1REFLECTIVE PAPER In nursing profession, reflection has become an important tool that helps the professionals to identify the positive or negative points of their process and then implement them to improve their future nursing practice (Lestander, Lehto & Engström, 2016). In this paper, I will also be reflecting upon my clinical skill assessment session using the Gibb’s Reflective Cycle and then will identify the aspects which I need to rectify for improvement in my clinical practice. Description For the clinical skill assessment, I was provided with the responsibility of administering IV medication to Mrs. Lilly Joseph (65), who was suffering from Chronic Obstructive Pulmonary Syndrome. My duty was to administer IV Hydrocortisone 100 mg every 6 hours as a circulator nurse and hence I had to be aware and cautious of the steps that need to be taken for successful administration of the drug such as the ANTT principles, correct application of water for injection to prepare the drug for injection, comply with the drug administration technique by the Australian injectable Handbook and hygiene policy of the helathcare facility. Feelings I was very hopeful prior to the assessment process, as I was aware of the ANTT or aseptic non-touch technique and the Australian injectable handbook guidelines for the administration of IV drugs. However, I was aware of my weaknesses that hinder my ability while working in a multidisciplinary team. Hence, this situation was important for me to overcome my weaknesses and provide my patient with holistic care. Evaluation
2REFLECTIVE PAPER The commencement of the session was positive and I was able to introduce my role and responsibilities to the patient (The Society of Hospital Pharmacists of Australia, 2019). Further I was able to obtain the vital signs of the patient and communicated the details loudly to each nursing staff present in the room. As per Queensland Health (2017), it was an important and effective step so that the scope of double checking the patient’s condition could be achieved and in case of any adverse sign, the medication administration could be stopped (Queensland Health, 2017). Further, I documented the signs and started calculating the amount of Hydrocortisone that need to be administered to the patient. This process was important for the quality and safety of the drug administration process (The Society of Hospital Pharmacists of Australia, 2019). I was aware of the information that the patient did not have any allergic conditions and hence, I directly administered the medication through IV. I maintained the ANTT method and did not touch the tip of the needle, however, while complying with the process, capped the used needle, however, this did not affected the care process for Mrs. Joseph (Dhhs.tas.gov.au, 2019). Analysis While analyzing my performance in the clinical skill assessment process, I found that beside few errors in the process, I was able to conduct each of the major processes without any fail so that quality and safety of drug administration could be achieved (Ghinai et al., 2015). I was able to maintain hand hygiene and injected the drug after double checking and confirming the safety of the process. However, I should not have capped the needle again as it can create a confusion in the care process and accidental re-use of the needle could exert negative effects on the patient (The Society of Hospital Pharmacists of Australia, 2019). Hence, the analysis was both positive and negative.
3REFLECTIVE PAPER Conclusion In conclusion, it could be said that, remembering each step of right of drug administration, ANTT process, and active communication method and drug calculation technique was effective in maintaining the quality and safety of the care provided to Mrs. Joseph (Dhhs.tas.gov.au, 2019). However, if I would have remembered the process of hand hygiene and not capping the needle after the drug administration, then the complete process would have become without any mistakes and quality could have been maintained (Bower, Jackson & Manning, 2015). Action plan To assure that I never repeat such mistakes again, I would set some tangible and achievable goals so that I could easily achieve them for the benefit of my patient’s health improvement. I will try to read all the hand hygiene documents and will focus on the ANTT principles where clear mention of the processes that I forgot to implement in the drug administration associated process of Mrs. Lily Joseph. Further, I will try to learn all the steps of drug administration through a flow chart so that while conducting the process I could comply with the prepared flow chart (Comerford, 2014).
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4REFLECTIVE PAPER Reference List Bower, R., Jackson, C., & Manning, J. C. (2015). Interruptions and medication administration in criticalcare.Nursingincriticalcare,20(4),183-195.DOI: https://doi.org/10.1111/nicc.12185 Comerford, K. C. (Ed.). (2014).Nursing2015 Drug Handbook. 35thedn, vol 1, Lippincott Williams&Wilkins.Retrievedfrom:https://books.google.co.in/books? hl=en&lr=&id=meXtAwAAQBAJ&oi=fnd&pg=PR1&dq=Comerford,+K.+C.+(Ed.). +(2014).+Nursing2015+Drug+Handbook.+Lippincott+Williams+ %26+Wilkins.&ots=kvNgyX7hPy&sig=gSKK0xG6qWjG2hNBk80q7SnCxNY#v=onep age&q&f=false Dhhs.tas.gov.au.(2019).Retrievedfrom https://www.dhhs.tas.gov.au/__data/assets/pdf_file/0017/86120/ANTT_V2_2015_B_and _Wprint.pdf Ghinai, R., El-Duah, P., Chi, K. H., Pillay, A., Solomon, A. W., Bailey, R. L., ... & Marks, M. (2015). A cross-sectional study of ‘yaws’ in districts of Ghana which have previously undertaken azithromycin mass drug administration for trachoma control.PLoS neglected tropical diseases,9(1), e0003496. DOI: https://doi.org/10.1371/journal.pntd.0003496 Lestander, Ö., Lehto, N., & Engström, Å. (2016). Nursing students' perceptions of learning after high fidelity simulation: Effects of a Three-step Post-simulation Reflection Model.Nurse education today,40, 219-224.DOI: https://doi.org/10.1016/j.nedt.2016.03.011
5REFLECTIVE PAPER QueenslandHealth.(2017).Aseptictechnique|QueenslandHealth.Retrievedfrom https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/ infection-prevention/standard-precautions/aseptic The Society of Hospital Pharmacists of Australia. (2019). Australian Injectable Drugs Handbook (AIDH) - 7th Edition - The Society of Hospital Pharmacists of Australia. Retrieved from https://www.shpa.org.au/australian-injectable-drugs-handbook-aidh-7th-edition