This reflective assignment discusses the different routes of drug administration including subcutaneous, intramuscular and oral routes. It utilizes the Gibbs model of reflection to analyze experiences and suggests best practices for future nursing practice.
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RUNNING HEAD: PROFESSIONAL PRACTICE EXPERIENCE NURSING1 Professional practice Experience Nursing Name: Institution: Tutor: Date:
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PROFESSIONAL PRACTICE EXPERIENCE NURSING2 Professional practice Experience Nursing INTRODUCTION In this assignment, I will utilize the Gibbs model of reflection o reflect on the different experiences that I came across together with my two other friends (Williams, Woolliams, & Spiro, 2012). The reflection is specifically about the routes of drug administration that include subcutaneous, intramuscular and the finally the oral route. DESCRIPTION During one of my clinical practice, I realized that one my peers was good at intramuscular administration of drugs. I realized that his preferred site of injection was the rectus femoris. There was another scenario I came across where a friend of mine administered medication using the subcutaneous route on the upper arm .I however noticed that he was injecting at the same site of one patient for two weeks. This eventually led to tissue damage. There was a situation where I was to administer oral medication to a child .I therefore mixed the drug with a sugary drink so that the child could drink quickly .I however realized that the efficacy was reduced. FEELINGS I felt very anxious since I wanted to learn and find out why he does not use the dorsogluteal site that were taught in class .I felt very sympathetic for the patient. This is because patients expect improvement when they visit nurses and we should not create other medical complications. I felt very bitter since the child was in acute pain and needed immediate relieve.
PROFESSIONAL PRACTICE EXPERIENCE NURSING3 EVALUATION The aspect of introducing drug intramuscularly through the rectus femoris was quite positive to me. This is because I learnt that using this site speeds up recovery since there is quick uptake of drugs especially if the upper arm is used. The aspect of injecting the same site frequently using the subcutaneous route is a negative aspect and should not be encouraged at all. Introducing drugs in sugary food is not a good practice at all and nurses should not attempt it. ANALYSIS I later came to realize that the reason why my peer did not prefer using the dorsogluteal site is that the site has a thick layer of adipose tissue and this therefore slows down the process of medicine uptake (Owen, 2011).I also learnt that this site has many nerves and blood vessels and could therefore pose a threat to the patient. Administering drugs through the subcutaneous by injecting the same site can cause damage to the underlying tissues due to the frequent disorientation of the tissue by the needle (Meyer, Krohne, Charbel Issa, Liu, & Holz, n.d.). Oral administration of drugs with food affects the efficacy of the drug due to food drug interaction mechanisms. CONCLUSION The rectus femoris is the best site of injecting IM drugs .This is the site that I will always use in future. It is wrong to inject the same site in the subcutaneous frequently according to the second case. Nurses should not introduce drugs together with drugs as it reduces their efficacy.
PROFESSIONAL PRACTICE EXPERIENCE NURSING4 ACTION PLAN. In future, whenever I meet a patient who is in need of an intramuscular injection or administration of drugs, I will also utilize the rectus femoris so that the patient recover quickly as there will be quick uptake of the medicine (Cassidy, Oyedele, Mickle, Guenther, & Budman, 2017) .In future when I meet a patient in need of subcutaneous injection, I will change the site so that I can avoid damage to the tissues. In future, I will never introduce drugs and sugary at the same time in children however bitter the drug might be.
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PROFESSIONAL PRACTICE EXPERIENCE NURSING5 References Cassidy,T.A., Oyedele,N., Mickle,T.C., Guenther,S., & Budman,S.H. (2017). Patterns of abuse and routes of administration for immediate-release hydrocodone combination products.Pharmacoepidemiology and Drug Safety,26(9), 1071-1082. doi:10.1002/pds.4249 Meyer,C.H., Krohne,T.U., Charbel Issa,P., Liu,Z., & Holz,F.G. (n.d.). Routes for Drug Delivery to the Eye and Retina: Intravitreal Injections.Developments in Ophthalmology, 63-70. doi:10.1159/000431143 Owen,P.S. (2011). Book Review: Handbook of Drug Administration via Enteral Feeding Tubes, 2nd EditionHandbook of Drug Administration via Enteral Feeding Tubes, 2nd Edition By WhiteRebecca BSc(Hons) MSc MRPharmS (I Presc) and BradnamVicky BPharm (Hons) ClinDip MBAopen MRpharmS. Published by Pharmaceutical Press, London, UK, 2011. ISBN 978-0-85369-928-6. Paperbound, xix + 614 pp.(21.5 × 13 cm), $74.99. www.pharmpress.com.Annals of Pharmacotherapy,45(4), 549-549. doi:10.1345/aph.1p775 Williams,K., Woolliams,M., & Spiro,J. (2012). Using a framework for reflection: Gibbs’ reflective cycle.Reflective Writing, 90-102. doi:10.1007/978-0-230-37724-0_16