Reflection on Nursing Practice

Reflective practice plays a crucial role in examining the nursing practice and identifying the gap in the practice. This reflection focuses on a subcutaneous injection administration and highlights the positive and negative experiences, evaluation, analysis, and action plan for improvement.

Running head: REFLECTION
Name of the student
Name of the university
Author note:

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REFLECTION
Description:
Reflective practice plays a crucial role in examining the nursing practice and identifying
the gap in the practice Replicative practice is the ability to examine one’s actions and
experiences with the outcome of developing clinical knowledge and enhancing practice. Gibb’s
model is a common model of reflection used by nurses to examine their practice. In the
hospital when I was appointed to give a subcutaneous injection of heparin to a patient with deep
vein thrombosis. I positioned the patient properly and provided privacy. I verified the order of
mediation and verified the site of administration then administered Heparin using 25 gauge
needle and syringe of 1ml using six rights of medication. Before administrating the infection I
performed hand hygiene then safely dispose sharps which could be done more carefully.
However, since I was nervous, I raised the bed before the equipment gathering that could give
rise to safety issues. It is the responsibility of a nurse to check the position of the patient and
repositioning the patient into a comfortable position after administration of the medication.
Feeling:
I verified the validity of medication order, identified the medication which would be
given to the patient, engaged patient in the communication. However, I was nervous during the
subcutaneous injection administration which highlighted the gap in the nursing practice.
Although I assess the site of infection before administration of the injection and followed
aseptic technique then safely administrate the medication, I raised the patient’s bed before
gathering equipment which highlighted patient safety issues. Since I was nervous, I was not able
to apply an accurate technique for the checking air in the syringe which could result in the safety
issues. However, I assessed the pain of the patient by engaging in the therapeutic communication

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and documented correctly the information which further helps in rechecking the health status of
the patient.
Evaluation:
The incident described above helped me to gain both positive and negative experiences
which I would apply in my future action. The optimistic experience was that I had good
understanding of why heparin was administrated and I perform hand hygiene before
administration, assessed site of administration and followed Aseptic technique then safely
administrate the medication to minimize the discomfort of the patient. The negative experience
was that I failed to identify the patient by checking information which could be resolved by
checking the name, date of birth and Ur number. The next issue was raising the patient’s bed
before gathering equipment which could give rise to the hazard if the patient had a high falls risk.
This problem requires action such as ensuring the position of the patient only during the
administration (Mackey & Bassendowski, 2017). Before administration, I failed to check the air
in the syringe which could be done using correct techniques. Moreover, although I have
deposited the sharp objects, I should be more cautious while disposing of the sharp objects to
avoid hazard resulted from the deposition.
Analysis:
In the current context, few social factors influence the current situation which further led
to the situation. The factors that influenced the situations are negligence, lack of illiteracy which
further questioned the patient safety. According to NMBA standard of nursing practice, a nurse
should provide provides comprehensive safe, quality practice to the patient ( standard 6) and
accesses, analyses the practice to provide the safe care ( standard 1)

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(Nursingmidwiferyboard.gov.au, 2019). In the current context, the lack of literacy regarding
patient handling observed which led to negligence.as discussed by Robichaux (2016), it is the
rights of every patient to receive safe and responsive care. Illiteracy regarding the positioning of
the patient highlighted the negligence of the risk factor of a fall injury. Moreover, illiteracy of the
proper deposition of the sharps has also influenced by the situation (Finnell et al., 2016).
Moreover, nervousness is also highlighted as the social factor because the root of the
nervousness is the pressure of providing accurate care so for minimizing the discomfort of the
patient. As discussed by Halcomb et al. (2016), from the decade the lack of proper
implementation of evidence-based practice and providing knowledge to nurses are highlighted as
the historical factor influencing the situation.
Conclusion:
From the above analysis, it can be concluded that i have certain skills which would
further facilitate my future practice. I had good knowledge of the medication and knew heparin
was administrated to prevent deep vein thrombosis which would further help me to handle the
patient with deep vein thrombosis. I had good therapeutic communication skills which would
further help me to provide comfort to the patient so that they feel empowered. I acquired correct
documentation, evaluation skills and I had skills of following aseptic technique while
administrating injection using six rights of medication which would help me to avoid medical
error. However, there are few gaps in my practice which affected my care process. I have poor
patient identification technique which affected my care process and questioned patient safety.
Moreover, I am unaware of proper positioning patient which could increase the fall injury and I
am unaware of the correct method of checking the air in the syringe which would give rise to
medical error. I am unaware of the safe disposition of sharp injects after medications which

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could give rise to the hazard. I was nervous while administrating the medication which
potentially affected my care process. These issues are required to address through the proper
action plan.
Action plan:
In the current context, I was nervous while administering the injection which further
affected my practice. In the current context, the action plan I would require is to manage the
anxiety and nervousness with the help of the counselor and my supervisor. I would require to
improve the patient identification skills by checking the DOB, name and UR number. I was
unaware of the proper positioning of the patient. This problem can be solved by ensuring the
position the patient only when fully ready to administer medication (Mackey & Bassendowski,
2017). I was unaware of the proper disposal technique of sharps. This problem can be solved by
proper safety training by the supervisor or nurse educator (Malik et al., 2015). I was unaware of
the proper syringe handling technique. This problem can be solved by checking for air in a
syringe and using correct technique to draw any air out of the syringe with the guidance of the
supervisor (Malik et al., 2015).

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References:
Finnell, D., Thomas, E., Nehring, W., McLoughlin, K., & Bickford, C. (2015). Best practices for
developing specialty nursing scope and standards of practice. OJIN: The Online Journal
of Issues in Nursing, 20(2).
Halcomb, E., Stephens, M., Bryce, J., Foley, E., & Ashley, C. (2016). Nursing competency
standards in primary health care: an integrative review. Journal of clinical nursing, 25(9-
10), 1193-1205.
Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing
education and practice. Journal of Professional Nursing, 33(1), 51-55.
Malik, G., McKenna, L., & Plummer, V. (2015). Perceived knowledge, skills, attitude and
contextual factors affecting evidence‐based practice among nurse educators, clinical
coaches and nurse specialists. International journal of nursing practice, 21, 46-57.
Nursingmidwiferyboard.gov.au, (2019). 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 10 April. 2019]
Robichaux, C., (2016). Ethical competence in nursing practice: Competencies, skills, decision-
making. Springer Publishing Company.8 (2), 681.