1 Critical appraisal and Reflection Case study 1- IV medication administration infusion The nurse has given a considerable performance in the preparation for the procedures. To perform all the procedures, nurses should introduces herself to the patient. The introduction is important to the patient in building better patient and nurse relationship. Nurses should explain the entire procedure to the patient as per the patient’s right to know about his or her treatment. Patient should know about his or her own treatment procedure. The right to know about the treatment gives the patients full right to know about the treatment procedure. The nurse is bound to inform a patient about the treatment and this will help to empower patient. The autonomy of patients will be established in the treatment procedures. Consent should be obtained by the nurse before administrating the medication to patient. Autonomy and beneficence must be established in the treatment and consent is integral part of it. Consent can reduce fear and anxiety in the patient and they can feel a safe environment in care provision. IV infusion medication administration has three step checking procedures. In the first step of checking the right medication should be selected as per the medication chart. Expiry date of the medication should be checked. Moreover, dosage must be calculated to measure the right amount of the medication. Every steps of first check has been performed. Thirdstepofcheckingconsistofre-evaluationofmedicationlabelwiththe comparison of the medication chart (Berman et al., 2017). The nurse did not perform the medication label with the medication chart. The nurse should check whether they are administered medication to the right patient or not. This checking will involve checking name in the wristband, asking the name of the patient and the date of birth. Evaluation of allergy in the patient is the last step of checking. AdministeringIVmedicationthroughtheIVinfusionneedspreparationof medication as per instruction of the manufacturer, organizational policies and Australian injectable handbook. The nurse did not clean IVC port with swab. This negligence can be caused as sepsis in the patient or infection contamination can occur. Nurse’ action has breached the standard 6 of NMBA nursing standard (NMBA, 2020). In the post procedures, the nurse has not returned back to the patient. She did not check the infusion site also. This is absolutely a result of negligence in nursing practice. The action of the nurse will lead to more critical circumstances in patient. This action cannot meet standard 6, 7 and the standard 5 of nursing standard (NMBA, 2020). Case Study 2 –IV bolus administration In this task the nurse did not check the inflow of line by the help of roller or side clamp. This can help to check the air vent of the line of burette. As nurse did not check the air flow in the IVC line system, different complications might be occurred by dysfunction of the airflow in the cannulation. One of the most common complications due to imbalance in the airflow is air embolism. In this case scenario the patient might be affected with the air embolism. Large air might be entered in the veins of the patient. NMBA standard 6 which promotes safe and appropriate with the responsive quality practice. Thesub clauseof
2 Critical appraisal and Reflection standard6 has explainedthatthecomprehensive safe andquality practice isneededin patient care (NMBA, 2020). Moreover the usage of appropriate processes to assess the risk related to the system must be detected. The nurse has failed to maintain the standard seven as this might affect the health situation of patient. The standard has emphasized on the evaluation of outcomes to inform the patient. In the post procedure, nurses did notreturned to the patient forreassessment which can be regarded as the severe action of negligence and increases the chances of medication error. Duties of a nurse do not restricted to the actions and measures taking but also rechecking the patient within proper interval (Stein and Hollen, 2020). Infusion site checking will help to avoid infection in infusion site. Multiple rechecking will help the nurses to avoid any medication error and adverse condition in patient care. The compliance to the standard procedures will be maintained in the process of reassessment. The reassessment procedure will help in maintaining the standard 6 and standard 4 of NMBA standard (NMBA, 2020). The medication administration regulation of the organization can be maintained more properly. The nurse has performed most of the action but she did not perform two of the delegated responsibilities. Clamp setting can be improved by the re-evaluation action in the post procedure. IV bolus route is most risky one among all the medication route, the nurse should be more careful during setting the arrangement (Berman et al., 2017). Therefore, the clamp should be set with more alertness. The nurse should set a reminder to execute the re assessment procedure after the completion of the IVC setting (Stein and Hollen, 2020). This will help the nurse in revising the action and will increase the perfection of the medication administration. Case Study 3 - IV medication