Patient Safety and Clinical Quality in Complex Nursing Care Report

This report focuses on patient safety and clinical quality within complex nursing care, addressing key areas such as falls prevention, blood transfusions, and medication safety. It includes reflections on learning experiences related to preventing falls in older adults, ensuring safe blood transfusions, and avoiding medication errors. The reflections cover insights gained, application to practice, and areas for further development. The report emphasizes the importance of patient assessment, risk management, and continuous learning in nursing practice to promote positive patient outcomes. This document is available on Desklib, a platform offering a wide array of study tools and resources for students.

Running head: COMPLEX NURSNG CARE
COMPLEX NURSING CARE
Name of the Student
Name of the University
Author note

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Table of Contents
Activity 1.........................................................................................................................................2
Activity reflection............................................................................................................................3
Activity 2.........................................................................................................................................4
Reflection.........................................................................................................................................5
References........................................................................................................................................9

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Activity 1
1. The definition of patient’s safety is very simple, it simply describes the prevention of the
errors and the effects which are very adverse to the patients who are associated with the health
care of the hospital.
2. Normally patients should be screened properly at the time of the admission to the hospital.
Mainly the older or the aged persons have more chances to fall down than the children or the
adults. The hospital days seem to be long to the elder persons than other persons. The four
occasions where a patient need to be assessed are the medical history of the patient and whether
she had incidents of falls or not, whether the patient has any cognitive problems or not, whether
the patient has any problem on her foot or not and the last one is the medications of the patient.
3. The 3 risk factors that the patient of the case study has in the hospital are she is already
suffering from hip injury in the last fall that she had, she was left undiagnosed in the weekends
so had chances of falling again and the last one is she was already an aged person and was not
having much control on herself.
4. Three nursing priorities in this case study regarding the case of falling are firstly as a nurse I
will check whether the patient is moving through any trauma or not, the next nursing priority is
to check the vital signs of the patient for making sure that the pulse rate, breathing rate, blood
pressure are normal or not. The last nursing assessment is observing the orientation of the leg,
noticing the pain that the patient is suffering in the hip joint and also the pelvic pain and the
spinal pain.

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5. The important advice that I can give to the patient to reduce the risk of falling are at the time
of walking she can take the help of some support to walk properly. The patient must also be
more conscious at the time of moving from the bed.
Activity 1 reflection
What are the 3 things that I have learnt?
I have learnt many things about the patients’ safety. Among them one of the most
important factor is the age factor. As people turn aged, the chances of falling down also
increases. At old age people lose control over themselves and so fall down. The second most
important thing that I learnt is proper treatment at proper time is needed. If the patient do not get
proper treatment at proper time then injury will no heal and at the same time the patient loose
hope of getting cured. The last important thing is the mental support, especially to the aged
persons who get mentally disturbed after falling down.
How will I apply this to my practice?
In my practice I will try to take more care of the aged patients as they have more chances
of falling down. I shall surely try my best to provide the patients with rope care and at right time
do that the patient will not be lagged behind from getting the latest treatments. Lastly I will try to
provide the patients with proper mental support for encouraging the mental strength of the
patient.
What do I need to do to continue to develop?
For developing my capabilities I think I need some training so that I can perform much
better in my workplace.

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Activity 2
What are the 3 key things that I have learnt?
I have learnt so many important things that are but among all of the three things that are
more important are at first it is very much essential to check the identity of the patient before
doing the blood transfusion. The next most important thing is that all the observations must be
taken and must be recorded before the administration of the blood components occur. The next
most important thing is that the observations that are obtained should be compared with the
observations that are obtained after the blood transfusion has happened. These are the most
important matter of concern.
How will I apply this to my practice?
Presently I am working as a registered nurse of a hospital, so it is very essential to do the
transfusion of blood in such a way that the safety of the patient is improved and also no negative
reaction occur after the blood transfusion is over. In my workplace I will check the identity of the
patient by checking any of the identity proof. If the management of the hospital is not concerned
about the checking policy of checking the identity proof, then I will try to make the management
agree such new rules. I will also check the observations of the patient before the transfusion in
order to make sure that the patient is suitable for blood transfusion or not and will also compare
with the observations after the transfusion is over.
What do I need to do to continue to develop?
In order to continue with the development, I need some more training so that in future I
will be able to proceed efficiently while transfusing blood.

