Engagement in Professional Nursing

SILO 3: Organizational Structure and Culture


Quality improvement in clinical practice is related to performance and culture on a broader concept. There were many quality concerns in healthcare organizations that I came across when I was in my placement period as a student nurse. They were like nurse-patient ratio, hand hygiene, electronic health records, medical, and drug supply shortages. Competency and skills were required to deal with all the quality concerns like this. Lectures and internships were the sources that catered to all the concepts on quality management. The nursing head was informed by me and my colleagues on the quality concerns that we observed in the healthcare organization (Coiera, Ammenwerth & Georgiou et al., 2018). Clinical care is evidenced by electronic health records and hence they are necessary to maintain. Another point is of hand hygiene as this is also important to maintain so that patients as well as staff are prevented from getting infected. Supplies and drug shortage at regular intervals creates difficulties in providing appropriate treatment to the patient and thus causes a delay in recovery.


Organizational background is required to be retained in health care associations to understand and operate past problems so that future processes could be improved with the re-treatment procedure. This necessitates observation and supervision of administrative philosophy in healthcare organizations (Faiola & Holden, 2017). The signs of discrepancies are seen in the way services like equipment and staff is provided with a range of activities in the institution. The importance of quality management was conveyed as this is the means of reducing the probability of patients as well as workforce and the happiness of both groups. Moreover, it includes clinical practices, communication processes, and care pathways. Melbourne Health’s Safety Culture Program and Mildura Based Hospital according to me should be followed as they have taken some initiatives for the improvements of program and transformation into the culture. Four elements were followed such as leadership capability development, quality and reliability improvement, we are system, and speaking up for safety. Mildura Based Hospital is the greatest clinic that performs routine instruction courses on health care protection (Gibson, Dixon & Abrams, 2015). Two parts have constituted the training program introduced by the hospital. The main body was of "speak-up" moment so that patients feel free to say if they found any risk to their health. The second was the maintenance of privacy and confidentiality of reports so that the rights of patients are not violated. The nurse-patient ratio is the critical point that has to be maintained so that quality of care is ensured to the patients. An unbalanced nurse-patient ratio in healthcare organizations is the lawful practice according to government rules (Hilty, Yellowlees & Parrish et al., 2015). Electronic health records are the appropriate form of saving the information to give a high level of patient safety in healthcare. Moreover, this is considered a breach of patient reports accessed in any form and from anywhere.


I was given a chance to speak on the promotion of patient protection and the upkeep of electronic fitness records. The care provided to the patient and clear documentation is the safe practice to ensure that patient care services are provided safely. However, this negatively impacts the delivery of patient care. Inconsistent patient care is reflected by poor patient conditions with the response of a healthcare service provider. Interoperability is the major reason that I felt a lack of updating his medications (Holzinger, 2016). This is the major point because in case the medications given to the patient are not recorded, then it can cause a discrepancy in again giving medications or skipping the important one. It is the responsibility of administration and healthcare service providers to maintain the levels of inventory with detailed information on medications and their date of expiry. Disasters are the time in which there is heavy consumption of medications, poor inventory management can lead to a crisis in patient care management at that time (Magrabi, Ammenwerth & McNair et al., 2019). The complications arise in access to medical records and the displacement of patient information. Hence, this was my learning and teaching of patient safety management in a healthcare organization by focusing on the appropriate healthcare provider. This will lead to the prevention of discrepancies that can happen with poor quality of services in a healthcare organization.

SILO 5: Health Informatics


Informatics skills are useful in incorporating nursing care management for the fundamentals of all professional levels and specialist services in the healthcare system. I and my colleagues from our institution were the fresh graduates who were going to serve in the healthcare system for appropriate patient care. The skills and capabilities are required to deal with patients in providing care with the ethical use of technology effectively and safely (Holzinger, 2016). I am a clinical nurse having hands-on the use of technical gadgets such as patient flow system, patient browsing, and maintenance and storage of electronic health records in inpatient care.


