Patient Safety and Clinical Quality: A Reflection on Nursing Practice

This essay provides a nursing reflection on key patient safety activities, including medication safety, blood safety, and fall prevention. It details the feelings, evaluations, and analyses associated with these practices, highlighting both positive and negative experiences. The reflection covers the importance of accurate medication dosage, proper blood transfusion procedures, and strategies for preventing falls in a clinical setting. The essay concludes with an action plan for continued development of awareness and adherence to safety protocols, emphasizing the core values of openness, respect, and empowerment in nursing practice. The student reflects on applying knowledge from professionals and awareness in blood transfusing services and practices. Furthermore, the essay emphasizes the importance of ongoing education and adherence to health policies to enhance patient safety and clinical quality, mentioning resources like NSW Health Policy.

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Nursing reflection
Essay
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1/18/2019

Nursing reflection 1
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Description:
The activities performed in the nursing for the medication safety and blood safety is to
provide right amount of dosage of medication to the right patient in a particular time. The
blood safety activity is done by administrating in less than four hours. Registered nurses and
licensed nurses are only allowed to maintain or monitor blood transfusion. Fall and injury
prevention is still a challenge considered by the care unit around the world. Medical errors
occurs due to failure of planned action to be completed as intended that is error of execution
or the use of wrong plan to achieve an aim also known as error of planning (Posey et al.,
2011).
Feelings:
Medication safety is essential for every patient as well as nurses. If the medication dosage is
not correct or the timing of giving the medication is not right a patient may be harmed. At
first, I was feeling restless during medication and blood safety but with my knowledge and
skills everything started to look easy. Blood transfusion is a common procedure done by the
nurses where blood is given to the patient through an intravenous line in the blood vessels.
Being a nurse, I was focused in the details required for blood safety. The important safety
rules about blood transfusion are giving required blood group to the right patient. Checking
the donor’s blood so that blood contamination does not takes place and patient does not get
harm by blood transfusion (Duric, 2017). Checking every donor’s blood and checking on
right dosage and other safety measures is essential part of being a nurse.
Evaluation and analysis:
Positive impact from this experience was that I learned medication safety, blood safety and to
prevent falls. The activities practiced for medication safety had positive outcome such as

Nursing reflection 2
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giving accurate amount of medication to the right patient. In addition, checking on the basic
medication details before giving the medication such as expire date, name of the drug or
unauthorised medication administration(Medhi et al., 2014). Dosage and time are important
safety measure to practice. By this activity, I learned to check the medication measures before
giving the medication to a particular patient.
From the activities nurses also started to ensure the safe environment by reducing
distractions, improving lighting, and minimizing noises levels. The area where nurses prepare
medications have accurate amount of lighting and a silent atmosphere. In addition, to
improve safety measures the medication room now have one medication dispensing system in
the care unit (Kowiatek, 2011).
The blood safety included activities such as testing the donor’s blood before donating to the
patient. Contaminated blood is harmful for anyone. Blood transfusion is a risky process.
Infections are one of the main risks that are faced by the patients. Transfusion reactions and
other non-infectious problems can be faced by the patients (NIH, 2016). Hence, from this
activity I applied the knowledge of following the blood safety measure effectively.
The other blood safety measure required in transfusion of blood is to meet the specific
requirements of the patient’s blood component. Nurses play a significant role in correct,
scientific, and safe usage of blood and its components and by evaluating all the roles make
the blood transfusion risk reduced to a minimum level(PSQH, 2018). In nursing practice, I
used my knowledge provided by the professionals and awareness while blood transfusing
services and practices.
Falls occur frequently in medical practice. Thus, medication and blood safety is essential in
nursing field. There are three different types of inpatient falls such as accidental falls,

