Practice Expectation Spotlight

As registered nurses, we are expected to effectively communicate with clients to optimize health outcomes. This is true whether we are working in clinical care, education, administration or research. The Interprofessional Collaborative Care Practice Direction informs us that we are to seek out the input and engagement of clients, integrate their information, and value clients as partners in designing, implementing, and evaluating care/services. To do so we are expected to: 

  • Empower the client.  
  • Ensure the client is always the primary professional obligation.  
  • Adhere to Standards of Practice, Practice Directions and Code of Ethics.  

How does client engagement impact health outcomes?    

Let’s explore the connection between practice expectations related to client engagement and patient safety. Consider the following point of care example: 

Mrs. B was recently transferred to Janet Smith RN’s unit. Janet walks into Mrs. B’s hospital room. She notes that the room is cluttered with personal belongings. Staff from the previous shift documented that Mrs. B. had almost tripped over an item during a recent transfer and there is a concern about the patient and staff’s safety. Janet informs Mrs. B of the team’s safety concerns. She asks questions to understand the importance of Mrs. B’s personal belongings to her and offers to help organize Mrs. B’s room. Janet provides Mrs. B with a couple of options including having family/friends pick up some of the items. When Mrs. B states that she would not have anyone to pick up the items and prefers to keep the items close by, Janet helps facilitate safekeeping of some of the items within the hospital. Janet provides Mrs. B. with written falls prevention information. She encourages Mrs. B. to ask questions and provide input into how they can work together to ensure the health care team can meet her needs safely. Janet communicates the situation with the team and encourages additional safety concerns to be brought forward. She also communicates the situation to her manager to see if more could be done to ensure a safe environment when patients are transferred to the unit.  

After reflecting on the situation, Janet realizes she could have asked about the importance of Mrs. B.’s personal belongings prior to informing Mrs. B of the team’s safety concerns. This would have helped her understand Mrs. B’s perspective and experiences so that she could ensure that the information was presented in a manner that promoted psychological safety.  

In this case Janet’s actions prevent poor health outcomes by reducing the risk for falls. Janet’s actions meet the practice expectations. 

  • Empowered the client: Janet empowers Mrs. B by providing information about the team’s safety concerns and recommendations. Janet partners with Mrs. B. to determine a solution based on Mrs. B’s unique needs and preferences. 
  • Ensured the client was primary professional obligation: Janet understands the unique reasons why Mrs. B’s personal belongings are in her room. She maintains their therapeutic relationship by addressing Mrs. B’s concerns while still accomplishing the common goal of patient/staff safety.   
  • Adhered to Standards of Practice, Practice Directions and Code of Ethics: Janet fulfills her obligation to inform Mrs. B of concerns related to her safety and provides Mrs. B with the information needed to prevent falls now and in the future. She communicates with both the client and team in a timely manner to promote continuity and delivery of safe, competent and ethical care. Janet reflects on her practice and identifies actions to improve her practice.  

Interested in learning more about our practice expectations for interprofessional collaborative care and/or how client engagement improves the safety and quality of care? Check out these resources: 

We support a culture of continuous improvement. If you have any questions, feedback or suggestions for practice expectation spotlight topics, please contact Allison Leveque RN at 204-784-6465 or email aleveque@crnm.mb.ca. Thank you for working with to us ensure Manitobans receive safe, competent and ethical registered nursing care. 

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