Reflection on Clinical Skills Assessment in Nursing Simulation

This reflection is about a nursing simulation scenario that involved caring for a female patient who was aged 65 years, and had been admitted to the hospital, following a diagnosis of fever, four days ago. The author reflects on their experience of conducting venipuncture on the patient and missing out sharp disposal. The reflection includes feelings, evaluation, analysis, and an action plan.

Running head: REFLECTION
Part B: Written Reflection: Clinical Skills Assessment
Name of the Student
Name of the University
Author Note

1REFLECTION
Description- Nursing simulation scenarios generally involve three components
namely, preparation work, simulation, and debriefing that allows nursing students to review
their performance, while considering the application of nursing theory to their practice,
followed by obtaining feedback from an instructor (Campbell & Daley, 2017). One such
simulation scenario involved caring for a female patient who was aged 65 years, and had
been admitted to the hospital, following a diagnosis of fever, four days ago. During the
simulation, three second year nursing students were permitted inside the clinical laboratory,
and had to select a nursing clinical role for attending to the needs and requirements of the
patient in quick succession. I was assigned with the duty of conducting venipuncture on the
patient and was able to perform the steps accurately. However, I demonstrated a failure by
missing out sharp disposal. I did not reach the patient bedside along with the sharp disposal
container. The following sections will contain a reflective account for this incident.
Feelings- The process of venipuncture helps in obtaining intravenous access, with the
primary objective of blood sampling or intravenous therapy, and it is imperative to show
adherence to the standard protocol during collection of blood specimen in order to obtain
appropriate laboratory results (Courtois et al., 2016). While treating the patient although I
was able to perform all the steps accurately, I did not give attention to bring a short disposal
container at the patient bedside. On noticing my mistake I became nervous and immediately
started worrying about the harmful impacts that it might create. This realisation increased my
level of anxiety, and I became fearful and concerned about repercussions of the event when it
would be detected by my supervisor. Prior to the event I was well aware of the fact that it is
imperative for a healthcare professional to use the sharps container for safely disposing sharp
medical instruments and hypodermic needles, in order to prevent any health hazards.
Nonetheless, on noticing my mistake during the clinical simulation, I became
immediately fretful and restless about out the fact that the needle and sharp medical

2REFLECTION
instruments could injure several people and might also result in transmission of infections,
thus leading to serious health conditions.
Evaluation- This clinical simulation had both bad and good elements, which increased
my understanding about the process of venipuncture, and the steps that should be followed
while collecting blood sample from any patient. My role was to who conduct venipuncture
using syringes and needles for obtaining blood that would be used for diagnostic purpose,
and for monitoring different levels of blood components, as per the best interests of the
patient. However, my failure as a nursing professional in not following the safety protocols
suggests that there was a lack of understanding on my part regarding the importance of
appropriate sharp disposal in healthcare settings and the health concern that they are
associated with.
Analysis- Acute Care Nursing is a speciality where nursing professionals are entitled
with the responsibility of restoring stability and health of the patients, following a chronic
illness or a surgery. It has often been established that healthcare workers across the globe are
concerned about sharp or needlestick injuries that have been associated with life threatening
infections. Sharps comprise of syringes, needles, autoinjectors, infusion sets, and lancets.
Therefore, failure to dispose sharp in a proper container results in an increased contact with
the contaminated needles and equipment that spread infections, most common of which are
hepatitis B, hepatitis C, and human immunodeficiency virus (HIV) (Coppola et al., 2016).
Drug and Alcohol Services South Australia’s (DASSA) Clean Needle Program (CNP)
also governs the sharp disposal service for individuals who inject drugs, and emphasizes on
the dissemination of sterile disposing containers that have injecting equipment. In addition, it
highlights importance of creating sharp disposal bin or facilities for returning used sharp
equipment (SA Health, 2019). It has also been emphasised by the NSW Work Health and

