Reflection in Professional Nursing Practice: NMBA Standards Analysis

This essay examines the critical importance of reflection, critical thinking, and evidence-based practice in professional nursing. The author analyzes a specific nursing incident where an elderly patient died due to a medication error, highlighting the lack of critical thinking and adherence to standards. The essay emphasizes the need for nurses to engage in personal reflection, evidence-based practice, and collaborative supervision to prevent adverse outcomes. It discusses the consequences of failing to adhere to NMBA and ACQSH standards, including patient death and loss of trust. A nursing action plan is presented, which includes goals aligned with evidence-based care, safety and quality training, and adherence to healthcare record-keeping and medication safety standards. The author reflects on the incident using Rolfe, Freshwater, and Jasper's (2001) reflective model, underscoring the importance of learning from mistakes and implementing preventative measures. The essay concludes by reiterating the significance of critical thinking and reflection in ensuring positive patient outcomes and adherence to professional standards.

Running head: REFLECTION IN PROFESSIONAL NURSING PRACTICE
REFLECTION IN PROFESSIONAL NURSING PRACTICE
Name of the Student:
Name of the University:
Author note:

1REFLECTION IN PROFESSIONAL NURSING PRACTICE
Introduction
Critical reflection, critical thinking and evidence-based paves the way for enlightening
professional nurses on their personal strengths, weaknesses and scope for future improvement.
Important examples of critical thinking and reflection in nursing include usage of
incorporation of evidence-based research and supervision from senior colleagues in nursing
interventions, as recommended by Standards 1 and 2 of the Nursing and Midwifery Board of
Australia (NMBA)
Thesis Statement: Personal reflection and usage of evidence-based practice coupled with
critical thinking, are essential nursing responsibilities and form the crux of ensuring long term,
positive health outcomes and satisfaction across patients and families.
This essay will discuss on importance of critical and the role of a nursing action plan and
personal reflection for future improvement.
Body
Description
An elderly patient of 97, lost her life after a nurse intravenously administered crushed
powders of tablets. Such an incident clearly demonstrates, a lack of evidence based critical
thinking and personal reflection (Bibby, 2019).
The incident occurred, after the elderly patient, was finding it difficult to swallow her oral
medications. This resulted in the accused nurse to powder the medications and injecting it
intravenously. This demonstrates a lack of critical thinking considering that the nurse proceeded

2REFLECTION IN PROFESSIONAL NURSING PRACTICE
with such as act, without any form of supervision or communication (Bibby, 2019). Professional
interpersonal communication must be adhered to obtain a credible second opinion directed at the
best interests of the patient (Snowdon, Leggat & Taylor, 2017). Nurses must also reflect on
their actions since it provides allows for scope for rectification (Pai, Ko, Eng & Yen, 2017).
Thus, this incidence demonstrates the importance of critical thinking and nursing
reflection in the prevention of adverse consequences on patients, families and organizations.
Consequences
Lack of adherence to evidence based practice, critical thinking and reflection by nurses
may result in patient death and loss of trust from the patient’s family.
According to standard 1 of NMBA (2016), nurses must engage in practice which is
critical, evidence based, and person centered and safe, in collaboration with personal reflection.
According to Friesen‐Storms, Moser, van der Loo, Beurskens and Bours, (2015), usage of
reflective evidence based practice results in implementation of nursing interventions which
credible and thus ensures prevention of errors and generates trust, satisfaction and long term
positive outcomes in the patient.
Standards 6 and 7 of the NMBA (2016) instructs nurses to implement nursing
interventions which are safe, of high quality and reciprocating patient outcomes. According to
Miraglia and Asselin (2015), nursing reflection provides scope for revision of care plan and
hence prevents adverse outcomes by ensuring deliverance of safe patient care.
Standard 2 of the NMBA (2016) dictates nurses to engage in practicing interventions
collaboratively. Aligning critical thinking and reflection with collaborative supervision improves

