Reflection on Safe Health Practices: Gibbs Reflective Cycle Analysis

This assignment presents a reflective analysis of a nursing student's experience in a medical-surgical ward, focusing on a critical incident involving a diabetic foot ulcer and a lapse in hand hygiene. Utilizing the Gibbs reflective cycle, the student describes the situation, their feelings of embarrassment and guilt, and evaluates the negative consequences of improper hand hygiene, including wound infection. The analysis delves into the transmission of healthcare-associated infections, emphasizing the importance of the five moments of hand hygiene as outlined by the WHO. The student concludes by expressing a commitment to improving hand hygiene skills and knowledge to ensure patient safety and prevent future adverse outcomes. The assignment also includes references to relevant literature supporting the importance of hand hygiene in healthcare settings.

Running head: REFLECTION ON SAFE HEALTH PRACTICES
REFLECTION ON SAFE HEALTH PRACTICES
Name of the student:
Name of the university:
Author note:

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REFLECTION ON SAFE HEALTH PRACTICES
First reflection: Ineffective hand hygiene practice
Introduction:
Gibbs reflective cycle is a framework, which is extensively used by healthcare
professionals to reflect their experiences. This cycle encourages and guides people in thinking
systematically about their experiences that they had during specific situation, event, or activity. It
comprises of six important stages. This assignment would use those six stages to reflect on such
an incident and help to develop meanings, knowledge, and skills from the experience.
Description:
During the time of placement, I had the opportunity of working in a medical-surgical
ward. It was a very busy shift and every nurse was rushing from one patient to another patient for
meeting the care needs. I was also overburdened with work and it seemed to me that I had no
time to breathe as well. However, I understood the urgency of the situations and made up my
mind to try my best to meet the needs of the patient. One of the patients in the ward had diabetic
foot ulcer, which needed to be dressed. I immediately attended her and started changing the
dressing where I failed to maintain proper hand hygiene before changing the wounds. Within two
days, I got the report that his wounds have worsened further with multiple infections. I was
called by me mentor who discussed with me about the unsafe approaches to care and made me
aware not to repeat such actions again.
Feelings:
I felt embarrassed in front of my mentor, as I could not provide care up to his
expectations. I felt upset and disappointed with myself in forgetting to maintain hand hygiene

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while caring for the patient. I also felt guilty thinking of the sufferings and pain that the patient
might have gone through because of my improper care services. At one time, I started feeling
that I am not suitable for this profession as I was exposing patients to more suffering than curing
their healthcare needs. However, I realized that I would need to face my fears and challenges and
overcome them to become an expert nurse.
Evaluation:
The bad aspect of the healthcare procedures that was adopted for the patient was that
proper hand hygiene was not followed which resulted in infection of wounds. Hand hygiene is
considered one of the most significant methods for the prevention of the spread of the infections.
Jones et al. (2017) is of the opinion that germs present on the hands of nursing professionals can
transmit dangerous organisms to the patients. Chassin et al. (2015) has stated that on average,
healthcare providers clan their hands less than half of the times they should do. Data shows that
this poor practice contributes to the spread of healthcare associated infections that have the
ability in affecting 1 in 25 hospital patients on any given day. This not only affects the patients
who have been admitted to the healthcare organization for the treatment of other healthcare
needs but also increases the risk of affecting their own selves and other healthcare professionals
affecting their productivity, their health and increasing absenteeism. Jeong and Kim (2016) had
stated that healthcare associated infections not only increases the suffering of patients who had
been admitted to treat other disorders but also increases their stay in hospital and possibilities of
re-admission as well. This creates huge financial burden on the patients but also on the
healthcare resources of the healthcare organizations. It also results in emotional pain and
suffering on the patient where they tend to lose their trust and respect on the healthcare
professionals (Kingston et al. 2017). This affects the collaboration and cooperation between

