Gibbs Reflection on Safe Administration of IV Medication: HNB2205

This report presents a Gibbs reflection on a student's experience administering intravenous (IV) Flucloxacillin. The student, a nursing professional, utilized the Gibbs reflective cycle to analyze the experience, detailing the process from patient introduction to post-administration care. The report describes the steps taken, including hand hygiene, patient identification, medication checks, and administration techniques. The student reflects on feelings of nervousness and excitement, and identifies both successes and errors, such as overlooking cannula site checks and failing to obtain verbal consent. The evaluation section assesses what went well (patient engagement, medication rights) and areas for improvement. Analysis attributes errors to nervousness and lack of practical experience, highlighting the need for skill enhancement and focus. The conclusion emphasizes the importance of safe IV medication administration and the student's commitment to improvement through workshops, feedback, and online resources. The action plan focuses on addressing weaknesses in focus, documentation, and consent, and building on strengths in compassion and patient engagement.

Running head: GIBBS REFLECTION ON SAFE ADMINISTRATION OF MEDICATION
Gibbs reflection on Safe Administration of medication
Name of the student:
Name of the university:
Author note:

1
GIBBS REFLECTION ON SAFE ADMINISTRATION OF MEDICATION
Introduction:
One of the greatest challenges for the nursing professionals to overcome while providing
care to the patients is the safe and effective administration of medication. As mentioned by
Roughead, Semple and Rosenfeld (2016), the medical errors have been recognized as the leading
public health issue which is attributed to add 25% of health care associated accidents in the
Australian health care system. However, among the various different types of medication errors
that are prevalent in the health care scenario, by far the most prevalent one can be considered
administering the intravenous (IV) medication (Maaskant et al., 2015). Administering IV
medications require advanced skill set and competencies due to the complicated and meticulous
procedure associated with the entire procedure of administering intravenous medication to the
patients (Parry, Barriball & While, 2015). Hence, it is very important for the nurses to develop
skill set sufficient for adequate intravenous medication administration. This essay will attempt to
explore my personal experience of administering IV Flucloxacillin to a patient taking the aid of
Gibbs reflection cycle.
Description:
I had been given the opportunity to administer Flucloxacillin via the IV route to a patient
and my course of action for this activity began with introducing myself to the patient. Then, as
per the standard guidelines, I carried out the five moments of hand hygiene all the while
engaging in small talk with the patient in to develop a therapeutic connection and build an easy
rapport. Followed by which I carried out identification check for the drug, by matching the drug
name with the prescription chart and the label of the container and also its expiry date
(Kemh.health.wa.gov.au, 2018). Then I ensured the patient is right for this administration
matching the name and medical record number prior to administration, along with any

2
GIBBS REFLECTION ON SAFE ADMINISTRATION OF MEDICATION
possibilities allergy or hypersensitivity to the drug components. The next three rights to be
checked is right time, right dose and right route which I completed next, although I also
confirmed with the buddy nurse before commencing with anything. I commenced with safely
preparing the medication dosage following the ANTT technique and reconstituted the medication
safely. Although, in the excitement of the entire experience I overlooked the aspect of checking
the probability of phlebitis the need for checking of the cannula site which is very important to
avoid the risk of the patient obtaining phlebitis or any pertinent infections. However, the buddy
nurse reminded me immediately carried it out effectively. The last task for me had been to
discard the sharps safely and adequately which I carried out and then educated the patient
regarding the medicine administered and what can be expected as adverse reactions and how to
communicate if experiencing and adverse reaction out of the norm before leaving the room.
Feelings:
First and foremost, I would like to add in this context that this had been an extremely
helpful experience for me to administer intravenous medication, which is the one of the most
challenging role of a practicing registered nurse. This had been my first experience of
administering intravenous medication on my own to a patient in the real clinical setting and I had
been extremely nervous while administering the medication and even my hands had been
shaking a little. Although, I tried my best to not let my nervousness and excitement cloud my
clinical decision making and medication administering skills and I attempted to invest complete
attention and dedication to the tasks I had to complete as per the basic standards of administering
intravenous medication safely. Although I did commit two unintentional errors while completing
the entire activity. First and foremost, I completely forgot to check the cannula site for
competency and possibility of phlebitis about which I was reminded by my buddy nurse.

