Consider a practice initiative from the perspective of the team leader. Critically evaluate the present situation against contemporary communication and management theory".

Authors Avatar

“Consider a practice initiative from the perspective of the team leader. Critically evaluate the present situation against contemporary communication and management theory”.

For the purpose of this assignment the practice initiative for consideration will be the redesign and management of a practice nurse led baby immunisation clinic within a general practice surgery. The background for the reason of choice will be established within this written work, and will then demonstrate areas for improvement and change from a practice nurse team leader perspective. A rationale for change will be presented. The issues surrounding change within the practice initiative will be linked to current theories within change management and discussed. Leadership qualities and communication in the general practice environment will be analysed in relation to theoretical views. To conclude the challenges of change within General Practice will be demonstrated and critically evaluated from a practice nurse team leader perspective.

The practice nurse’s traditional role as a caring, task orientated person carrying out doctors orders has progressed beyond recognition (Norman, 2005). Since the development of General Practitioner (GP) fund holding, the practice nurse role has rapidly grown (Carey, 2000). This combined with the establishment of integrated nursing teams in community health provision (DOH, 2005), has lead to the vast evolvement of the practice nurse and their contribution made to the health of the practice population. The National Health Service (NHS) plan (DOH, 2000) outlined the development of “clinical leaders” to deliver organisational change and quality to service users. A further Department of Health (DoH) white paper, Liberating the Talents (2002) took this further, placing great importance to improve leadership and change within the roles of primary care nurses.

Practice nurses’ are now encouraged to take responsibility for assessment, planning, care and management of patients that were previously the domain of medical staff. The advent of nurse led clinics and advanced nursing roles have led to the inevitable evolution of nursing leadership roles (Norman, 2005).

The general practice surgery in question currently recognises the importance and significance of the role of the practice nurse and utilises their leadership skills to run nurse led clinics. At present, the baby immunisation clinic is nurse led, running on the same day every week, for one afternoon, by the same practice nurse. The

practice nurse who runs the clinic is very experienced and has assisted and subsequently run the clinic over a period of 20 years. Each patient is allocated a time slot of 10 minutes, irrespective of where they are on the immunisation schedule, from first immunisations to pre school booster. The clinic rarely runs overtime.

Vaccination is the most effective public health intervention in the world, after clean water,  saving lives and promoting good health (Health Protection Agency, 2006). Nonetheless, in recent years vaccine uptake has declined,  mostly due to public alarm fuelled by anti-vaccination forces and news stories about the purported adverse effects of vaccinations (Campbell, 2004). The evidence supporting the efficacy and safety of vaccinations and immunisations is extremely strong (McCarthy, 2000). The research data, however, is not always easy to interpret. Health professionals, particularly those with a public health perspective should have the skills to understand this data. Parents may very well not as such data can be confusing. According to McCarthy (2000) there are risks with vaccines, which are infinitely smaller than the risks of the diseases but from the perspective of the parents today, the vaccine risk is real, more real than the disease. Therefore, when once our mothers and grandmothers beat a path to have their children vaccinated, today’s changing society sees a greater reluctance and a public that necessitates information. Government policy (DoH, 2000, DoH, 2006) has been clear that it expects the front line practitioner, and patients themselves, to be more active about the care they give and the care the patient wants to receive. In other words, passive acceptance that the care the nurse is giving is the right care needs to be questioned by the giver and  the receiver. Practice nurses are now at the forefront in promoting and delivering immunisations (Kassianos, 2001). This places the practice nurse with an ideal opportunity to promote and educate her practice population, to maintain the uptake of immunisations.

Recently after a media leak in February 2006, the DOH (2006) announced that important changes will be made to the childhood immunisation schedule later this year. These changes will ensure that young children in the United Kingdom (U.K.) have the best possible coverage against disease via the inclusion of pneumococcal vaccine, and modification of the existing schedule (Appendix 1) based upon the best evidence in practice. The changes will have implications for both clinical practice and the patient. The proposed schedule will mean the administration of more routine vaccines and subsequently ensuing workload this produces. For the parents it will mean the increased need for education and information on the vaccines being given, thus enabling practitioners to achieve informed consent and maintain adherence to the uptake of immunisations. For babies being immunised, they will be receiving more vaccines and rather than 2 needles they will be having 3 injections during periods within the schedule.

Join now!

Due to the forthcoming changes in the immunisation schedule the rationale for change was decided. For the purpose of change to be made a reflective approach has been adopted. Reflective practice of a practice nurse new to immunisations, bought about the notion of researching the possibility of changing the way in which the nurse led baby clinic was run. According to Blackie (1998) reflection is a key concept available to nurses, to assist them to develop and advance practice. The outcomes of reflection depend on the individuals’ capacity to explore their own experiences.  Handy (1993, cited in Hewison, 2004) ...

This is a preview of the whole essay