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Reflection
Description
The three activities that I have undergone are preventing falls and also preventing the
harm that a person may get after falling down. The second activity is related to the blood and the
products of blood and the third activity is about a wrong dose of medication where the doctor
only provided the wrong dose of medications. All of three activities were very important
activities of nursing and every nursing student should learn this during the study days so that in
their professional life they can do their work efficiently and also can take required steps if any
misconduct occur regarding the safety of the patient.
Feelings
My thoughts and feelings regarding the matter of maintaining the safety of the patient has
changed completely after going through these three activities. Before conducting these activities
I was not concerned much about the requirements of maintaining. I was not able to maintain the
safety of the patient before commencing these three activities. I had studied much about the
procedures to be followed to maintain the safety of the patients but the experience of dealing
with those activities practically had increased my confidence about the effective care giving
policies of the patients, especially the old aged people (Boyle et al. 2015). I was not aware about
the blood transfusion policies and also the necessary requirements that are needed to be checked
for completing the transfusion and the necessary steps that are required to be taken to avoid the
risks of negative reactions after transfusing the blood. Another most important priority was the
administration of the proper drugs as wrong administration of drugs may lead to fatal

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consequences to the patient and sometimes it even lead to the death of the person (Ulas et al.
2015).
Evaluation
Each and every activities or any experiences can be judged by considering the positive
and the negative aspects of the activities. In this experience, I had undergone three different
activities involving three different nursing aspects. Regarding the first activity the important
thing that went good was that I became concerned about the required steps to be taken to reduce
the risk of fall of a patient suffering from neurodegenerative disease (Miller, Zimmermann and
Herbert 2016). The other thing that went well in the activity was that the patient whom I was
giving care was also very cooperative and use to listen everything that was told to her. The
negative aspect was that the patient was an aged person and so I was finding it a little bit difficult
to communicate with her. The second experience of blood transfusion was one of the most
important activity as ineffective blood transfusion may even take the life of the patient. The
positive thing about this experience was that my knowledge about the processes of blood
transfusion has increased a lot though I was very nervous before commencing the activity. The
last activity was another important aspect of the medical sciences (Meybohm et al. 2016). I learnt
about proper administration of medicines as the patient was administered with wrong medicines.
It is one of the greatest responsibility of the nurses to take legal actions if they find that the
doctor has prescribed wrong medicines. While doing this activity I was very happy that I was
able to know that the patient was administered with wrong medicines (Bagheri-Nesami et al.
2015). I also came to know about the legal action that can be taken when any misconduct
happens with the patient.
Analysis

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This experience is not doubt a very successful experience that I ever attended. All of the
activities that I attended are very important nursing activities. The nurses have to take care of the
patient and they have to do this in anyway however bad the circumstances are. All the three
activities are very helpful and I have gained much knowledge regarding all of these activities. I
future also this activities will no doubt help me in developing the practices of nursing. I will able
to determine the risks of fall of the patients suffering from neurodegenerative disorders, will be
able to administer patients with appropriate medicines so that the patient may start recovering
from the diseases (Yazer et al. 2016). Age is another important factor, patients from all age
groups are not able to communicate properly with the nurses also not all age groups will be
administered with appropriate with the same medicines. Different age groups require different
types of treatments. The other positive aspect of this activity was that I became aware about the
essential concerns about the blood transfusion practices. The negative consequences of the blood
reactions should be avoided as much as possible (Shields et al. 2015). Blood transfusion if do not
occur properly can even led to the death of the person. The last most important thing is the
administration of medicines. Wrong administration of medicines may lead to the death of the
person. If the patient would continue with the wrong medicines, then fatal consequence would
have happened.
Action plan
After completing all the three activities I realised that I have become much more
concerned about all the activities that are undergone. I have come to know that my abilities of
taking care of the patient has increased, I have become much confident about the activities of
taking care of patients, especially saving those patients who have tendencies of falling down
because of the neurodegenerative diseases (Maben, et al. 2016). The care giving strategies are