3
GIBBS REFLECTION ON SAFE ADMINISTRATION OF MEDICATION
Another mistake I committed due to my nervousness and the hurriedness to complete the activity
within the given time had been missing out explaining the patient the need for administering the
medication and taking verbal consent to the process.
Evaluation:
The evaluation section of the Gibbs reflective framework allows the nursing professional
to revisit the entire experience in acute details and explore all the positive and negative aspects of
the experience, recognizing what worked and did not work in the activity (Husebø, O'Regan &
Nestel, 2015). I believe that although I have made certain errors while engaging in this extremely
helpful activity, I had been correct in the majority of the tasks that are needed to be completed by
the nurse administering IV medication. Hence, there are a lot of aspects that worked and had
been correctly carried out with respect to the present standards and guidelines of administering
IV medication to the patients (Lenz et al., 2017). For instance, patient introduction and engaging
with patient before actually carrying out any care activity is a very important aspect of care
delivery which I had correctly demonstrated, it not only helps in developing an adequate
therapeutic connection with the patient but also helps in calming and comforting a patient
(Safetyandquality.gov.au, 2018). The five rights of medication administration is another integral
element of safe medication administration guidelines which I have also carried out effectively
and efficiently. The timely administration of five moments of hand hygiene along with infection
control is one of basic requirements which is needed to be followed by all health care
professionals across the globe, which I believe I carried out effectively as well.
However, there are certain errors made by me as well, which could have led to
considerable negative outcomes for the patient. First and foremost, I missed out on taking verbal
consent from the patient by explaining the need for administering the medication and along with

4
GIBBS REFLECTION ON SAFE ADMINISTRATION OF MEDICATION
that I missed out on checking the cannula site for phlebitis as well. Another mistake which can
be considered as a mistake on my part is missing out on documenting the experience adequately
and spontaneously where my buddy nurse had to remind me more than once to document certain
details of the activity. Hence, these represent certain incompetence with respect to my
professional skills and there is need for improvement in certain skills to be able to carry out
professional growth and be able to provide safe, effective and patient centred care to the patients.
Analysis:
While analysing the errors made by me, I believe the nervousness and excitement of
carrying out the entire activity had been the primary contributor to my errors. As mentioned by
the Shahrokhi, Ebrahimpour and Ghodousi (2013), nervousness stemmed from the insufficient
work experience of the nurses and the huge gap in the theoretical learning and knowledge with
respect to practical application in the correct manner is a considerable contributing factors
leading to errors in practice, especially the medical errors. Although, it is inevitable for the
nurses that are transitioning into practice to be nervous, there is need for skill advancement to be
able to overcome the impact of nervousness and excitement leading to considerable errors. The
lack of applicative educational experience is another reason behind the extent of errors of the
transitioning nurses, hence the need for more application based education setting rather than
focusing mostly on theory is conspicuous (Parry, Barriball & While, 2015).
However, the errors that I had made can also been attributed to being distracted by the
chaotic activity and noise in the background which is also a prominent factor that leads t
medication errors in clinical settings. In such case, there is need for effort and skill enhancement
to enhance focus and attention of nurses while in practice so that they are not easily distracted by
the noise or any other form of distractive activities going on in the clinical setting. Lastly, not

5
GIBBS REFLECTION ON SAFE ADMINISTRATION OF MEDICATION
properly documenting the medication administration and not checking the cannula site for
phlebitis are errors that not only hint at incompetency but can potentially harm the patient.
Furthermore, phlebitis is a concern which leads to even pulmonary embolism in certain cases and
can be life threatening if adequate care is not taken (Dunda et al., 2015). Hence, needless to say,
it is very important for nurses to employ utmost dedication and follow a set protocol effectively
while administering the IV medication to ensure not harming the patient. Hence, I will require to
invest efforts to rectify my lack of skills that led me to commit to the unsafe practice.
Conclusion:
On a concluding note, administering intravenous medication is indisputably the sector of
professional responsibilities where the nurses commit the most mistakes, and unfortunately I also
committed certain mistakes which could have potentially harmed or disrespected the patient.
This had been an excellent opportunity for me to understand my strengths and weaknesses with
respect to this professional practice and I will be taking adequate efforts based on this knowledge
to improve my skills and competency as a practicing nurse.
Action plan:
First and foremost, attention, dedication, focus and being able to conquer nervousness
had been one of the greatest challenges and weaknesses that I discovered from my practice.
Hence I will be enrolling in different professional practice workshops to build on the mentioned
skills to strengthen my professional competencies. Along with that, I will also reach out to my
supervisor for feedback and suggestions so as to how I can improve my skills and be able to
attain the competencies that I am lacking. I will also take the aid of online courses and webinars
to enhance my knowledge or documentation and patient consent. I discovered compassion,

