The opportunities offered by clinical governance are explored by a chief nurse and director of quality and a senior nurse (R&D) working in an inner-city NHS trust at a time of considerable change and uncertainty. The paper offers an insight into each of our perspectives on clinical governance-the latest concept behind recent health reforms in the UK-and contributes to the debate on the subject by suggesting the adoption of a strategic approach to encourage nursing research that is more related to practice. First, clinical governance is defined, following which its component elements-clinical effectiveness, education and training, quality monitoring and cost control in healthcare-are explored in relation to the general concept of clinical governance. Examples of key initiatives, based on our recent experience at this NHS trust, are provided to examine how the various strands of the clinical governance framework (such as risk management) have the potential to benefit patients by their focus on improving the standard of healthcare being provided. Questions are then raised about the place of nursing research within the wider NHS R&D agenda.
We suggest that the adoption of clinical governance will offer a unique opportunity for nursing leaders, researchers and practice developers to work together to help shape the future culture of healthcare, particularly at the point of clinical delivery. If such an opportunity is to be maximised, a number of fundamental issues must be addressed with urgency. These include ensuring that successful initiatives are identified and implemented to demonstrate the contribution that nursing research can make to tangible healthcare improvements.
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