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different for different age groups. Previously I was not aware about the symptoms of the
different degenerative diseases and also about the fall prevention strategies of the patients
(Burgess et al. 2015). After this activity was completed, the whole concept about the fall
prevention strategies and the neurodegenerative diseases became clear. I also became aware
about the administration of appropriate medicines for the respective diseases and also about the
legal actions required to be taken in case the doctor has already prescribed wrong medicines
(Paull et al. 2015).
Conclusion
Though I have completed the activities effectively but still I think I need to develop and
improve a lot so that I can take care of the patients effectively in future. Firstly I need to work on
my communication skills with the patients as the wrong communication skills hamper the
effective care giving process. The requirements of treatments are different for different persons,
all the requirements of the patients must be known properly by the nurses for providing
appropriate care. Regarding the activities of blood transfusion, though I have gained much
knowledge about the matters that are related with the blood transfusion activities but still I need
more training and practices for becoming more efficient in the activities of blood transfusion and
different conditions that need to be considered about the blood transfusion activities. Also I need
to know about the administration of different medicines according to the diseases. If I overcome
all these, I will successfully take care of patients.

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References
Bagheri-Nesami, M., Esmaeili, R. and Tajari, M., 2015. Intravenous medication administration
errors and their causes in cardiac critical care units in Iran. Materia socio-medica, 27(6), p.442.
Boyle, D.K., Cramer, E., Potter, C. and Staggs, V.S., 2015. Longitudinal association of
registered nurse national nursing specialty certification and patient falls in acute care
hospitals. Nursing Research, 64(4), p.291.
Burgess, N., Strauss, K., Currie, G. and Wood, G., 2015. Organizational ambidexterity and the
hybrid middle manager: The case of patient safety in UK hospitals. Human Resource
Management, 54(S1), pp.s87-s109.
Maben, J., Griffiths, P., Penfold, C., Simon, M., Anderson, J.E., Robert, G., Pizzo, E., Hughes,
J., Murrells, T. and Barlow, J., 2016. One size fits all? Mixed methods evaluation of the impact
of 100% single-room accommodation on staff and patient experience, safety and costs. BMJ
Qual Saf, 25(4), pp.241-256.
Meybohm, P., Herrmann, E., Steinbicker, A.U., Wittmann, M., Gruenewald, M., Fischer, D.,
Baumgarten, G., Renner, J., Van Aken, H.K., Weber, C.F. and Mueller, M.M., 2016. Patient
blood management is associated with a substantial reduction of red blood cell utilization and safe
for patient's outcome. Annals of surgery, 264(2), pp.203-211.
Miller, L.E., Zimmermann, A.K. and Herbert, W.G., 2016. Clinical effectiveness and safety of
powered exoskeleton-assisted walking in patients with spinal cord injury: systematic review with
meta-analysis. Medical devices (Auckland, NZ), 9, p.455.

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Paull, D.E., Mazzia, L.M., Neily, J., Mills, P.D., Turner, J.R., Gunnar, W. and Hemphill, R.,
2015. Errors upstream and downstream to the Universal Protocol associated with wrong surgery
events in the Veterans Health Administration. The American Journal of Surgery, 210(1), pp.6-
13.
Shields, L.E., Wiesner, S., Fulton, J. and Pelletreau, B., 2015. Comprehensive maternal
hemorrhage protocols reduce the use of blood products and improve patient safety. American
journal of obstetrics and gynecology, 212(3), pp.272-280.
Ulas, A., Silay, K., Akinci, S., Dede, D.S., Akinci, M.B., Sendur, M.A., Cubukcu, E., Coskun,
H.S., Degirmenci, M., Utkan, G. and Ozdemir, N., 2015. Medication errors in chemotherapy
preparation and administration: a survey conducted among oncology nurses in Turkey. Asian
Pac J Cancer Prev, 16(5), pp.1699-1705.
Yazer, M.H., Jackson, B., Sperry, J.L., Alarcon, L., Triulzi, D.J. and Murdock, A.D., 2016.
Initial safety and feasibility of cold-stored uncrossmatched whole blood transfusion in civilian
trauma patients. Journal of Trauma and Acute Care Surgery, 81(1), pp.21-26.