administration bolus The nurse did not rechecked the label of the medication bag , therefore high risk of medication erroris presentin thescenario. Chances of contraindication and side effects become higher. This action has not maintained standard 6 and standard 7(NMBA, 2020). The nurse has failed to apply her critical thinking and analytical actions. Re-assessment helps the nurses in reducing the chances of mistakes and minor errors in medication administration. Additionally she did not check patent’s history to know about allergies or asked any questions regarding that. This action has shown the negligence in the treatment procedures. Without asking about allergy, a nurse cannot administered any medication in a patient as this action opposed the standard 4 (sub clause 2) (NMBA, 2020).This action breached patient centeredcareapproachofnurse.However,nurseshouldthequalityofcareinany circumstances and patient centered care is one of the most competent practice to maintain the quality of the treatment.Nurses should collect every possible medical details about the patient while administering the medication through intravenous line (Berman et al., 2017). This action has breached the beneficence and autonomy of the patient. Nurse did not tell the patient that she will come back and for further follow-ups. The follow-ups help the nurse to avoid any kind of adverse situation with the progression of the dosage. This will help the patient feel safer and bonded with the nurse. The patient can ask for any help from the nurses after the administration of the medication. Nursing standard 2 (sub clauses2.2, 2.4, 2.5, 2.6) has not maintained in this case as effective communication is
3 Critical appraisal and Reflection not present (NMBA, 2020). Supervision, coordination and provision of support were not maintained in patient care. Standard 6 as not maintained in this action as follow ups reduce chances of errors and increase the safety and quality of care (NMBA, 2020).IV medication administration involves different risks of bacteremia and inflammation, therefore post action procedures should not be ignored. Nurse did not return to the patient for the reassessment of the patient and this negligence is present in the previous two scenarios. The nurse needs to focus on the re- assessment and the evaluation of the steps taken during the medical administration (Stein and Hollen , 2020). Nurse should have maintained a checklist to avoid any adverse effects. Nurses should attend training sessions to improve actions during care provision. She should be monitored by the senior nursesin those training session. Reflection Through the three scenarios, I have come to know about the importance of every duty or responsibility is equally important for the treatment of a patient. The significance of the steps underlies in the promotion of safe and quality of care. Nurses should focus on every stepsduringmedicationadministrationthroughtheIVC.Medicationinstructionsand directions printed in the label of medical ampule will help the nurses to understand the composition. Therefore, they can avoid the allergies and side effects in the patients. The patients should be re-evaluated as during intravenous medication administration involves different complications. Ilearnedthatsincerityandpromptactionsshouldbemaintainedduringthe medication administration. Compliance to the regulation and standards will help the nurses to avoid adverse circumstances. If the nurse perform every delegated responsibilities, care provision will be safer and quality of the service will increase. Most of the time nurses do not focus on the reassessment of the medication administration which reduce the critical thinking and logical reasoning ability of the nurse. As re-visit to the patient give a chance of improvement in care setting. I learned that I have to maintain all the possible steps in the care provision as these will reduce the chances of the medication errors. I will focus on the revisit of patients and will recheck all the equipment of IV setting. I will definitely take concern and inform the patient about all the decisions of care provision. I will ask the patientwhetherheor she have any allergy as this will help me to reduce the chance of medication errors among the patient. After assessing the three cases I have come to know about the details of the procedures during intravenous infusion in a patient. The cases will help me to understand the importance of every steps involves in intravenous cannulation.
Paraphrase This Document
Need a fresh take? Get an instant paraphrase of this document with our AI Paraphraser
4 Critical appraisal and Reflection References Berman, A., Snyder, S., Levett-Jones, T., Burton, T., & Harvey, N. (2017).Skills in clinical nursing. Pearson Australia. Nursing and Midwifery Board of Australia (NMBA), 2020.Nursing And Midwifery Board Of Australia - Registered Nurse Standards For Practice. [online] Nursingmidwiferyboard.gov.au. Available at: <https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional- standards/registered-nurse-standards-for-practice.aspx> [Accessed 18 April 2020]. Stein, L. and Hollen, C.J., 2020.Concept-Based Clinical Nursing Skills E-Book: Fundamental to Advanced. Elsevier.