clinical governance presentation details available

1. Students Name
Institutional Affiliation
Due Date

2.  Clinical governance is a framework through
which;
 NHS organisations are accountable
 For continuously improving the quality of their
services
 Safeguarding high standards of care
 By creating an environment in which excellence in
clinical care will flourish (Gottwaldov and Lansdowne,
2021).
 Introduced in the late 1990s, in response to
public concern about the quality of NHS.

3.  Aspects of ClinicalGovernance include
ensuring that
 Patients receive high quality care
 Medical staff are properly trained and competent
 There are systems in place to monitor and
improve the quality of care (Donaldson, 2018).

4.  Through clinical governance healthcare organisations are able to
monitor and improve the quality of the care they provide through
 Setting standards for clinical practice
 Measuring performance against these standards (Van Zwanenberg
and Edwards, 2018).
 Clinical governance has improved practice is by
 Increasing the transparency of healthcare organisations.
 Providing a framework for quality improvement (Van Zwanenberg and
Edwards, 2018).
 instances of clinical governance in action;
 Introduction of quality standards such as the NICE quality standards,
 The introduction of the Care Quality Commission (CQC) in England
(UK Health Security Agency, 2022).

5.  Clinical audit is a process in which health care
providers review their own performance in
order to identify areas in which they can
improve (Backhouse and Ogunlayi, 2020).
 This process can;
 Help providers enhance the quality of care they
provide.
 Help to ensure that patients receive the best
possible care (Backhouse and Ogunlayi, 2020).

6.  Lack of standardization.
 Lack of resources such as;
 Lack of funding
 Lack of staff
 Lack of time
 Resistance from staff such as;
 Resistance to change
 Skepticism of the process
 Lack of buy-in from leadership (Backhouse and
Ogunlayi, 2020)

7.  Clinical audit: peri-operative care in relation to
surgical site infections (SSIs).
 Why?
 SSIs are a common complication of operation
 Can lead to significant morbidity mortality (CDC, 2021).
 SSIs are a major source of healthcare-associated
infections (HAIs) (Okeahialam,Thakar and Sultan, 2022).
 Purpose: to determine the compliance of peri-
operative care with evidence-based guidelines for the
prevention of SSIs.
 The specific practice: use of prophylactic antibiotics
in peri-operative care.

8.  These measures include the
 Use of preoperative antimicrobial prophylaxis
 Use of sterile techniques during surgery
 Use of postoperative wound care (UK Health
Security Agency, 2022).
 These guidelines are based on the evidence-
based guidelines from the Centers for Disease
Control and Prevention (CDC) (CDC, 2021).

9.  procedure: Medical records reviews
 Variables;
 Type of surgery
 Use of preoperative antimicrobial prophylaxis
 Use of sterilization during surgery
 The use of after surgery wound care
 Data; occurrence of SSI

10. Standards No of
Patients
%ages
Preoperative Antimicrobial
Prophylaxis
97 97%
SterileTechniques 100 100%
Postoperative Wound Care 100 100%
Developed an SSI 1 1%

11.  The final of this audit indicate that our
facility is doing well its job of complying with
the standards of best practice related to SSI
prevention
 The results of this audit are subject to a
 Selection Bias
 Recall Bias

12.  The audit results comparatively goes with
standard of best practices.
 All patients
 Received before operation antimicrobial
prophylaxis
 Underwent surgery using sterile techniques
 Received after surgery wound care.
 One patient developed a SSI, which is well
below the expected rate.

13.  Focus: The consumption of preoperative
antimicrobial prophylaxis.
 Strategy: Implementation of a new protocol
that includes the use of a broad-spectrum
antibiotic before surgery
 Potential Outcomes: reduction in the rate of
SSI, an improvement in the quality of care,
and a decrease in the cost of care.

14.  Method: orienttaion andTraining Process.
 Stakeholders: All surgeons, Operating Room
staff, and postoperative care team
 Goal: Importance in combating SSI
 Trainer: Infection Control Nurse
 Dissemination: Didactic presentations and
hands-on training

15. challenges Solutions /
alternatives
Resistance of some surgeons
to change.
Education and training
Lack of understanding of the
new protocol
Protocol should be clearly
written and easily accessible
Potential for errors in the
implementation
Monitor compliance with the
new protocol to identify and
correct errors

16.  The remaining elements of the audit process
include the;
 Development of an action plan to implement the
changes
 Monitoring of compliance with the new protocol
 Evaluation of the results

17.  These include the
 National Institute for Health and Care Excellence
(NICE) introduction on the prevention of SSI
 Department of Health's guidance on the
prevention and control of HAIs
 Health and Social Care Act (2012) (UK Health
Security Agency, 2022)

18.  There are a number of reasons why clinical
governance is so important
 It helps to ensure that patients receive the best
possible care.
 It drives continual improvement in the quality of
care provided
 It helps to safeguard high standards of
care(Gottwaldov and Lansdowne, 2021).

19.  Clinical audit in healthcare;
 Make sure that the care provided to patients is of
the best quality and meets all required standards
 Allows organisations to identify areas where
improvements can be made
 Help to improve patient outcomes
 Reduce healthcare costs (Backhouse and
Ogunlayi, 2020).

20.  The audit and plans will improve practice by
ensuring that evidence-based measures are
in place to prevent surgical site infections.
 This will ultimately lead to
 A decrease in the rate of SSI
 A decrease in the morbidity and mortality
associated with this condition. (Backhouse and
Ogunlayi, 2020).

21. Barriers Solutions
Lack of time Increase provider staffing
Create more efficient systems
Lack of resources Increase funding for healthcare
Create a system where providers can
share resources
Lack of knowledge
(Backhouse and
Ogunlayi, 2020)l
Provide more training for providers
Create a system where providers can
consult with experts

22.  Backhouse,A. & Ogunlayi, F., (2020). Quality improvement into practice. BMJ, 368.
 Boyle, A. and Keep, J., (2018). Clinical audit does not work, is quality improvement any
better?. British Journal of Hospital Medicine, 79(9), pp.508-510.
 CDC National and State Healthcare-Associated Infections Progress Report, published November
(2021), available from: https://www.cdc.gov/hai/data/portal/progress-report.html
 Dixon, L.K., Biggs, S., Messenger, D. & Shabbir, J., (2022). Surgical site infection prevention
bundle in elective colorectal surgery. Journal of Hospital Infection, 122, pp.162-167.
 Donaldson, L., 2018. Clinical governance: a quality concept. In Clinical governance in primary
care (pp. 1-16). CRC Press.

Gottwaldov, M. and Lansdowne, G., (2021). Clinical governance: improving the quality of
healthcare for patients and service users. McGraw-Hill Education (UK).
 Jones, B.,Vaux, E. & Olsson-Brown, A., (2019). How to get started in quality
improvement. Bmj, 364.
 Okeahialam, N.A.,Thakar, R. & Sultan, A.H., An Audit ofWound Healing Complicafions Including
Surgical Site Infecfion Following Laparoscopic Surgery. J Surgery. 2022; 2 (1), 1022.
 UK Health Security Agency, (2022). Protocol for the Surveillance of Surgical Site Infection Surgical
Site Infection Surveillance Service.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/f
ile/1048707/Protocol_for_the_Surveillance_of_Surgical_Site_Infection.pdf
 Van Zwanenberg,T. & Edwards, C., (2018). Clinical governance in primary care. In Clinical
Governance in PrimaryCare (pp. 17-30). CRC Press.