Heparin Administration and Nursing Care

This assignment focuses on the safe and effective administration of heparin, a common anticoagulant medication. It covers various aspects of nursing care related to heparin, including intramuscular injection techniques, patient education on medication use, and the importance of clear communication with healthcare providers. The document also highlights the rationale behind specific nursing actions, such as avoiding aspiration during intramuscular heparin injections.

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Reflection on Objective Structured Clinical Examination (OSCE) performance
Description
(100 words)
Objective Structured Clinical Examination (OSCE) is very important tool for the assessment of
healthcare professional while performing actual practice. I was assigned to administer intramuscular
heparin to a patient who underwent cholecystectomy. Cholecystectomy was performed to remove
gallbladder. This surgery can relive from pain due to gallstones and this surgery is with minimum risk.
These patients with pre-existing cardiac conditions require anticoagulant treatment. I was monitoring
prothrombin time of the patient to prevent haemorrhage. Cardiopulmonary functions of the patient were
carefully monitored.
Feelings
(100 words)
Due to OSCE, I was nervous prior to administration of the heparin. However, I was sure about my best
performance. I was worried about the pain to patient at the time of injection. Hence, I took him in
confidence and asked him to divert his mind form the injection. It gave me confidence and patient also
felt comfortable at the time of injection. I felt relived after the completion of the procedure. I was
thinking, whether I could have done in better way ? . I strongly believe that, there is always scope for
improvement in the nursing practice.
Evaluation
(150 words)
Even though, I was nervous prior to the procedure, it was in mind that I can perform this procedure
accurately. Nervousness is obvious before certain important assessment. However, my skills and
interest in patient care gave me confidence. I was aware that nervousness can be effectively managed

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by effective communication. In nursing practice, effective communication plays important role in
providing holistic care. It was evident during my OSCE. Non-verbal communications can inform you
about your accuracy. Through non-verbal communication with my evaluator, I understood that my
procedure was correct.
Prior to administration of the heparin to the patient, allergic reaction to the patient need to be assessed.
However, as I was more focusing on the administering heparin, I forgot to administer patient with
antibiotic. Medication administration error specifically antibiotic administration is not acceptable in the
nursing practice. Hence, it was important learning for me.
Analysis
(200 words)
One can understand importance of effective communication, by understanding its need and importance
either in the verbal or non-verbal form. Coping with certain conditions can be achieved by effective
communication. Both nurses and patients are crucial in effective communication because it is helpful in
providing and receiving information (Bramhall, 2014). It is evident that, communication is the only skill,
each nurse should possess. Most of the patients may have phobia about the hospitals. This phobia can
be effectively managed by the effective communication. Patient phobia not only affects treatment of
patient but also distract nurses from their nursing intervention. It would be difficult for the nurses to work
with positive attitude those patients with hospital phobia. Patients with hospital phobia may be anxious
about the communicating with nurses, hence nurses should initiate communication. I also did the same
thing (Andrews, 2011).
OSCE is the important platform for the disclosing medical error. It taught me, how a little negligence can
affect patient treatment. It may lead to more detoriation of the patient because medication error in the
antibiotic treatment can lead to uncontrolled spread of infection. Specifically, in this patient I should
have taken more care because patients with potential haemorrhage are more susceptible for the

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infection (Karthikeyan and Lalitha, 2013’; Brown et al., 2015).
Conclusion
(200 words)
In this OSCE, I understood that, if you have adequate skills, nervousness would not affect your nursing
procedure. Most important learning for me from OSCE, is that nurses should not display their
nervousness in front of the patients. On the other hand, nurses could build confidence in the patient
with effective communication. Medication error is the preventable error, however medication error in
case of antibiotic treatment can detoriate patient’s condition to very serious level. There should be
systematic procedure for the prevention of medication error. Double check—or even triple check—
procedures can be beneficial in the prevention medication error (Schwappach et al., 2016). Clinical
communication is important not only between patient and nurse but also among healthcare
professionals. My non-verbal communication with my evaluator helped me get confidence in performing
my procedure effectively (Newell and Jordan, 2015). OSCE gave me opportunity to me understand
both weakness like medication error and strength like communication. Both the things are useful for me
to improve my nursing practice. In future, I will take more precautions in administration of medications. I
will use communication skills as strength to handle patients with unacceptable behaviour (Chatswood et
al., 2013; Tollefson and Hillman, 2016).
Action Plan
(250 words)
I should implement Double check—or even triple check—procedures for the prevention of medication
error in the nursing practice. I should take more precaution in handling a patient with antibiotic
treatment. I also understood that, I should use both verbal and non-verbal communication in the nursing
practice. Implementation of these factors would be helpful for me to improve my nursing practice
(Tiziani, 2013).