3REFLECTION
Safety Act 2011 and NSW Work Health and Safety Regulation 2011 that in order to reduce
risks of accidental transmission of blood borne infection and injury by safe handling usage
and disposal of sharps and needles that are contaminated with body fluids and blood, it
always needs to be ensured that accessible and adequate resources for their disposal that
comply with different Australian standards are available (NSW Health, 2011). It is also
imperative for a nominated supervisor to ensure that healthcare staff disposes of syringes,
sharps, and needles immediately after their usage by directly discarding them into a puncture
resistant and impermeable container that is designated for their disposal.
According to standard 1 of practice nurses are expected to use ethical frameworks at
the time of making decisions. The Standard 6 emphasizes on the role of registered nurse to
provide safe, comprehensive, and quality practice to all patients, besides highlighting the
importance of practicing in accordance with contemporary guidelines, standards, regulations,
and policies (NMBA, 2016). Hence, I realised that it I did not show compliance to the
legislation of the nation, thereby demonstrating of failure in accurately fulfilling my duties as
a nurse.
Action Plan- From this experience I intend to be more mindful about the importance
of safe disposal of sharp instruments and needles while conducting venipuncture or any other
assessment that involve contact with blood and body fluids. If similar situations are to arise
in future, the insight gained from this clinical simulation would help me to follow the
registered nurse standards of professional practice, consequently preventing any health
hazards. My specific aim is to increase my competency and skills related to sharp disposal of
medical equipment. I intend to attend a training or workshop that will help in increasing my
awareness on the possible environmental and public health hazards that might be associated
with inappropriate storage, collection, segregation, handling, and disposal of sharks. It will
also help me to identify my roles and responsibilities associated with management of sharp

4REFLECTION
waste. My goal is to complete this training within three months of this clinical simulation
scenario that will help me to prevent any untoward incident in future, while caring for
patients. I also so want to show adherence to safety practices that will play an important role
in preventing disease transmission such as, wearing protective clothing, washing my hands
prior to and after coming in contact with a patient, handling sharps with carefulness, getting
complete immunization against infectious diseases that can spread in the healthcare setting
through improper sharp disposal, and prevent sorting through these hazardous waste.
On encountering similar incidents in future I also want to report sharp related injuries
to the designated personnel, while maintaining a log of any such accident that will help in
gaining a clear understanding of the events that led to the incident. I also intend to use a
protected sharps barrel in future to prevent any injury. Besides following the waste
management policies of the healthcare setting, I aim to locate sharps container at a safe
position to avoid spillage, and which is distant from public access, and out of reach of
patients. I will also ensure not using needles that are broken or bent, prior to disposal, and
will focus on not recapping used needles.
I will also demonstrate obedience to the legislation imposed by the health department
of the nation, in order to ensure that I have followed the standard protocol that is expected
from a registered nurse. Hence in future I am to increase my proactive nature, while dealing
with such a situation, regardless of my level of experience or role within the healthcare team.
I will also ensure to intervene in all such circumstances that impose a risk to the health of a
service user or caregiver.

5REFLECTION
References
Campbell, S. H., & Daley, K. (2017). Simulation scenarios for nursing educators: Making it
real. Springer Publishing Company. https://books.google.co.in/books?
hl=en&lr=&id=FvAnDwAAQBAJ&oi=fnd&pg=PP1&dq=nursing+simulation&ots=c
nO42msk8H&sig=ugxGAWQAbmgTEaoQcFSg7nwUBzk#v=onepage&q=nursing
%20simulation&f=false
Coppola, N., De Pascalis, S., Onorato, L., Calò, F., Sagnelli, C., & Sagnelli, E. (2016).
Hepatitis B virus and hepatitis C virus infection in healthcare workers. World journal
of hepatology, 8(5), 273. doi: 10.4254/wjh.v8.i5.273
Courtois, E., Cimerman, P., Dubuche, V., Goiset, M. F., Orfèvre, C., Lagarde, A., ... &
Nanquette, M. C. (2016). The burden of venipuncture pain in neonatal intensive care
units: EPIPPAIN 2, a prospective observational study. International journal of
nursing studies, 57, 48-59. https://doi.org/10.1016/j.ijnurstu.2016.01.014
NSW Health. (2011). Work Health and Safety - Blood and Body Substances Occupational
Exposure Prevention.
https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/GL2018_013.pdf
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice.
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/
Professional-standards/registered-nurse-standards-for-practice.aspx
SA Health. (2019). Clean Needle Program.
https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/
health+services/drug+and+alcohol+services/clean+needle+program