Managing Risk in the Clinical Environment

This essay explores the clinical risk of falls in the workplace and how to manage it. It uses the Gibbs Reflective Model to analyze the situation and suggests an action plan to prevent future incidents. The subject is nursing care practices and the course code and college/university are not mentioned.

Managing Risk in the clinical Environment

TABLE OF CONTENTS
INTRODUCTION......................................................................................................................3
GIBBS REFLECTIVE MODEL................................................................................................3
Description.............................................................................................................................4
Feeling....................................................................................................................................5
Evaluation..............................................................................................................................5
Analysis..................................................................................................................................6
Conclusion..............................................................................................................................7
Action Plan.............................................................................................................................8
CONCLUSION..........................................................................................................................8
REFERNCES.............................................................................................................................9

INTRODUCTION
Global health is described as an area of a research and practices that places a priority
on improving health and attain equity in health for all people (Benedet and et.al., 2021). To
improve the health, nursing care practices are designed that helps to improve the
communication between patients and hospitals. Thus, in this critical reflection, I will
exploring the clinical risk that I have identified in my current workplace which is related to
fall of an old lady. The reflection will be explained by using Gibbs reflective model where
it’s all 6 stage will be described in order to explore about risk along with all the stages. The
stages include description, feeling, analysis, evaluation, conclusion and action plan.
Kim and Shin (2020) defined in their study that fall is an event where individual
involuntarily coming to a rest at ground. Therefore, it is consider as a serious concern
regarding clinical aspects because it is one of the largest cause of harm in a patient. Hence,
different factors need to be considered while minimizing the risk which include human and
organizational factors. So, by sharing my own experience regarding fall will help to analyse
and reflect on an experience to obtain more insight about an incident. Also in this essay, I
will examine my own experience by using the reflective model as well as risk assessment tool
as suitable in the relevant experience. Further, with the help of action plan, I also suggest
ways to deal with such situation in near future so that the situation may not getting worse.
GIBBS REFLECTIVE MODEL
The model is developed by Graham Gibbs in 1988 in order to give a structure to
learning from experiences. The model also assists to examine experience and allow to learn
and plan from things that either went well or did not go well. Thus, with the help of these 6
stages, an individual well explained their views and experiences along with proper ways that
can be beneficial in near future. Hence, the description of each stage of a model is as
mentioned below:
 Description: In this stage, person describe the situation in detail in order to determine
what happened that helps to draw the conclusion in better manner. Along with this,
some of the questions are already framed that helps to describe the situation which
includes when and where did this happen, why were you there etc.
 Feeling: In this, encourage individual to talk about their thoughts and felt during the
experience (Gibbs’s reflective cycle, 2020). In this, individual should not commenting

on their emotions and try to answer the questions like what is the feeling before and
after the situation etc. Evaluation: In third stage, individual are encouraged to look objectively regarding
what approaches worked and which one did not. Here, questions like what was
positive and negative about situation, what went well or did not. Analysis: It is a step where individual have a chance to make sense of what happened
in order to extract the meaning. Conclusion: here, a summary of learning presented along with highlight the changes
of an actions in order to improve the outcomes in future. Action plan: An individual defined the ways through which the weaknesses can be
overcome by focusing upon different strategies. This will be helpful in the near future.
Description
The critical incident which I described here had most impact on me. The incident
occurred during my clinical placement where I was working in a renal ward in my workplace.
During my whole career, I have experienced many situations involving patients who are at
high risk of fall due to various reasons. Thus, the situation I will be critically reflecting
involves a 70 year old female fell when going a bathroom. She was already suffering a
problem of dementia. It was my first incident where a risk of fall noticed and as the duty
timing varies where I received a complete information about a lady from a previous staff.
During the situation, I realized that organization must have to set up a fall risk assessment
and management plan in order to ensure that the risk should not be increases and appropriate
intervention must be applied in order to make the situation better rather than worse.
As a part of safety, it has been realized that proper management actions need to be
taken and also, I was supposed to wait for another registered nurse to help me to move her to
the bathroom. However, the patient insisted that it was quite urgent and start requested to
mover her to the bathroom (Jones and et.al., 2020). As a result, I realized that due to fall, she
has fractured her right elbow and sprained right ankle. This in turn reflected that that was the
major issue and due to handover the things, it has been analysed that I was able to carry out
some of an intervention like foot wears, non-slip socks etc. but due to not following such
aspects, the lady fall sleep. However, it become a challenging for me to take care of
appropriate things and as a result, it has become one of the highest risk. Also, the
consequence of fall resulted in a large skin tear to her arms and legs that cause a major risk to
her health as well (Thiamwong, 2020). The entire incident reminds me to analyse the role and

