401007: Approaches to Professional Nursing Practice Essay

This essay critically reflects on a case of nursing negligence involving the intravenous administration of crushed oral medication, which resulted in a patient's death. The essay discusses the incident, its consequences, and the ethical implications, citing references to nursing ethics of beneficence and non-maleficence. It explores the importance of medication safety, proper documentation, and adherence to nursing standards to prevent similar incidents. The author reflects on the application of ethical limitations, the importance of awareness, and plans for improvement in practice, including communication with supervisors and maintaining proper documentation. The essay highlights the gaps in care and emphasizes the need for nurses to exercise greater caution in medication administration, referencing various standards implemented to improve the quality of care in healthcare settings.

Running head: NURSING
NURSING
Name of the student
Name of the University
Author Note

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Introduction- Critical reflection has become an important part in the nursing practice.
Administering medication via wrong route is one of the major contributors of death in
hospitals. According to Abs.gov.au, 2019, it is found to be the cause of death for more than a
half million people in Australia. All the professionals in the healthcare industry thus should
be equally skilled in order to provide best quality treatment to patients. There is no confusion
that critical reflection is a useful skill that helps to empower the nurses. Thus this essay
focuses on such a nursing negligence that led to death of the patient.
Discussion- description of the incident- Medical malpractice can be occurred due to
numerous reasons. In Australia there are many evidences that caused the death of the patient
due to medical negligence (Mulheron, 2016). An unfortunate incident took place in St.
George Hospital in the year 2009. A patient named Mrs. Anderson was admitted in the
hospital due to nausea, vomiting, infection in urinary tract, angina as well as dehydration.
The nurse named Ms. Lopez crushed the oral tablets and administered them intravenously.
Therefore, as a result of this the grandmother suffered from severe pain in her arm as well as
wrist (Bibby, 2019). This incident thus led to a worse consequence for the nurse as well as for
the patient.
Consequence of this incident- The immediate result of such wrong administration of
medicine was reported to be death of Mrs. Anderson. Her case taken as the case of criminal
negligence and she was not found guilty (Ryll, 2015). He tried to safeguard herself by stating
that the patient was having swallowing issue and that is the reason she chose for intravenous
route of administration. However, the post-mortem report defended her as it clearly portrays
that there were foreign particles found in the blood of the patient’s body which blocked her
oxygenation and finally resulted in heart attack. Citing from references of nursing ethics of
beneficence as well as non-maleficence, it can be concluded that they should be do their best
without causing harm to their patient. Hence, Ms Lopez was subjected to ethical

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confrontation of beneficence as well as non- beneficence in which she did not succeed to
balance the risk factors against all the benefits. However, this incident only had negative
consequence both for the patient as well as to the nurse. However, there should be some
implementations in the nursing practice in order to improve their learning and avoid
reoccurrence of such incidents.
Nursing action description and improvement- Medications are the most important
form of treatment in healthcare. They are used in order to provide relieve to patients and also
prevent or cure illness. They should be administered in the way they are prescribed into.
Wrong administration may arise into difficult situation which is hard to handle. They should
be provided with proper teaching about the importance of specific route of administration and
the reason why a particular drug can only be administered through the assigned route.
According to the case study, Ms. Lopez did obey the 7 rights of medication administration.
Insufficient documentation makes it difficult for the patient in order to cope with the
medicine provided (Booth et al. 2016).
Many clinical mangers are implementing various standards in order to reduce such
medication incidents and hence improve the safety as well as quality of usage of medicines
(Shahrokhi et al., 2013). Many standards like the National Recommendations for User-
applied Labelling of Injectable Medicines, Fluids and Lines; National Tallman Lettering List;
Medication Safety Alerts and many more were introduced in order to improve the medicines
use (Safetyandquality.gov.au., 2019). According to medication safety standard, proper
documentation is one of the main implementations that should be done in order to decrease
such incidents. The organisation should support and help in safety promotion for procuring,
supplying, storing, compounding and dispensing the effects of a particular medicine. All
patients’ medications should be reviewed daily and appropriate information regarding each
medication should be conveyed to the nurses as well as to the patients (Adhikari, et al., 2014).

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The nurses should be trained as per the guidelines of Nursing and Midwifery Board of
Australia (NMBA) and only registered nurses with NMBA registration should be appointed
in the hospitals. It was also stated by Nursing and Midwifery Board of Australia (2016) that
the nurses should engage themselves in cultural awareness practices. Another implementation
that ight be helpful in order to reduce the risk of medication errors in emergency unit is by
appointing emergency-medicine clinical pharmacists (Weant, Bailey & Baker, 2014). All
these improvements should be done in the healthcare in order to provide quality care to
patients and decrease the amount of such incidents (Ralph, Birks & Chapman, 2015).
Rolfe et al’s reflective model of reflection- Based on all the evidences provided it can
be easily concluded that medical negligence is prominent in the case scenario. It is beyond
my expectation that being a registered nurse, Ms. Lopez would commit such a careless act.
She should have known the outcomes of administration of medication via wrong route.
Hence, from the above case study I learned the application of ethical limitations while
one is administering a medicine. I understood the importance of being aware while
administering the medicines to patients.
Now, my plan is to communicate with my supervisor and maintain proper
documentation of how to administer medication. I had also planned to keep my eye on the
vital signs for better understanding of the impact that was created by the wrong
administration.
Conclusion- Medicines are the important form of treatment in the healthcare industry.
The above case study provided with a clear image about the gaps in care. The nurses should
be more careful on administering medications to patients or otherwise will face the same
condition which is faced by Ms. Lopez when she administered oral medicines intravenously

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to Mrs. Anderson. Various standards are implemented by clinicians and nursing practice in
order to bring a change and improve the quality of care.

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References
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disciplinary approach to medication safety and the implication for nursing education
and practice. Nurse education today, 34(2), 185-190.
https://doi.org/10.1016/j.nedt.2013.10.008
Bibby, P. (2019). Sydney grandmother who died after nurse's error was already 'at death's
door', court hears. Retrieved 27 July 2019, from
https://www.smh.com.au/national/sydney-grandmother-who-died-after-nurses-error-
was-already-at-deaths-door-court-hears-20150222-13lim1.html
Booth, R. G., Sinclair, B., Strudwick, G., Hall, J., Tong, J., Loggie, B., & Chan, R. (2017).
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Mulheron, R. (2016). Medical negligence: non-patient and third party claims. Routledge.
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Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice.
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Safetyandquality.gov.au. (2019). Retrieved 27 July 2019, from
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