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Cut the risk with quality care

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VOL: 96, ISSUE: 36, PAGE NO: 1

Caroline Pennels, MA, MSc, BSc, RGN, is a barrister and clinical governance coordinator, East Gloucestershire NHS Trust, Cheltenham

How often have you wondered whether your tissue viability practice fulfils the requirements of clinical risk management and clinical governance? The most important thing to remember is that if the highest level of professional practice is maintained at all times, the demands of providing quality patient care, effective risk management and a defence against litigation will all be satisfied.

How often have you wondered whether your tissue viability practice fulfils the requirements of clinical risk management and clinical governance? The most important thing to remember is that if the highest level of professional practice is maintained at all times, the demands of providing quality patient care, effective risk management and a defence against litigation will all be satisfied.

Concentrate on developing and improving practice rather than protecting against litigation. Elements of clinical risk management, that is complaints, claims and incident reporting, make up a small but significant part of the concept of clinical governance. But clinical governance is also about creating a better service by integrating audit, evidence-based practice and patient and user experiences with effective communication, strategic planning, use of resources and educational opportunities for both staff and patients.

So what does it mean for pressure ulcer prevention and wound care and what needs to be done to manage clinical risk and comply with the principles of clinical governance?

In pressure ulcer management, the emphasis is on standardised early patient assessment on admission and prompt liaison with specialist nurses at the first indication of need. You need to offer quality clinical care through individual, accurate and updated care plans that are crystal clear to any complaints manager. Document all clinical care conscientiously so that a complete picture of the patient's treatment, clinical decisions and any changes are apparent to the inquisitive lawyer, including dates, signatures and staff titles. Support relatives and patients by giving them as much information as they find useful and write down what has been discussed and the patient's reactions and wishes.

In wound care, offer the most practical, up-to-date and appropriate advice. Clinical risk management and clinical governance demand that this role is evidence-based and takes a multidisciplinary approach.

Finally, do not forget to use audit and adverse-incident reporting systems constructively and intelligently to learn and improve. Above all, remember that although top quality care and good patient experiences are at the heart of both risk management and clinical governance, the motivation to achieve this is the foundation of professional nursing.

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