NRSG367 Assessment 2: Clinical Experience and NSQHS Reflection

This report presents a student's reflection on a clinical experience during a Bachelor of Nursing practicum at Liverpool Hospital. The reflection focuses on two key National Safety and Quality Health Service (NSQHS) standards: medication safety and infection control. Using Gibbs' Reflective Model, the student describes a critical incident involving medication administration errors and breaches in infection control protocols. The report details the student's feelings, evaluation of the incident, and analysis of the event in relation to relevant literature and the NSQHS standards. The analysis highlights the importance of adhering to medication safety protocols and infection control guidelines. The report concludes with an action plan for improvement, including further training and development to enhance clinical skills and knowledge. The student emphasizes the importance of attention to detail, adherence to safety measures, and the role of nurses in preventing healthcare-associated infections. References to supporting literature are provided, demonstrating the student's understanding of the subject matter.

Running head: NRSG367 ASSESSMENT 2 REFLECTION
Title page
Student Name:
Semester 2, 2019
Word count: 1075

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NRSG367 ASSESSMENT 2 REFLECTION
Introduction
The National Safety and Quality Health Service Standards were put in place by the
commission of Australia in collaboration with the government of Australia (Russo et al.,
2018). The main objective of the standards framework is to improve the quality of healthcare
of the patients (NSQHS Standards, 2017). The essay aims to reflect on the two standards of
NSQHS which is medication safety and infection control in relation with my clinical
experience. In the following reflection, Gibb’s Reflective Model will be used to explain a
scenario which I have experienced during my bachelor of nursing practicum (Porter et al.,
2018).
Description
I was in my Bachelor Program of the Nursing Practicum when I was interning in
Liverpool Hospital in North Sydney. There was a 54-year-old male patient named Mr Adam
Johnson, admitted for blood cancer in his last stage. There was another male patient named
Mr Adam Parker, suffering from tuberculosis. Mr Adam Parker was kept in a secluded room
because of the severity of his disease. I was accompanying a senior nurse to administer
medicines. However, I mistakenly administered the drug orally instead of intravenously. This
has caused lethal health issue in the patient. Additionally, I did not perform hand hygiene and
wore gloves while assessing Mr Adam Parker. However, it has not caused any harmful
consequence, but I was questioned about my unhealthy and unethical practices.
Feelings
From the incidence I felt that I lacked in many nursing skills which is important to be
maintained for quality health of the patient. I felt unhappy with my experience which has
caused negative health impact on the patient and my practice could have caused cross-
contamination. I was guilty in front of the health administration, but I tried to be accountable

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for my action. However, from the experience I came to know about the importance of
NSQSH standards which are important to be maintained by the health care professional.
Evaluation
From the incident, I evaluated my weak areas in care of the patient. The bad thing
happened in the situation is lethal health consequence to cancer patient. I was unaware of the
standard of medication safety and infection control. I was not assertive, I should have
consulted the senior nurse to ensure the right route of administration of drugs. I also
evaluated the importance of hand hygiene in infection control. During my investigation, I
realised my weak area and importance of NSQHS standard. It is evident from the study of
NSQHS Standards (2017) where Australian Commission on safety and quality in health care
has discussed the importance of NSQHS standard and concluded that any negligence by
nurse in these standard can cause severe health issue to the patient. The only good thing
happened that I became aware about the significance of NSQHS standard of medication
safety medication safety and infection control.
Analysis
Through my experience I learned about the medication safety standard and infection
control guideline describe as NSQSH by Australian Commission on safety and quality in
health care. It is evident from the study of Roughead, Semple and Rosenfeld (2016) that
medication safety standard discuss about medication management by maintaining safe
administration, prescribing and dispensing of medicine in order to give quality care of the
patient. The author has also stated that health care professional need to be conscious enough
in the process of medicine to avoid any error. In the incident I was not having adequate
knowledge about the cancer drugs, thus failed to work by per the medication safety standard.

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I analysed that I need to build more knowledge and acquire clinical experience to become
competent nurse.
Referring to standard number 3 of NSQHS which describes about the preventing and
controlling health care associated infections intends to focus on the implement healthy
practice and systems to prevent associated infection (NSQHS Standards, 2017). This could be
achieved by performing hand hygiene and wearing glove before assessing the patient. It is
reported it the paper of Grayson et al. (2018) that negligence in the work of nurse to control
infection in health care system can increase long stay in hospitals or can cause death of the
patient. Author has concluded that nurse need to do hand hygiene before and after handling
the patient in order to avoid any cross contamination. From review of the paper I
comprehended that I lack in significant area in nursing which is related to healthy practice. In
the incident I was not conscious towards my work which could have caused lethal issue to
both patient and other nursing staffs. Thus, my clinical experience has given me insight about
healthy practice and importance of role of nurse in care of the patient.
Conclusion
In conclusion, it can be understood that medication safety and infection control is the
important domain which need clear awareness and knowledge. I should have consulted to my
senior nurse about the basic protocol and route of administration of drugs. This would have
avoided any error in my practice. The medical negligence and unawareness about the
infection control caused by not following the standards of NSQHS can be disadvantageous to
the patient as well as the health organization.
Action Plan
My action plan to overcome these kinds of situations will be to involve myself in a
training program under a registered nursing professional to understand the intricacies that are

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involved in an acute care setting. I will get enroll in course in the nursing principle where I
will learn about the NSQSH standard to give effective care to the patient. I plan to achieve
this in the next six months before I pass out of my degree. I will also be involve clinical care
of patient under the supervision of senior nurse to develop necessary skill like
communication, assertiveness and awareness about evidence based practice.
Conclusion
Finally, it can be concluded that to overcome this, proper attention to detail must be
given by the nurses towards the patient. Proper safety measures must be taken before
assessing the patient. From the following experience, I have learned that hospital-acquired
infection incidents are prevalent which must be avoided by health care professional by
adopting healthy practice measure.

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References
Bates, M., Marais, B. J., & Zumla, A. (2015). Tuberculosis comorbidity with communicable
and noncommunicable diseases. Cold Spring Harbor perspectives in medicine, 5(11),
a017889.
Gluyas, H. (2015). Understanding non-compliance with hand hygiene practices. Nursing
Standard (2014+), 29(35), 40.
Grayson, M. L., Stewardson, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M., ...
& National Hand Hygiene Initiative. (2018). Effects of the Australian National Hand
Hygiene Initiative after 8 years on infection control practices, health-care worker
education, and clinical outcomes: a longitudinal study. The Lancet Infectious
Diseases, 18(11), 1269-1277.
NSQHS Standards. (2017). 2nd ed. [ebook] Sydney: Australian Commission on Safety and
Quality in Health Care. Available at:
https://www.safetyandquality.gov.au/sites/default/files/migrated/National-Safety-and-
Quality-Health-Service-Standards-second-edition.pdf [Accessed 13 Aug. 2019].
Porter, J., Perkins, A. J., Lyons, J., & Sewgolam, S. (2018). Thinking like a nurse. The Road
to Nursing, 117.
Ralph, N., Birks, M., & Chapman, Y. (2015). The accreditation of nursing education in
Australia. Collegian, 22(1), 3-7.
Roughead, E. E., Semple, S. J., & Rosenfeld, E. (2016). The extent of medication errors and
adverse drug reactions throughout the patient journey in acute care in Australia.
International journal of evidence-based healthcare, 14(3-4), 113-122.
Russo, P. L., Cheng, A. C., Mitchell, B. G., & Hall, L. (2018). Healthcare-associated
infections in Australia: tackling the ‘known unknowns’. Australian Health Review,
42(2), 178-180.