Bachelor of Nursing: Clinical Reflection on NSQHS Standards

This nursing assignment is a reflective report detailing a nursing student's clinical experiences and their connection to two National Safety and Quality Health Service (NSQHS) standards: medication safety and preventing and controlling healthcare-associated infections. The student recounts two significant incidents: an overdose of Panadol due to a medication error and an encounter with a patient exhibiting symptoms of Clostridium difficile. The reflection analyzes these experiences, evaluating the importance of adhering to the 'five rights of medication administration' and NSQHS standards for patient safety. The student discusses feelings, evaluations, and analysis of the incidents, emphasizing the role of nurses in ensuring patient safety through proper documentation, medication reviews, and infection control protocols. The report includes an action plan for improvement, highlighting the need for ongoing training, adherence to hospital protocols, and the importance of maintaining a clean and safe environment. The student supports their reflections with evidence-based literature, demonstrating a critical understanding of the issues and a commitment to professional development and patient safety.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student
Name of the university
Author’s note

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In this paper, I will reflect on my two clinical experience and will link them to two NSQSH
standard, preventing and controlling health care associated infection standard and
Medication safety standard.
Description
At the time of my placement, I was working under one of the registered nurse in a clinical
settings. While I was checking the vital signs of a certain patient, he informed that he was having
terrible headache since morning. Checking the medical chart, I found that the patient was on
PRN Panadol and there had been an overdose of Panadol. The normal dosage of Panadol for this
patient was only the 2g per day, but the patient had received an over dosage of the medicine.
Feelings
I was perplexed and worried as, I had knowledge, that over dosage of Panadol might lead
to serious adverse effects lie vomiting, nauseas, hepatic encephalopathy and in severe cases
might cause permanent liver damage causing mortality in the patient.
Evaluation
As I evaluated this incident mindfully, I realized the importance of following “five rights
of medication administration and why National safety and Quality Health service standards had
set the `medication safety standards to be followed by the nurses (Australian Commission on
Safety and Quality in Health Care , 2017). I have realized that the nurses should check the
medications daily and including the PRN dose, route of administration and timing, including the
time and the dosage of the previous administration. By evaluating the incident, I have noticed
that the nurse who committed this mistake was on double shift and was probably fatigued by the

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end of the day. According to Vrbnjak, Denieffe, O’Gorman and Pajnkihar, (2016) chances of
medication administration becomes higher with burnout, fatigue and uneven delegation of the
workload. I personally believe that the nurse could have shared his concern with the other peer
nurses, if she felt stressed out.
Analysis
I have learnt, that nurses should follow the NSQHS standards for a continuous
improvement of their professional standards and to ensure safety of the patient. Nurses are liable
to use safety and quality following the best possible way of documenting the history of the
patient as well as the treatment plan (Australian Commission on Safety and Quality in Health
Care , 2017). The framework had suggested how medication review for patients could be useful
and should be in line with evidence based practices. In order to prevent similar incidents nurses
should cross check the prescription, administration and documentation of each of the medicines
before the administration of the drugs to the patient and before signing the medication chart
(Yung et al., 2017).
Discussion of the incident 2
This part of the reflection is also based upon the placement in an acute ward, where I was on the
morning shift, when a nurse came running for help to manage a patient, who is showing
symptoms of the clostridium difficile. The nurse was perplexed as the patient was a Clostridium
difficile positive. I washed my hands and done my apron and the gloves before entering the
room. After that I assisted the patient to do the toileting activities. After the completion of the
task, I removed the apron and other protection clothing.

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Feelings
Initially, when, I heard about the Clostridium difficile infection, I was nervous and thought
maybe I will not be able to manage this, but I successfully did by following the hospital protocol.
Evaluation
I made an evaluation of the incident and found out that, Clostridium difficile infection
causes severe ailments like diarrhea, which can be dangerous for the other patients already
admitted and are struggling with multiples comorbidities. Hence, as a nurse we should not
compromise with the rules and the norms of infection control. Nurses should follow by the rules
set by NSQHS, for infection control, like isolating the patients and making precautions or them
to be applied in a daily basis for preventing hospital acquired infection. In order to manage
patients with such infectious conditions, some of the rules that can be adhered are- Maintaining
five moments of hand hygiene, use of the personal protective equipment and maintaining a clean
hospital environment (Dekker et al., 2016).
Action plan for these two incidents
After these two incidents, I have realized that nurses should take up training for
becoming updated about the current practices of infection control and medication administration.
Medication administration and maintaining a clean environment is an important performance
indicator of both the healthcare professionals and the health care organization. Nurses should
take up special classes or training to become confident and competent to perform safe medication
practices (Yung et al., 2017). Nurses should be able to follow the five rights of medication
administration as well as the pharmacokinetics of the drugs as well as their contraindications.
Nurses should be competent enough to assess the risk of the infections and use transmission

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based precautions on the basis of the risks of transmission of the infectious agents (Australian
Commission on Safety and Quality in Health Care , 2017). I believe that the nurses should be
acquainted with the standard protocols for hospital acquired infections. Proper protocols for hand
hygiene like “five moments of hand hygiene has to be maintained (Weston, Burgess & Roberts,
2016). Aseptic conditions should be strictly maintained while performing some invasive
procedures. I strongly believe that it is the duty of the health care organization to assess the
competence of the workforce. In case the nurses are not trained enough, proper training can be
given to them for addressing the gaps in the competency (Jeong, et al., 2017). Nurses should also
look upon the following things like proper sterilization of invasive equipment. Lastly, feedback
and self-reflection can be an effective measure for rectifying the mistakes.

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References
Australian Commission on Safety and Quality in Health Care , (2017) .National Safety and
Quality Health Service Standards. Access date: 21.8,2019. Retrieved from:
https://www.safetyandquality.gov.au/sites/default/files/migrated/National-Safety-and-
Quality-Health-Service-Standards-second-edition.pdf
Dekker, M., Jongerden, I. P., van Mansfeld, R., Ket, J. C., van der Werff, S. D., Vandenbroucke-
Grauls, C. M., & de Bruijne, M. C. (2019). Infection control link nurses in acute care
hospitals: a scoping review. Antimicrobial Resistance & Infection Control, 8(1), 20.
Jeong, S. Y., Lee, J. Y., Kim, S. R., Shin, M. J., Lee, S. E., & Kim, O. S. (2016). Development
and implementation of an education program for novice infection control nurses. Korean
journal of nosocomial infection control, 21(1), 18-30.
Vrbnjak, D., Denieffe, S., O’Gorman, C., & Pajnkihar, M. (2016). Barriers to reporting
medication errors and near misses among nurses: A systematic review. International
journal of nursing studies, 63, 162-178.
Weston, D., Burgess, A., & Roberts, S. (2016). Infection Prevention and Control at a Glance.
John Wiley & Sons.
Yung, H. P., Yu, S., Chu, C., Hou, I. C., & Tang, F. I. (2016). Nurses’ attitudes and perceived
barriers to the reporting of medication administration errors. Journal of nursing
management, 24(5), 580-588.