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clients and nurses and this negatively affect the adherence of the patients to treatments. Hence, it
could be evaluated from the case scenario that a single step of not following hand hygiene has
series of negative consequences on patient, professionals, and healthcare organizations
(Luangasanatip et al. 2015). The only good part of the incidence is that it taught me that I was
not competent enough to maintain hand hygiene practice and it helped me realize that I need to
work more to develop such skill.
Analysis:
I wanted to analyze the ways (by which not following the hand hygiene practice) resulted
in infection of the wounds of the patient in the work. Literature search helped me realize that
transmission of health care-associated infection might take place through direct and indirect
contacts as well as through air, droplets, and common vehicles (Foote and el-Masri 2016). Out of
them transmission through contaminated hands of healthcare workers are most common as stated
by WHO. WHO has researched and it had found that five steps mainly take place. Organisms
remain present on skin or can be shed into inanimate objects that immediately surround the
patient, which then is transferred into the hands (Castle et al. 2016). Such organisms need to be
capable of surviving on at least for several minutes on hands of the healthcare professionals. The
nursing professionals then forget hand-washing and maintaining hand hygiene. Such
contaminated hands must come in direct contact with the patient or with another inanimate object
that is used by the patient. I realized that the same procedure had happened with me that had
resulted in infection of the wounds of the patient. I learnt that I had to follow the 5 moments of
hand hygiene, which could have prevented the spread of infection to the wounds of the patient.
WHO states that hand hygiene needs to be maintained before touching the patients, before
cleaning and aseptic procedures, after the body fluid exposure, after touching the patient and

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after touching patient surroundings (Reilly et al. 2016). This could have prevented me from
spreading infection to the patients through proper hand hygiene.
Conclusion:
From the experience, I learnt that I needed to develop proper skills of hand hygiene to
provide safe care to the patients. Not following the hand hygiene is associated with increased
negative health outcomes of patients along with mental and financial issues. Even healthcare
organizations lose reputation and suffer from unnecessary expenditures from preventable
infections. Hence, I would be very careful about hand hygiene maintenance in my practices and
work more to develop knowledge and skills for hand hygiene practices.
Action plan:
I would discuss with my mentors so that I can work over his feedbacks about my hand
hygiene skills. It would help me in understanding the areas where I need improvements.
Moreover, I will go through evidence-based articles to adopt the best practices of hand hygiene
to develop the expertise for my future practices.

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References:
Castle, N., Handler, S. and Wagner, L., 2016. Hand hygiene practices reported by nurse aides in
nursing homes. Journal of Applied Gerontology, 35(3), pp.267-285.
Chassin, M.R., Mayer, C. and Nether, K., 2015. Improving hand hygiene at eight hospitals in the
United States by targeting specific causes of noncompliance. The Joint Commission Journal on
Quality and Patient Safety, 41(1), pp.4-12.
Foote, A. and El-Masri, M., 2016. Self-perceived hand hygiene practices among undergraduate
nursing students. Journal of Research in Nursing, 21(1), pp.8-19.
Jeong, S.Y. and Kim, K.M., 2016. Influencing factors on hand hygiene behavior of nursing
students based on theory of planned behavior: A descriptive survey study. Nurse education
today, 36, pp.159-164.
Jones, D., Martello, M., Biron, A. and Lavoie‐Tremblay, M., 2017. A systematic review on the
effectiveness of interventions to improve hand hygiene compliance of nurses in the hospital
setting. Journal of Nursing Scholarship, 49(2), pp.143-152.
Kingston, L.M., O'Connell, N.H. and Dunne, C.P., 2017. Survey of attitudes and practices of
Irish nursing students towards hand hygiene, including handrubbing with alcohol-based hand
rub. Nurse education today, 52, pp.57-62.
Reilly, J.S., Price, L., Lang, S., Robertson, C., Cheater, F., Skinner, K. and Chow, A., 2016. A
pragmatic randomized controlled trial of 6-step vs 3-step hand hygiene technique in acute
hospital care in the United Kingdom. infection control & hospital epidemiology, 37(6), pp.661-
666.

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Luangasanatip, N., Hongsuwan, M., Limmathurotsakul, D., Lubell, Y., Lee, A.S., Harbarth, S.,
Day, N.P., Graves, N. and Cooper, B.S., 2015. Comparative efficacy of interventions to promote
hand hygiene in hospital: systematic review and network meta-analysis. bmj, 351, p.h3728.