responsibilities of a nurse and this in turn cause a positive impact over the organization as
well as minimize the chances of risk of fall.
Feeling
The critical incident made me feel sad and disappointed in myself because I cannot do
anything to such situation and as a result due to such circumstances the lady fall. Hence,
during my shift, I started blame myself for fall and this also affected my nursing practice
throughout some days. Along with this, during starting days, I was not completely confident
to performing the nursing skills. Moreover, I still being uncomfortable throughout the days
because the incident affected the entire life. However, the positive impact of this incident was
such that it helps me to refocus on my entire nursing practice by studying hard over the
prevention (Molés Julio and et.al., 2020). This in turn helps me to make happy and grab
further knowledge pertaining to risk of fall. On the critically side, it has been identified that I
feel negative aspect of this issue is such that I felt dejected as well as blame myself for patient
falling. This affect the entire results in and my mind-set in opposite manner.
Overall, I realized that according to Nursing and Midwifery Board of Australia, there
is a need to understand the roles and responsibilities of a nurse, and they should also practice
in their own scope of practice. Initially, I felt cautious and uncertain because of early
patient’s behaviour and also it is quite difficult for me to understand the same and implement
the strategies to over this. But at the end, I was thankful to all the staff members who assist
me and handle the situation to getting worse. It is so because of getting immediate medical
and psychiatric needs that helps to provide an effective solution and minimize the problem as
well.
Evaluation
Throughout the entire situation, I evaluated that fall is one of the most common and
serious concern that might lead to fatal as well as non-fatal injuries. The secondary study that
more than 35% of the old age people fall in a year because of not getting proper care and
intentionally (Kadylak and Cotten, 2020). The similar incident occurred and thus, relating
this to my clinical experience, I evaluated that patient was already suffered from many other
disease and she was hospitalized from last many years and that is why, it was quite common
that she was completely depended upon nurses and without their assistance, she is not able to
walk easily. Also, due to the problem of dementia, she also lost her thinking abilities that also
lead to cause such incident. Holmberg and et.al., (2020) supported the same in their study that

there is also a financial cost of falls and fall related to injuries to an organization. Thus,
businesses must have to reduce the cost, if the incident takes place within premises.
In an older people, I have identified that there are many risk associated which include
intrinsic and extrinsic risk factors. Also, both risk factors are involved within a situation of a
patient such as under intrinsic, different risk factor are related to person’s behaviour that
involves sensory impairment and medication. However, on the other side, extrinsic factors
involved premises environment i.e. structure of a building etc. Relating to my own
experience, I have analysed that both risk factors are involved during the situation,
nevertheless it is the duty of a nurse to take care of such situation in order to prevent a patient
from fall (Chen and et.al., 2020). Also, such risk factor must be realized and resolved timely
so that the incident may not take place. In addition to this, I also evaluated that effective
policy must be implemented in order to realize the importance of such situation that lead to
prevent a patient’s safety. It can be stated that it is not necessary that every individual learn
from the situation and make steps to modify the strategies in order to protect the same from a
risk.
Being work for so long years, I evaluated that my workplace also implemented the
Falls Risk management policy which is especially designed to old age people who are already
suffer from many disease. Along with this, I personally implement different intervention so
that such situation can be minimized and there will be no negative impact over the
businesses. As per the standard set by the government, it is also examined that premises
should be adhere with health and safety where organization must implement different
strategies that assist to reduce the amount of clutter in patient areas (Steven and et.al., 2020).
Through the entire incident, I also examined that adhering the laws will help to minimize the
situation. Whereas, communication plays an important role while changing the duty and
handover the things to other nurses. Here, understanding the situation of a patient and provide
effective care to them also assist to minimize such situation.
Analysis
The experience assists me to highlight the importance of using policy regarding fall
Risk Management that there is a need to comply with specific requirements that might assists
to improve the situation and reduce the chances of fall as well (Chen and et.al., 2020). In
accordance with the standard set by government, I also analysed that effective strategies need
to be implemented which helps to resolve the problem of target people. I also analysed that

organization is able to comply with different rules and regulations in order to prevent from
falling risk. For that, I learn using Berg Balance scale and Mobility Interaction
Fall chart helpful to determine the chances of falling. Here, the standard score is 56 which
indicates that individual may be at a greater risk of falling (Akande-Sholabi, Ogundipe and
Adisa, 2020). Thus, the old lady also falls under this score where the chances of falling high
and this in turn reflected that the lady needs excess care, however I am not able to provide the
same.
Apart from this, due to low knowledge and poor concentration towards patients, I am
very disappointed with my roles and responsibilities. That is why, there is a need to manage
the situation and provide effective tools or techniques in order to generate best outcomes.
However, I could also engage with learning by experience because of present incident in my
career life. For that, Risk Management Tool should be complied that helps to understand the
hazards can range from slip, trips within a healthcare premises (Muthukrishnan and Maqbool
Ahmad, 2021). Thus, with the help of this tool, individual is able to be aware of hazard and
reduce the chances of incident at workplace. Similarly, as per my case, I analysed that a
patient always need an extra care and attention because a sudden mistake leads to cause
negative impact over their health. Also, in the case of lady, it has been examined that
different interventions must be implemented on ward that helps to provide positive
environment like adequate lighting, clean and dry floor surface which in turn reduce the
chances of fall. Single nurse or ward-boy must be presented at a room that helps to let them
understand about the situation and minimize the chances of incidents as well (Keglovits and
et.al., 2020). Here, I provide proper support to that lady in order to get relief, otherwise
failure to do this will definitely lead to a significant risk to patient and staff safety.
Conclusion
By summing up above it has been summarized that during this situation, I have done
differently that helps to enhance the knowledge and develop a critical thinking abilities.
Throughout the above evaluation and analysing, I also concluded that there are different
interventions which can be used during a situation in order to remove or minimize the
challenge. However, with proper attention and effective strategies, the situation can be under-
controlled that helps to remove the chances of fall. Hence, the overall experience assists me
to understand the role and responsibility play by nurses within a hospital premises. Along
with this, I am able to handle such complex situation and realize the importance of team work
so that effective results can be generated by considering the health of a patient as well.