The computer system is not in the reach of everyone to use as in our group I was utilizing technological devices very efficiently, though my collaborators were stand facing problems in using. The difficulty was for the reason that everybody is not competent and trained to use the computer system and deliver the appropriate information. The clinical documentation system was found to be a little complicated because this is the sensitive information that has to be recorded under several features. Thus, due to advancements in the system, health information science has a greater role to play in healthcare service delivery (Lai, Hsueh & Choi et al., 2017). Many barriers are faced by the staff in the system such as the support of administrative staff, managerial policy development, staffing resources, and economic assets. Agreeing to my examination from associate's presentation, I found that role of different staff members can help in overcoming technological challenges in a successful manner. Strong informatic systems should be followed to leverage the data applications for improving clinical performance. Departmental coordination, training, and information sources are required to cater to the need of nursing informatics. According to my, nursing professionals are at the forefront of delivering patient care as per patient’s expectations of safer and quality care. The problem faced by my classmates was of maintaining coordination and collaboration of treatment services and computerized data (Nazi, Hogan & Woods et al., 2016). The emergence of healthcare data will help in managing and processing knowledge, information, and expertise to help take care of training, learning, exploration, and management. The advancement of data skills has helped in processing nursing clinical knowledge reasonably. Poor nursing care affects the nursing duty of care by causing a discontinuity in the process.

The major difficulties faced by nursing professionals were of locating the patient and their details such as laboratory investigations, radiological investigations, and medications. Thus, the major difficulty was faced in the maintenance of the clinical documentation system and from this, the details of the patient are updated at regular intervals. Nursing professionals have the duty to maintain drug inventory so that administration staff and clinical healthcare providers are informed about the system. Not only the nursing professionals, I found that doctors were also facing issues in reviewing patient records, documentation of history, physical examination, access to reference information, and prescription of medicine (Holzinger, 2016). Other problems are also associated with electronic systems such as the non-availability of printers, pop-up blocking system, and lack of fast typing are discrepancies of the health system. Hence, these were the barriers observed by me in the healthcare system to mark the influence of health informatics.


I am a clinical nurse and also, I know the importance of health information systems so, this was my duty to promote. There is a wonderful want to deliver reliable, competent, and compassionate treatment in the technical and arithmetical situation. This could be done by raising knowledge of health informatics in the nursing profession. The major mistakes found in the scheme were demographic documents management of the critically ill patient. Also, it was observed that automated fitness chronicles of the patient were upheld throughout persistent appointments with harm of eye interaction, processers being too sluggish, dwindling behind agenda, feeling that use of processer in obverse of the enduring is rude, the inability of authorities to type quickly, and partiality of authorities in writing long notes (Sapci & Sapci, 2017). This will thus contribute to resolving multiple issues and challenges that were marked in care processes. Nurses could be encouraged to serve in the healthcare system with the resourcefulness of treatment information science to improve patient safety and quality in patient care (Holzinger, 2016). The dedicated public services are one way to provide excellence treatment nursing in the hospital atmosphere. Hence, the moral use of care for information science will provide to the protection of automated wellbeing records and patient stream system.

SILO 6: Transition to Practice


There is a great difference in the nursing profession between the care delivery of an undergraduate nurse and a professional nurse. During my internship period, I observed that treatment specialists want to adjust themselves to their responsibilities, tasks, and identity in a new environment. Demotivation is the factor that causes stress and dissatisfaction among staff members which results in a high turnover rate and resignation from the job of employees. Hence, in this case, the staff does not receive any assistance and thus triggers resignation from the job. The fresh graduate nursing professionals face difficulty in developing relationships with colleagues for the adoption of a new role. However, the staff was ready to discover new roles, but it was very frustrating to build and maintain the level of care delivery as per expectations (Valdez, Ziefle & Verbert et al., 2016). The difficulty was faced by the nursing professionals in handling registers and patients to other staff. Communication with seniors is required here and my colleagues were also facing difficulty in speaking up about the issues in the system. So, this reflects the communication gap between senior staff, nursing professionals, and clinicians. These are the times when staff feels discouraged with the variation in expected and actual care delivery. This leads to a lack of confidence and poor staff performance among fresh graduate nursing professionals. Eight challenges were identified and happened in the profession of clinical nurse, relationship with colleagues, workload, support, working environment, clinical knowledge and skills, confidence, communication, and expectations. At a job, the major role played by nursing professionals is to use knowledge and skills powerfully and sufficiently (Valdez, Holden & Novak et al., 2015). Moreover, we were able to confront difficulties in handover the records of the patient and handling emergencies despite having expert knowledge, and skills than existing facilities. The instructions should be given to students on advanced cardiovascular life support (ACLS), basic life support (BLS), electronic clinical management system (CMS), and blood extraction helped us in dealing with patients.