Nursing reflection 3
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anticipated physiological falls and unanticipated physiological falls. The common falls in
nursing practice in medication safety is psychoactive medications. These kinds of
medications have a tendency to be painkillers, modify the sensorial, and weaken balance and
gait(Organization, 2018). A key scheme is to decrease the dosage of any indicated medication
that adds fall risk and to decrease and stop any medications that are no longer indicated.
The negative experience about the medication safety is that a clinic contain a huge amount of
patients and as a new nurse sometimes I get confuse as some patient have same kind of
medication with different dosage or time interval. In blood safety, the negative experience I
have faced as a nurse is the transfusion effects a patient faces after blood transfusion. A
patient’s safety can be improved by observing the patient’s physical or internal reactions
towards the new blood (Hill, 2010).
The hazard of being a nurse and working can impair health both acutely and in long term.
These health issues includes, fall and injuries, infections or mental health problems and many
more. The major problem I faced was when lifting a patient if injured which includes
awkward postures or any kind of physical demand. Another negative experience faced by me
was long shift hours in case of emergency injuries. Working continuously without getting
enough sleep gives stress and makes me tired of my work.
Conclusion:
From this essay, I have learned about three patient safeties that are medication, blood and fall.
The clinical quality is focused on the safety activities in the care unit. Some of the basic
medication safety is to use accurate dose of drugs and to check before giving the drug to the
right patient. Medication giving in the wrong time can also make a big difference and it can
harm the patient. Being a nurse, I have used my knowledge and skills in managing the safe

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environment and gone through every precaution before giving the exact amount of dose to the
patient.
The blood safety is another activity to be concerned about in the nursing practice. I have
learned the basic blood transfusion safety and used my knowledge and skills to practice blood
safety rules on the patients as well as donors. The basic rules are to check the donor’s blood
group, haemoglobin level, or checking if the donor has contaminated blood or not. I have to
improve the knowledge of using blood transfusion at different places such as in surgeries or
any other medication emergency.
Falls or injuries is common, from the above activities I have realised that falls have high risk
in the clinical care unit. To prevent fall risk I have learned some basic prevention methods
such as checking on the patient in intervals, providing safety companions, keeping the patient
busy and setting bed alarms. I have improved my knowledge and skills and exercised it well
in the care unit.
Action plan:
From the safety awareness activities, I have learned to maintain the safety rules and follow it.
I need to develop confidence while I work for example; I need to focus on one patient at a
time. I have to increase my understanding and communication level with the patients. I will
read the NSW health policy and apply the core values of the policy in the nursing practice.
The core values of NSW health is openness towards the patient and their respective families,
in addition with respect and empowerment (NSW, 2016).
The three specific actions to continue to develop my awareness of patient safety are:
 To follow the basic medication safety rules before giving the patient their medications
such as checking the name of the drug, expire date, dosage, time of giving the drug,

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and giving to the right patient. Awareness can be also developed by maintaining
silence to work properly and check on the patient’s.
 To develop my awareness in blood safety I need to run blood tests accurately and
check it twice before blood transfusion with the help of professionals.
 To develop awareness in fall and injuries the patient’s must take his/her
responsibility. Other than that, it being a nurse I try to prevent any kind of fall risk in
the health care unit (Bremdal et al., 2016).
References:
Bremdal, A., Olofsen, H. & Danielsen, A., 2016. Increasing fall risk awareness using
wearables: A fall risk awareness protocol. Journal of Biomedical Informatics, pp.184-94.
Duric, P., 2017. Blood donors’ awareness and attitudes towards bloodtransfusion safety in the
Autonomous Provinceof Vojvodina, Serbia. Transfusion Medicine.
Hill, K.S., 2010. Improving Quality and Patient Safety by Retaining Nursing Expertise.
OJIN, 15.
Kowiatek, J., 2011. Establish a Successful Medication Safety Program. Pharmacy purchasing
and products, 8(10), p.6.
Medhi, B. et al., 2014. A prospective study to evaluate awareness about medication errors
amongst health-care personnel representing North, East, West Regions of India. International
Journal of Applied Basic Medical Research, 4(1), pp.43–46.
NIH, 2016. 2016 Scientific Priorities in Pediatric Transfusion Medicine. [Online] Available
at: https://www.nhlbi.nih.gov/events/2016/2016-scientific-priorities-pediatric-transfusion-
medicine [Accessed 18 january 2019].

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NSW, 2016. NSW Health Policy Directives and Other Policy Documents. [Online] Available
at: https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2016_049.pdf [Accessed
18 january 2019].
Organization, W.H., 2018. Falls. [Online] Available at: https://www.who.int/news-room/fact-
sheets/detail/falls [Accessed 18 january 2019].
Posey, L.M. et al., 2011. Chapter 5. Principles and Practices of Medication Safety. In
Pharmacotherapy: A Pathophysiologic Approach. 8th ed. China: McGraw-Hill Education.
PSQH, 2018. CAN NURSES LOOK FORWARD TO NEEDLE-FREE BLOOD DRAWS?
Health Leaders.