6
GIBBS REFLECTION ON SAFE ADMINISTRATION OF MEDICATION
empathy and patient engagement to be my strengths, I will be taking additional efforts to further
improve these skills as well to build on to my strength (Bengtsson & Carlson, 2015).

7
GIBBS REFLECTION ON SAFE ADMINISTRATION OF MEDICATION
References:
Bengtsson, M., & Carlson, E. (2015). Knowledge and skills needed to improve as preceptor:
development of a continuous professional development course–a qualitative study part
I. BMC nursing, 14(1), 51.
Dunda, S. E., Demir, E., Mefful, O. J., Grieb, G., Bozkurt, A., & Pallua, N. (2015). Management,
clinical outcomes, and complications of acute cannula-related peripheral vein phlebitis of
the upper extremity: A retrospective study. Phlebology, 30(6), 381-388.
Husebø, S. E., O'Regan, S., & Nestel, D. (2015). Reflective practice and its role in
simulation. Clinical Simulation in Nursing, 11(8), 368-375.
Kemh.health.wa.gov.au. (2018). Intravenous Medicines – Checking and the Administration.
[online] Available at:
https://www.kemh.health.wa.gov.au/~/media/Files/Hospitals/WNHS/For%20health
%20professionals/Clinical%20guidelines/Pharmacy/guidelines/Checking%20and
%20Administration%20of%20Intravenous%20Medications.pdf [Accessed 12 Sep. 2018].
Lenz, J. R., Degnan, D. D., Hertig, J. B., & Stevenson, J. G. (2017). A Review of Best Practices
for Intravenous Push Medication Administration. Journal of Infusion Nursing, 40(6),
354-358.
Maaskant, J. M., Vermeulen, H., Apampa, B., Fernando, B., Ghaleb, M. A., Neubert, A., ... &
Soe, A. (2015). Interventions for reducing medication errors in children in
hospital. Cochrane Database of Systematic Reviews, (3).

8
GIBBS REFLECTION ON SAFE ADMINISTRATION OF MEDICATION
Orbæk, J., Gaard, M., Fabricius, P., Lefevre, R. S., & Møller, T. (2015). Patient safety and
technology-driven medication–A qualitative study on how graduate nursing students
navigate through complex medication administration. Nurse education in practice, 15(3),
203-211.
Parry, A. M., Barriball, K. L., & While, A. E. (2015). Factors contributing to Registered Nurse
medication administration error: A narrative review. International journal of nursing
studies, 52(1), 403-420.
Pendleton, D. (2018). Australia joins international push to halve medication errors | Safety and
Quality. [online] Safetyandquality.gov.au. Available at:
https://www.safetyandquality.gov.au/media_releases/australia-joins-international-push-
to-halve-medication-errors/ [Accessed 12 Sep. 2018].
Roughead, E. E., Semple, S. J., & Rosenfeld, E. (2016). The extent of medication errors and
adverse drug reactions throughout the patient journey in acute care in
Australia. International journal of evidence-based healthcare, 14(3-4), 113-122.
Shahrokhi, A., Ebrahimpour, F., & Ghodousi, A. (2013). Factors effective on medication errors:
A nursing view. Journal of research in pharmacy practice, 2(1), 18.
Standard 4: Medication Safety. (2018). Retrieved from https://www.safetyandquality.gov.au/wp-
content/uploads/2012/10/Standard4_Oct_2012_WEB.pdf