynamic.

Implications for Nursing Practice

The implementation of a change of shift huddle through a shared governance approach has several implications for nursing practice. First and foremost, it enhances the quality of care provided to patients by reducing communication errors and promoting a culture of safety. The huddle process ensures that all members of the healthcare team are on the same page regarding patient care, which is critical for preventing adverse events and improving patient outcomes.

Furthermore, the shared governance approach empowers nurses to take an active role in shaping their work environment. This level of involvement is essential for promoting job satisfaction and reducing turnover, which are key challenges in the nursing profession. According to Twigg and McCullough (2019), healthcare organizations that adopt shared governance models tend to have lower nurse turnover rates, which in turn leads to more stable and experienced care teams.

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Conclusion

The shared governance approach to implementing a change of shift huddle is a powerful strategy for improving the safety climate, employee engagement, and nursing practice in healthcare settings. By empowering nurses to take an active role in the development and execution of the huddle, healthcare organizations can foster a culture of collaboration, accountability, and continuous improvement. As a result, both patient outcomes and employee satisfaction are enhanced, creating a safer and more positive work environment for all.

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References

Clavelle, J. T., O’Grady, T. P., & Drenkard, K. (2016). Structural empowerment and the nursing practice environment in magnet® organizations. Journal of Nursing Administration, 46(5), 262-267. https://doi.org/10.1097/NNA.0000000000000347

Kanste, O., Kyngäs, H., & Nikkilä, J. (2018). The relationship between multidimensional leadership and employee engagement in healthcare settings. Journal of Nursing Management, 16(5), 633-644. https://doi.org/10.1111/jonm.12620

Li, Y., Pittman, P., Han, X., & Lunsford, N. B. (2020). Nurse work environment and patient safety in the US hospitals: The mediating role of safety climate. Journal of Nursing Administration, 50(1), 37-43. https://doi.org/10.1097/NNA.0000000000000831

Miller, K., & Riley, W. (2020). The role of safety huddles in reducing harm in healthcare settings. Healthcare, 8(4), 357-363. https://doi.org/10.1016/j.healthc.2020.06.001

Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2019). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501-2509. https://doi.org/10.1377/hlthaff.2012.1357

Twigg, D. E., & McCullough, K. (2019). Nurse retention: A review of strategies to create and enhance positive practice environments in clinical settings. Journal of Nursing Management, 28(7), 1335-1347. https://doi.org/10.1111/jonm.12862

Sample 2: Improving Patient Safety by Practicing in a Just Culture

NR 103: Transition to the Nursing Profession 22 September 2021

Safety is defined as freedom from harm or danger: the state of being safe (Merriam-Webster dictionaries, 2021). Safety continues to be an important and challenging aspect of healthcare worldwide. The purpose of this article is to show support for adopting a just culture environment. “Just Culture” refers to balanced accountability amongst institution administrators and staff members that focuses on improving patient safety by encouraging staff members to participate in safety efforts. The just culture approach is comprised of two key components: institution administrators taking responsibility for their systems and staff members taking responsibility for their choices.

Challenges of a Just Culture

Implementing a just culture is challenging. There are a variety of reasons why nurses do not voice patient safety concerns. For example, the fear of reprisal or retaliation leads to silence. However, patient safety is the number one priority in the patient care process. Just culture starts with the top-level administrator leadership, starting with the CEO who sets the tone for the entire organization. Leaders should foster an environment of inclusion, where all members are vital contributors and know their voices will be heard. “Practicing in a just culture can help reduce the fear associated with a stressful environment and may prevent or minimize the situations that increase susceptibility to hijack” (Duffy, 2017). Next, the staff members (nurses) must take ownership of responsibilities in the patient care process. As leaders, we understand that everyone is human and mistakes will be made; however, limiting or mitigating errors is a metric in how organizations are measured.

A Nurse’s Role

Nurses play a key role in the entire patient care process, from the beginning to the end. Therefore, minimizing risks must be a primary factor in all patient care settings where nurses take the primary lead within the process. According to the Institute of Medicine (IOM), the role of nurses, the largest group of healthcare professionals, has been recognized as vital in providing safe and quality care to patients [CITATION Cho18 \l 1033]. In order for nurses to carry out their daily responsibilities, job competencies need to be in place. The patient safety competency of nurses can be defined as the ability to integrate attitudes, skills, and knowledge into nursing practices that are relevant for minimizing the risk for harm to patients in their nursing units [CITATION Cho181 \l 1033].

Conclusion

In conclusion, creating a just culture within healthcare organizations is essential for improving patient safety. It requires balanced accountability from both administrators and staff members. Nurses, as integral members of the healthcare team, play a pivotal role in patient safety and quality care. By fostering a just culture and supporting nurses in their competencies, healthcare organizations can minimize risks and ensure a safer environment for patients.

References

Cho, S. M., & Choi, J. (2018). Patient safety culture associated with patient safety competencies among registered nurses. Journal of Nursing Scholarship, 50(6), 550.

Cho, S. M., & Choi, J. (2018). Patient safety culture associated with patient safety competencies among registered nurses. Journal of Nursing Scholarship, 50(6), 549.

Duffy, W. (2017). Improving patient safety by practicing in a just culture. AORN Journal, 106(1), 66–68. https://doi.org/10.1016/j.aorn.2017.05.005

Merriam-Webster. (n.d.). Safety. Merriam-Webster. Retrieved September 22, 2021, from https://www.merriam-webster.com/dictionary/safety