4Medical Surgical Nursing (Spring 2017)
Nursing Action
Double check—or even triple check—procedures
Rationale
Medications errors can be prevented and patient
wellbeing can be improved. Proper documentation
related to the schedule, dose, brand name and
route of administration should be maintained and
other nurse help should be taken to prevent
medication error (Kellett and Gottwald, 2015).
Nursing Action
Demonstrate effective verbal and non-verbal
communication when communicating with the
patient and other healthcare professionals.
Rationale
Clinical practice comprises of stakeholders from
different fields including family members. All these
stakeholders should work in collaboration to
provide holistic care to the patient. Effective
communication is most important factor for the
collaborative work. Communication can be useful
in improving morale of the patient and it can be
useful in providing medication education to the

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patient (McCarthy et al., 2014).
Nursing Action
Do not perform aspiration when administering
heparin through intramuscular route.
Rationale
Intramuscular injection can increase chances of
entry of fluid into the blood vessels. Generally,
aspirations should be performed while
administering through intramuscular route.
However, heparin intramuscular administration is
exception for this because there are chances of
bleeding while administering heparin through
intramuscular route (Sisson, 2015).
References:
Andrews, G.J. (2011). 'I had to go to the hospital and it was freaking me out': needle phobic encounter space. Health Place, 17(4),
pp. 875-84.
Bramhall, E. (2014). Effective communication skills in nursing practice. Nursing Standard, 29(14), pp. 53-9.
Brown, D., Edwards, H., Seaton, L., & Buckley, T. (eds). (2015). Lewis’s medical-surgical nursing: assessment and management of
clinical problems, 4th edn, Elsevier Australia.
Chatswood, NSW. Crisp, J., Taylor, C., Douglas, C. & Rebeiro, G. (eds). (2013). Potter & Perry’s fundamentals of nursing 4th edn,
Elsevier Australia, Chatswood, NSW.

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Karthikeyan, M., and Lalitha, D. (2013). A prospective observational study of medication errors in general medicine department in a
tertiary care hospital. Drug Metabolism and Drug Interactions, 28(1), pp. 13-21.
Kellett, P., and Gottwald, M. (2015). Double-checking high-risk medications in acute settings: a safer process. Nursing
Management, 21(9), pp. 16-22.
McCarthy, B., Trace, A., O'Donovan, M. (2014). Integrating psychology with interpersonal communication skills in undergraduate
nursing education: addressing the challenges. Nurse Education in Practice, 14(3), pp. 227-32.
Newell, S., and Jordan, Z. (2015). The patient experience of patient-centered communication with nurses in the hospital setting: a
qualitative systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports, 13(1), pp 76-87.
Schwappach, DLB., Pfeiffer, Y., and Taxis, K. (2016). Medication double-checking procedures in clinical practice: a cross-sectional
survey of oncology nurses' experiences. BMJ Open, 6(6), e011394.
Sisson, H. (2015). Aspirating during the intramuscular injection procedure: a systematic literature review. Journal of Clinical
Nursing, 24(17-18), pp. 2368-75.
Tollefson, J. Hillman, E. (2016). Clinical psychomotor skills : Assessment tools for nursing students, 6th edn, Cengage Learning,
Melbourne.
Tiziani, A. (2013. Havard’s nursing guide to drugs 9th edn, Elsevier Australia, Chatswood, NSW. The Gibb’s (1988) reflective
cycle.