Reflection on the Removal of Drainage Tube

This essay reflects upon the experiences of a student nurse while removing the surgical drain from a patient's leg. It describes the procedure, feelings, evaluation, analysis, and action plan. The essay emphasizes the importance of informed consent, aseptic technique, and time management skills. The subject is nursing, and the college/university is not mentioned.

REFLECTION ON THE REMOVAL OF DRAINAGE TUBE
REFLECTION ON THE REMOVAL OF DRAINAGE TUBE
Name of the Student
Name of the university
Author’s note

1REFLECTION ON THE REMOVAL OF DRAINAGE TUBE
Reflection on the removal of drainage tube
Surgical drains are tubes that are normally place near the surgical incisions in some post-
operative patient, in-order to remove the pus, blood and other types of body fluid in order to
prevent them from accumulating within the body that may give rise to infection (Allegranzi et
al., 2016). Drainage tubes are removed normally after the amount of the surgical drainage has
ceased. Removal of the drainage tube can be painful at the time of the removal and also poses
considerable chances of infections.
In this essay I would reflect upon my experiences as I worked to achieve the learning
outcome of the successful removal of the surgical drains.
.
Description
I was assigned to remove the surgical drain from the left leg of a female patient who have
underwent a hip arthoplasty. In the past, I have gained enough theoretical knowledge regarding
surgical drains and is well aware of the clinical guidelines. However this was my first experience
of a hands on technique. Before the conduction of the procedure, I brainstormed through the
literatures and reviews about the different importance of the drains, the indications and the risks
associated with the drains, the risks associated at the time of the removal.
However, when I first arrived in the room, I made it sure that that was the correct patient, by
cross checking the history of the patient and confirming the patient ID with two patient
identifiers like the name and the date of birth. As I entered the room, I greeted her cordially,
introduced myself and tried to make the ambience a lighter as the patient was quite anxious about

2REFLECTION ON THE REMOVAL OF DRAINAGE TUBE
the procedure. Then I explained the entire procedure to the patient making sure, that I do not
frighten him with medical jargons. I took consent from the patient and performed the
conventional five moments of hand hygiene. I collected the necessary supplies required for the
removal procedure such as the drainage measurement container, waterproof pads and an alcohol
swab. I donned the non-sterile gloves and initiated the procedure. Maintaining the sterile
technique, I removed the plug from the pouring spout indicated on the drain. I released the
suction on the reservoir and record the drainage. I carefully removed the tape and the dressing
from the insertion site for allowing the drain removal.
I cleaned the site as per the simple dressing change procedures. I carefully cut and removed
the suture anchoring the drain with the help of a sterile suture scissors and stabilized the skin
with my dominant hand. I asked the patient to take a deep breath and slowly removed that drain
as the patient exhaled. The skin was stabilized with a sterile gauze around the site of the
drainage. The drain and the tube was discarded in to the garbage disposal bag The Royal
Children’s hospital Melbourne, (2018). A new set of gloves was worn and the drainage site was
cleaned properly with aseptic technique and a dressing was applied. I finally assisted the patient
back to the comfortable position. The whole procedure took about 15 minutes.
Feelings
As I was ready for the procedure, I felt a bit nervous about the procedures that I would do
some mistakes as my educator would be watching me performing the procedure. My educator
assured me to concentrate and not to worry as he will be guiding me throughout the process.
I made it a note that that the plan for the removal of the rain tube was discussed with the
registered nurse in the progress notes of the patient. I made it sure to inform Mrs. Brown about
the removal procedure and the associated pain that she can experience. The entire removal

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process has been discussed to the patient. Informed consent is an important procedure as per the
nursing codes of ethics as this implies a shared decision making and that every patient has the
right to refuse any kind of treatment (Kinnersley et al., 2015). We discussed and planned for the
procedural management of the pain and the different non pharmacological interventions that can
be taken up for minimizing the pain at the time of the procedure.
I was mindful about the use of the standard aseptic technique for the removal of the surgical
drains and was geared up with all the personal protective equipment. PPE reduces the chances of
transmission of microorganisms and helps in protecting against any exposure to the body fluids
(Anderson et al., 2016). Aseptic technique is extremely important in preventing surgical site
infections (Allegranzi et al., 2016). Hence, I understand the importance of proper hand washing
and the maintenance of sterility throughout the process.
Evaluation
With this entire learning experience I had become more proficient with the handling and the
re-vacuuming of the drains. The patient reported of no negative outcomes and admitted that I had
been extremely gentle and quick. However, there were few mistakes that occurred on my part
during the procedure. I had been allotted with 10 minutes to complete the entire procedure, but
had an issue with the time management skills and took longer time to complete the procedure.
Furthermore, I also forgot to make use of the other personal protective equipment beside gloves
like, goggles or mask and aprons. Although, I was constantly checking on whether I was
performing each and every steps aseptically, but somehow I got nervous and used only one
cotton swab to wipe around the tube twice. Apart from this I worked in compliance with the
nursing standards and showed good communication, patient identification and informed consent.

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Analysis
I have learnt that cleaning the site prevents infection in the site and permits the surture to
be seen easily for the removal. This have also made me realize how informed consent promotes
patient autonomy and helps to build the rapport between the nurse and the patient (Colloca &
Finniss, 2012). I have also realized how releasing of the suction reduces the potential of the
tissue damage and how appropriate dressing using aseptic techniques helps in preventing
infections and edema. The entire procedure has helped me to be more cautious for all the future
procedures.
Conclusion and Action plan
Based on this experience, I plan to enhance my knowledge about the surgical drains. This can
be done by dong more researches and by gaining experience with other different types of
surgical drains. Dealing with complicated cases would allow me to develop my clinical skills and
would also polish my time management skills. I also wish to be mindful about the aseptic
procedures as this is the part where near misses can occur and which can give rise to
complications. However, I also intend to remain updated about the current knowledge of nursing
protocol and guidelines and I strongly believe that this would enhance my scope of lifelong
learning and would also help me in continuing my professional development.

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References
Allegranzi, B., Bischoff, P., de Jonge, S., Kubilay, N. Z., Zayed, B., Gomes, S. M., ... &
Boermeester, M. A. (2016). New WHO recommendations on preoperative measures for
surgical site infection prevention: an evidence-based global perspective. The Lancet
Infectious Diseases, 16(12), e276-e287.
Anderson, D. J., Podgorny, K., Berrios-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene, L.,
... & Kaye, K. S. (2014). Strategies to prevent surgical site infections in acute care
hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S66-S88.
Colloca, L., & Finniss, D. (2012). Nocebo effects, patient-clinician communication, and
therapeutic outcomes. Jama, 307(6), 567-568.
Kinnersley, P., Phillips, K., Savage, K., Kelly, M. J., Farrell, E., Morgan, B., ... & Blazeby, J.
(2013). Interventions to promote informed consent for patients undergoing surgical and
other invasive healthcare procedures. The Cochrane Library.
The Royal Children’s hospital Melbourne, (2018).Surgical drains .Access date: 17.9.2018.,
Retrieved from:https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/
Surgical_Drains_(Non_Cardiac)/