University Nursing: Critical Reflection on Abdominal Assessment

This document presents a critical reflection by a nursing student on their experience performing an abdominal assessment on a patient. The reflection details the student's actions, feelings, and evaluation of the assessment process, including the use of HIAPP (History, Inspection, Auscultation, Percussion, Palpation) and hand hygiene practices. The student discusses initial nervousness, errors made (such as forgetting hand hygiene and the order of assessment), and feelings of guilt and embarrassment. The reflection incorporates relevant NSQHS standards and the Nursing and Midwifery Board of Australia's code of conduct to analyze the student's shortcomings. It also highlights the student's strengths, such as effective communication with the patient and escalation of errors to a mentor. The conclusion emphasizes the importance of safety measures, evidence-based practice, and building confidence. The student outlines a future action plan focused on skill development through training programs and practical application of learned techniques. The reflection offers insights into the practical application of nursing principles in clinical settings and serves as a learning tool for nursing students.

Running head: CRITICAL REFLECTION: ABDOMINAL ASSESSMENT
CRITICAL REFLECTION: ABDOMINAL ASSESSMENT
Name of Student:
Name of University:
Author’s Note:

1CRITICAL REFLECTION: ABDOMINAL ASSESSMENT
Description
My clinical duty was to perform abdominal assessment of the patient name Roodney,
who was going to have appendicitis surgery. The patient was suffering from pain in right lower
quadrant of the abdomen. I executed HIAPP assessment, checked peristaltic movement, and
done light palpation. Auscultation, percussion, palpation showed controlled outcome. After every
assessment, I also did RLQ for better result. The patient was responding well to the question in
the assessment. However, in such a course of examination, I failed to collect the history of the
patient in initial time and did after the auscultation stage in HIAPP assessment. I performed
hand hygiene before assessing the patient, but forget to execute it after evaluating him. I have
also assisted the patient in positioning him by adjusting the height of bed.
Feelings
During my clinical experience, which involves abdominal assessment, initially, I was
nervous and low in confidence which has led to the occurrence of lots of error in my practice.
However, as I am responsible for providing adequate care to the patient, I gathered self-
confidence in my ability to deal with the patient and perform HIAPP assessment proactively.
While performing the evaluation, I felt massive pressure as I was closely monitored by the senior
nurses. Though, I managed the situation effectively, on the other hand, ended up making medical
and safety error. I was feeling guilty and embarrassed for not maintaining safety measures and
quality of care to the patient. I need to work on my weak areas to become a competent nurse.
Evaluation
At the time of my clinical experience, I have evaluated the weak and strong point that can
help me to become a successful nurse. I regret that I have not executed the role of competent

2CRITICAL REFLECTION: ABDOMINAL ASSESSMENT
nurse in assessing Mr Roodney. Due to huge pressure and nervousness, I missed to perform hand
hygiene and to use HIAPP assessment with perfection. I realised my shortcoming after
completion of the assessment, which could not be resolved. However, in practice, I actively
communicated with the patient and helped him in repositioning for his comfort. I have learned
the practical application of HIAPP assessment and evaluated the weak area where I need to
improve. As I have missed assessing the history of the patient, I immediately escalated the error
to my mentor, which proved that I have good interpersonal communication skill. However, I
have to work hard to utilise the nursing principle in my practice for better execution of role and
responsibilities of nurse.
Analysis
NSQHS standard number 3 states that nurse has to adopt the healthy practice to avoid the
risk of infection for better health outcome of the patient (Australian Commission on Safety and
Quality in Health Care, 2017). Scheithauer et al. (2017) have indicated that nurse has to include
quality improvement activities like hand hygiene before and after assessing the patient for
quality care. Therefore, it can be said that I have not maintained the standards and executed the
role of responsible nurse. Rastogi et al. (2019) have highlighted in his study that HIAPP
assessment, it helps to detect any health issue related to stomach and changing the order of the
evaluation have the potential to cause an error in interpretation of the illness. Thus, I analysed
that I have to improve my skills and competency for providing quality care to the patient.
According to the nursing and midwifery council code of professional conduct, nurse has to act in
a way that can identify and lower the health risk of the patient (Nursing and Midwifery Board of
Australia, 2016). Being a student nurse, I am also responsible for adopting the standards and
nursing principle. Therefore, I need to take action to become a successful nurse.

3CRITICAL REFLECTION: ABDOMINAL ASSESSMENT
Conclusion
Looking at the clinical experience, I can conclude by saying that I have learned the
importance of safety measures and evidence-based practice for delivering effective care to the
patient. I have also learned the nursing principle and analysed that I should have been more
active and mindful while assessing the patient. I should have taken care of the safety of the
patient and other staffs by performing hand hygiene after evaluating the patient. Moreover, I
should have reviewed HIAPP assessment tool before examining the patient. After the completion
of the clinical practice, I realised that I need to build more confidence in my practice area.
Action plan
In future, I will focus on developing essential nursing skills and imbibing those in my
practice. I will get enrol in a training program where I will learn about safety measure and use of
HIAPP tool for abdominal assessment. To measure the effectiveness, I will include those
learning in practical care of the patient.

4CRITICAL REFLECTION: ABDOMINAL ASSESSMENT
Reference
Australian Commission on Safety and Quality in Health Care. (2017). Retrieved 19 September
2019, from https://www.safetyandquality.gov.au/sites/default/files/migrated/National-
Safety-and-Quality-Health-Service-Standards-second-edition.pdf
Nursing and Midwifery Board of Australia. (2016). Nursing and Midwifery Board of Australia -
Professional standards. Retrieved 19 September 2019, from
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards.aspx
Scheithauer, S., Batzer, B., Dangel, M., Passweg, J., & Widmer, A. (2017). Workload even
affects hand hygiene in a highly trained and well-staffed setting: a prospective 365/7/24
observational study. Journal of Hospital Infection, 97(1), 11-16.
Rastogi, V., Singh, D., Tekiner, H., Ye, F., Mazza, J. J., & Yale, S. H. (2019). Abdominal
Physical Signs and Medical Eponyms: Part II. Percussion and Auscultation, 1924–
1980. Clinical medicine & research, cmr-2018.