Reflection on Clinical Skills Assessment in Acute Care Setting

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

REFLECTION1
Description- Acute care setting is an umbrella term used for describing the healthcare
facilities where a patient is subjected to short-term treatment for an illness episode, recovery
from surgeries, or during severe injury. We had been assigned the task to perform
venepuncture in acute care setting for enhancing our clinical skills. Venepuncture commonly
refers to the procedure that is followed for getting intravenous access in order to administer
intravenous therapy to patients, or for performing blood sampling of the patient’s venous
blood (Skarparis & Ford, 2018). We were a group of three nursing students and the event
required us to show adherence to the standard protocol for venepuncture with the use of an
evacuated tube system. During the procedure, while I was able to correctly follow the steps
that involved application of pressure on the arm and removal of the needle, I mistakenly
punctured the evacuated tube prior to needle insertion and did not remove the filled tube,
prior to needle removal.
Feelings- For me the most significant part of the procedure was insertion of the
collection tube inside the holder until the former reached the needle. Initially I felt confident
while putting the tourniquet on the arm of the patient, few inches above the site of
venepuncture. I also felt self-assured while locating the vein and cleaning the site of
venepuncture. Moreover, successful removal of the needle and disposal of the sharps in a
container made me feel satisfied with my work. I felt that I was initially able to perform the
procedure by showing adherence to the standard protocols and was quite satisfied with my
performance. However, soon after I realised that the collection tube had been mistakenly
punctured at the time of removing cap from the needle. I immediately started to panic and
dreaded the consequences of this irresponsibly. Moreover, I felt extremely nervous and
concerned when I did not remove the tube filled with blood. We had been taught during our
classroom sessions that the order of drawing blood determines the sequence in which the
tubes need to be filled. Hence, failure to perform the steps accurately increased my fretfulness

REFLECTION2
over the fact that if I perform similar mistake in real-time settings, it might create adverse
health impacts, and might also produce wrong blood test results for the patients.
Evaluation- Having experienced this incident I feel that each and every step that are
encompassed in the procedure of venepuncture directly create an impact on the quality of the
blood specimen and is thus significant for averting any kind of laboratory error, events of
patient injury or even death. I realised that the practice of accurately drawing blood from
patients is a skill and clinical expertise that we must learn during our baccalaureate program.
In addition, my failure in performing the venepuncture steps accurately helped me
comprehend that venepuncture is imperative for a plethora of medical procedures and
diagnosis and without correct specimen, there might be the likelihood of implementing
harmful or unhelpful treatment. Moreover, I have learned that it is imperative for nurses to
learn venepuncture skills, with the aim of delivering best patient care, and enhancing patient
health outcomes.
Analysis- On conducting a comprehensive and thorough analysis of the clinical
practice incident described above, I can state that the practice of venepuncture is not a
nursing skill that can stringently be learned by viewing videos or thoroughly reading
guidelines framed by particular healthcare organisation, but is a skill that needs to be
practiced frequently in a controlled healthcare environment, in the presence of supervisors
and other trained healthcare professionals. The World Health Organisation has formulated
best practice guidelines for drawing patient blood and elaborated on completion of three steps
in sequence namely, (i) planning beforehand, (ii) selecting an appropriate site of blood
collection, and (iii) quality control (WHO, 2010). In addition, it has also been mandated by
the World Health Organisation (2010) that protective equipment and post-exposure
prophylaxis (PEP) must be available prior to blood collection, and that contamination of the
equipment used for venepuncture must be completely avoided. I also realised that one of the