Action Plan
In this stage, different actions can be taken in order to minimize the problem and this
also allow an individual to make effectual decision while the same situation arise in near
future. Thus, it will allow me to act differently with a given situation. Therefore, there is a
need to implement different strategies which in turn assists to provide safer environment to
their patients (Glauser and et.al., 2020). Along with this, all the staff needs to adhere with
defined protocols with an aim to practice safe quality care among patients. Also, an effective
training must be provided within specific tenure that helps to let them understand about the
changes implemented within an organization. This also helps to reduce the chances of human
error and also improve the quality of patient care so that they can also adjust within a hospital
environment (Dibra and et.al., 2020). Overall, it can be stated that fall is the most common
injury identified among old age people and that is why, tools and techniques must be
implemented that helps to reduce the chances of fall.
CONCLUSION
Through the above experience, it can be summarized that Gibbs model of reflection is
helpful to share the experience regard with any incident. Also, it is necessary for an
organization to comply with effective policies and procedures so that it will assist to mitigate
the risk of falls. Hence, the entire experience assists me to improve the learning and
implement the ways that helps to minimize such situation in near future.

REFERNCES
Books and Journals
Akande-Sholabi, W., Ogundipe, F. S., & Adisa, R. (2020). Pharmacists’ knowledge and
counselling on fall risk increasing drugs in a tertiary teaching hospital in
Nigeria. BMC health services research. 20(1). 1-9.
Benedet, D. C. F. & et.al., (2021). Strengthening nurses in prenatal care through reflection-
action. Revista Gaúcha de Enfermagem. 42.
Chen, P. L. & et.al., (2020). Development of a fall-risk assessment profile for community-
dwelling older adults by using the National Health Interview Survey in Taiwan. BMC
public health. 20(1). 1-10.
Chen, S. & et.al., (2020). Prevalence and risk factors of dysphagia among nursing home
residents in eastern China: a cross-sectional study. BMC geriatrics. 20(1). 1-10.
Dibra, F. F. & et.al., (2020). The risk assessment and prediction tool accurately predicts
discharge destination after revision hip and knee arthroplasty. The Journal of
arthroplasty. 35(10). 2972-2976.
Glauser, G. & et.al., (2020). The Risk Assessment and Prediction Tool (RAPT) for discharge
planning in a posterior lumbar fusion population. Neurosurgery. 86(2). E140-E146.
Holmberg, M. & et.al., (2020). Dyadic teams and nursing care: A critical incident study of
nurses in the emergency medical service. Journal of Clinical Nursing. 29(19-20).
3743-3753.
Jones, J. & et.al., (2020). Reflection in practice: How can patient experience feedback trigger
staff reflection in hospital acute care settings?. Health Expectations. 23(2). 396-404.
Kadylak, T., & Cotten, S. R. (2020). United States older adults’ willingness to use emerging
technologies. Information, Communication & Society. 23(5). 736-750.
Keglovits, M. & et.al., (2020). A scoping review of fall hazards in the homes of older adults
and development of a framework for assessment and intervention. Australian
occupational therapy journal. 67(5). 470-478.
Kim, J. H., & Shin, H. S. (2020). Effects of self-reflection-focused career course on career
search efficacy, career maturity, and career adaptability in nursing students: A mixed
methods study. Journal of Professional Nursing. 36(5). 395-403.
Molés Julio, M. P. & et.al., (2020). Characteristics and circumstances of falls in the
community-dwelling older adult population. Journal of Primary Care & Community
Health, 11, 2150132720940508.
Muthukrishnan, R., & Maqbool Ahmad, J. (2021). Ergonomic risk factors and risk exposure
level of nursing tasks: association with work-related musculoskeletal disorders in
nurses. European Journal of Physiotherapy. 23(4). 248-253.
Steven, A. & et.al., (2020). Critical incident techniques and reflection in nursing and health
professions education: systematic narrative review. Nurse educator. 45(6). E57-E61.

Thiamwong, L. (2020, April). A hybrid concept analysis of fall risk appraisal: Integration of
older adults’ perspectives with an integrative literature review. In Nursing forum (Vol.
55, No. 2, pp. 190-196).
Online
Gibbs’s reflective cycle. 2020. [Online]. Available through: <
https://www.mindtools.com/pages/article/reflective-cycle.htm>.