3REFLECTION IN PROFESSIONAL NURSING PRACTICE
interprofessional practices and overall functioning of the concerned healthcare organization
(Schuelke & Barnason, 2017).
Medication Safety Standard 4 of ACQSH (2012) guides health professionals to conduct
medication assessments, prepare medication lists, patient medication history and educate the
patient on the same. This is of special relevance to this incidence and adherence to it could have
prevented adverse medical errors and ensured patient safety.
Thus, the identified NMBA standards clearly demonstrate the importance of critical
thinking, evidence based practice and reflection by nurses which must be incorporated in nursing
action plans.
Nursing Action Plan
According to standard 5 of NMBA (2016), nurses must engage in the development and
implementation of nursing plans in professional practice. According to Harper et al., (2018), a
nursing action plan, assists nurses in the identification and implementation of personal and
professional improvement goals and objectives directed at best standards of patient care.
Nurses must engage in evidence care as per standards of the ACQSH (2017),. A nursing
action plan comprising of nursing goals in alignment with the best available sources of evidence
ensures deliverance of high quality care and holistic recovery (Mackey & Bassendowski, 2017).
The nursing action plan can also comprise of ACQSH (2017) standards of safety and quality
training. It has been evidenced that personal and professional engagement in safety and quality
clinical training programs by nurses paves the way for safe and patient-centered practice in the
future (Ballard et al., 2018). The nursing action plan must also include ACQSH (2017) standards
of healthcare record keeping and Medication Safety Standards (ACQSH, 2012). Hence, to

4REFLECTION IN PROFESSIONAL NURSING PRACTICE
prevent errors, nurses must ensure evaluation of patient health and medication records and
documents prior to implementation of interventions (Lavin, Harper & Barr, 2015). A
professional’s nurses action plans must include adherence to ACQSH (2017) patient safety and
quality standards of procedures and policies. Nursing engaging in patient care policies and
quality standards stipulate by the healthcare organization can ensure strict deliverance of safe,
evidence based care (Ortiz, 2018). Lastly the nursing action plan must be compliant to ethical
practice as per the Code of Ethics by the Iinternational Council of Nurses (ICN, 2012),
Thus, adherence to a nursing action plan comprising of care policies, evidence based
practice, patient documentation and participation in quality training can ensure prevention of
errors and long term positive patient outcomes. For successful nursing actions, such a plan must
be in alignment with personal reflection.
Personal Reflection
The incident prompted me to reflect my feelings associated with it, the relevance of the
situation in my personal life and my future actions to prevent the same, using the reflective
model by Rolfe, Freshwater and Jasper (2001).
Throughout my academic experience, nurses like me have been taught to engage in
critical care based on best evidence and personal reflection. Hence, this incident has prompted
me to ensure personal prevention of such errors in the future.
This incidence taught me that I must engage in nursing interventions which are evidence
based. Evidence based practice has been implicated to guide nurses in delivering patient care
which is safe and effective. This incident has also taught me the importance of reflection.

5REFLECTION IN PROFESSIONAL NURSING PRACTICE
Reflecting on one’s actions will guide nurses like me to identify mistakes and rectify them
promptly considering the needs of the patient (Melnyk et al., 2016).
To prevent such incidences, I must adhere to standards of 1, 6 and 7 of NMBA which
dictate nurses to deliver care which is safe, evidence based and in alignment to patient needs. I
must also adhere to NMBA standard 2 and promptly communicate with my supervisors prior to
administering care for a patient (NMBA, 2016). Further, I must strictly adhere to Standard 4 of
the ACQSH (2012) and strive to administer medications to patients which are safe and in
alignment with a comprehensive medication record.
Conclusion
Thus, this paper demonstrates the importance of nursing critical thinking and reflection.
To conclude, nurses must critically reflect on their actions, and promptly seek for clarification to
obtain credible second opinions.

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