Professionalism is the means that defines that professionals must be properly dressed, costumed, and polite with the patients. It includes a set of values that need to be improved for providing valued patient care with the use of standards, methods, and judgments. Moreover, professionalism helps the nursing professionals to develop their knowledge and skills as desired in their service (Valdez et al., 2016). A combination of education and competencies in the healthcare system are developed to create opportunities for strengthening the system. The attitude and behavior of employees help in maintaining the physical and mental well-being of patients with the strong role of a registered nurse in the profession. Moreover, professionalism honors the principle of accountability, regard, and activism for delivering understandable treatment (Holzinger, 2016). It also expands the ability of a nursing professional by connecting and reflecting an appropriate behavior for professional and individual development. Three components follow attitudes and behavior in the nursing profession such as cognitive, psychomotor, and attitudinal. These principles should be applied in professional conduct to develop direct commitments for providing high-level patient care. The attitude and behavior should be exhibited into professionalism so that coworkers, caregivers, and organizations are benefited. Coordination and collaboration are known as the useful aspect to respect the team members and their contribution to patient service delivery (Nazi, Hogan, et al., 2016). This helps in building connections and mutual learning environment for contribution to care. This way clinical practitioner will not feel awkward in seeking help from other staff and comprehending the necessary facts. Hence, collaborative support will be built to share knowledge and practices in reducing the chance of mistakes in clinical care. The second approach would be high standards of care that could be achieved by being punctual in the system and removing all the obstacles that disrupt providing high standards of care. Hence, the society of collaboration, dignity, admiration, and integrity by unifying definite goals to provide patient care.

References for Consumer Health Informatics

Coiera, E., Ammenwerth, E., Georgiou, A., &Magrabi, F. (2018). Does health informatics have a replication crisis?. Journal of the American Medical Informatics Association25(8), 963-968. https://doi.org/10.1093/jamia/ocy028

Faiola, A., & Holden, R. J. (2017). Consumer health informatics: Empowering healthy-living-seekers through mHealth. Progress in cardiovascular diseases59(5), 479-486. https://doi.org/10.1016/j.pcad.2016.12.006

Gibson, C. J., Dixon, B. E., & Abrams, K. (2015). Convergent evolution of health information management and health informatics: A perspective on the future of information professionals in health care. Applied clinical informatics6(1), 163. https://dx.doi.org/10.4338%2FACI-2014-09-RA-0077

Hilty, D., Yellowlees, P. M., Parrish, M. B., & Chan, S. (2015). Telepsychiatry: Effective, evidence-based, and at a tipping point in health care delivery?. Psychiatric Clinics38(3), 559-592. https://doi.org/10.1016/j.psc.2015.05.006

Holzinger, A. (2016). Interactive machine learning for health informatics: When do we need the human-in-the-loop?. Brain Informatics3(2), 119-131. Retrieved from: https://link.springer.com/article/10.1007/S40708-016-0042-6\

Lai, A. M., Hsueh, P. Y., Choi, Y. K., & Austin, R. R. (2017). Present and future trends in consumer health informatics and patient-generated health data. Yearbook of Medical Informatics26(1), 152. https://dx.doi.org/10.15265%2FIY-2017-016

Magrabi, F., Ammenwerth, E., McNair, J. B., De Keizer, N. F., Hyppönen, H., Nykänen, P., ... & Georgiou, A. (2019). Artificial intelligence in clinical decision support: challenges for evaluating ai and practical implications: A position paper from the IMIA technology assessment & quality development in health informatics working group and the EFMI working group for assessment of health information systems. Yearbook of Medical Informatics28(1), 128. https://dx.doi.org/10.1055%2Fs-0039-1677903

Nazi, K. M., Hogan, T. P., Woods, S. S., Simon, S. R., & Ralston, J. D. (2016). Consumer health informatics: Engaging and empowering patients and families. Clinical Informatics Study Guide (pp. 459-500). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-319-22753-5_19

Sapci, A. H., & Sapci, H. A. (2017). The effectiveness of hands-on health informatics skills exercises in the multidisciplinary smart home healthcare and health informatics training laboratories. Applied clinical informatics8(4), 1184. https://dx.doi.org/10.4338%2FACI-2017-08-RA-0136

Valdez, A. C., Ziefle, M., Verbert, K., Felfernig, A., &Holzinger, A. (2016). Recommender systems for health informatics: State-of-the-art and future perspectives. In Machine Learning for Health Informatics (pp. 391-414).Springer, Cham.Retrieved from: https://link.springer.com/chapter/10.1007/978-3-319-50478-0_20

Valdez, R. S., Holden, R. J., Novak, L. L., &Veinot, T. C. (2015). Transforming consumer health informatics through a patient work framework: connecting patients to context. Journal of the American Medical Informatics Association22(1), 2-10. https://doi.org/10.1136/amiajnl-2014-002826

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