University Nursing: Practice Reflection on Medication Administration

This assignment is a practice reflection by a nursing student on a medication administration incident. The student describes an event where they considered administering medication without proper assessment and reflection, highlighting the importance of adhering to the College of Nurses of Ontario (CNO) Medication Practice Standards. The reflection covers the student's strengths (reflection prior to action) and areas for improvement (adherence to medication precautions, competency, and safety standards). The student also includes peer feedback and identifies learning needs related to entry-to-practice competencies and changes in the practice environment. The student emphasizes the need for organizational support, such as readily available medication handbooks and access to evidence-based information, to enhance safe and patient-centered medication practices. The reflection concludes with references supporting the importance of critical thinking, reflection, and adherence to standards in nursing practice.

Running head: PRACTICE REFLECTION: MEDICATION ADMINISTRATION
PRACTICE REFLECTION: MEDICATION ADMINISTRATION
Name of the Student:
Name of the University:
Author note:

1PRACTICE REFLECTION: MEDICATION ADMINISTRATION
Describe an experience, event or change in your practice or practice setting that was
significant to you.
A major experience which was of significance to me was associated with a patient whom
I had recently adhered to as a new registered nurse in the hospital where I am currently working
in. An 80 year old male patient, with a history of stroke and diabetes, was recently admitted to
the facility upon complaints of chest pain. After two days, he was quite stable and was shifted to
the acute care department, where the nurse practitioner who is supervising me was allocated.
One day, when I was alone reading the patient handover, the concerned patient
complained of feeling feverish with headache. In response, I felt that I attend to the patients
needs with an NSAID like ibuprofen. The patient also had trouble in swallowing, which further
prompted me to administer the same intravenously by crushing the same. However, I reflected
and stopped since I felt that my ideas were not evidence based, as per the Medication Practice
Standards recommended by the College of Nurses of Ontario (College of Nurses of Ontario,
2019). By then, the nurse practitioner arrived and the situation was handled effectively.
Based on what you described above, what were your strengths and what were your areas
for improvement?
One of my major strengths was reflecting prior to be actions. Nursing reflection assists in
identification of one’s limitations, prevention of errors and scope of improvement (Pai, 2016). I
must improve upon adherence to precautions before administering medications not mentioned in
the medication order. I must also improve on competency and safety standards as per the
specified medication standards and administer medications which are safe and evidence based
(College of Nurses of Ontario, 2019).

2PRACTICE REFLECTION: MEDICATION ADMINISTRATION
What input have you received from your peers about your practice?
I was appreciated by my peers on my skills of reflection. However, I was equally rebuked
by the nurse practitioner for not critically thinking prior to administration of a medication.
Critical and evidence based thinking in nursing must be performed to ensure that nursing
interventions which are administered are safe, patient-centered and will ensure the positive
health outcomes (Carvalho et al., 2017). I was also then advised by my peers to check the
patient’s details and medication order prior to administering a medication. Not aligning
medications with a patient’s needs and records is a gross violation of nursing ethical
responsibility and can result in adverse consequences (Härkänen et al., 2015).
Based on your own reflection and the input you received, what are your learning needs?
Based on this reflection, I believe that my practice needs must be centered around ‘entry-
to-practice competencies’ and ‘changes in the practice environment’. In terms of ‘entry-to-
practice competencies’ I must first enlighten myself with the scope of practice formulated by
the College of Nurses of Ontario (College of Nurses of Ontario, 2019). I must also learn to align
my medication practices as per the medication standards postulated by the CNO (College of
Nurses of Ontario, 2019).
In terms of ‘changes in the practice environment’ I believe if the organization can
arrange of a medication handbook or instruction manual beside every patient record, then it will
be helpful for nurses like me to prevent any errors and check prior to administration of any
medications (Fallatah, Laschinger & Read, 2017). Additionally, prior to practice, every new
nurse like me must be enlightened on the patient care practices and policies followed by the
organization, so that nurses can align their interventions in a safe and patient-centered manner

3PRACTICE REFLECTION: MEDICATION ADMINISTRATION
(Härkänen et al., 2015). Lastly, arrangement of accessing evidence based information within the
hospital premises is an innovative environment change which can benefit new nurses like me
when transition to professional practice (Häggman-Laitila, Mattila & Melender, 2016).

4PRACTICE REFLECTION: MEDICATION ADMINISTRATION
Which elements relate to your learning needs?
 Entry-to-practice competencies
 Changes in the practice environment

5PRACTICE REFLECTION: MEDICATION ADMINISTRATION
References
Carvalho, D. P., Azevedo, I. C., Cruz, G. K., Mafra, G. A., Rego, A. L., Vitor, A. F., ... & Júnior,
M. A. F. (2017). Strategies used for the promotion of critical thinking in nursing
undergraduate education: a systematic review. Nurse education today, 57, 103-107.
College of Nurses of Ontario. (2019). Medication Practice Standard. Retrieved 18 August 2019,
from https://www.cno.org/globalassets/docs/prac/41007_medication.pdf.
College of Nurses of Ontario. (2019). Standards & Guidelines. Retrieved 18 August 2019, from
http://www.cno.org/en/learn-about-standards-guidelines/standards-and-guidelines/.
Fallatah, F., Laschinger, H. K., & Read, E. A. (2017). The effects of authentic leadership,
organizational identification, and occupational coping self-efficacy on new graduate
nurses' job turnover intentions in Canada. Nursing outlook, 65(2), 172-183.
Häggman-Laitila, A., Mattila, L. R., & Melender, H. L. (2016). Educational interventions on
evidence-based nursing in clinical practice: a systematic review with qualitative
analysis. Nurse education today, 43, 50-59.
Härkänen, M., Ahonen, J., Kervinen, M., Turunen, H., & Vehviläinen‐Julkunen, K. (2015). The
factors associated with medication errors in adult medical and surgical inpatients: a direct
observation approach with medication record reviews. Scandinavian journal of caring
sciences, 29(2), 297-306.
Pai, H. C. (2016). An integrated model for the effects of self-reflection and clinical experiential
learning on clinical nursing performance in nursing students: A longitudinal study. Nurse
education today, 45, 156-162.