Description
I am referring to the incident that occurred as I was placed in the rehabilitation ward. There was an elderly female patient, and I was requested to assist her in taking a bath. I will refer to the patient as Mrs. A to maintain confidentiality. When I proceeded to give care to the patient, she was already sited in a wheelchair. I first introduced myself to the patient and asked her questions, such as if she could bathe herself to assess if she could do it herself. She said yes, but she needed me there in case she needed any help. I helped her stand in the wheelchair and helped her undress. She requested I allow her to proceed with the showering process. For the first minute, she was doing well, and then I heard a falling thud. I dashed in and saw the patient lying on the floor unconscious. I quickly pressed the emergency button, and the emergency team arrived in a few minutes to assist me with the patient.
Feelings
Reflecting on the incident, I felt that I did not act in the best interest as I was supposed. I am supposed to be answerable for my actions in cases of decision-making, giving advice and directives for my practice. I felt that I would have controlled the occurrence of the situation by performing extra patient assessments on their state of health to avoid the fall occurrence.
Evaluation
The doctors and the nurses commended me for taking responsibility for pressing the emergency button that allowed the team to come to the assistance of attending to the patient reasonably, avoiding major injuries and complications to the patient. Unfortunately, the patient suffered from small bruises on her hand and head, but there was no fractured bone injury. Areas of improvement are that I should have done an intensive assessment of the patient’s situation before accepting her request to shower herself.
Analysis
Based on my analysis, the occurrence of the event would have been prevented if the proper evaluation and assessment of the patient’s condition. Proper communication between the patient and the nurses is essential to identify areas of challenge. The occurrence was a mind-opening encounter to me that nurses should be more task-oriented rather than patient-centered (Liu et al., 2022). The welfare and safety of the patients are supposed to be an area of great concern during caregiving. Patient falls common challenges experienced n health and care institutions. The major causes of such accidents are medical conditions, dizziness, and physical conditions such as amputation (Rashid, 2019). Whatever the case, the patient should be prevented by performing appropriate assessments and interventions.
Conclusion
Gibbs’ Reflective Cycle is essential in providing assessments and evaluations for a patient. The process entails six stages of exploring an experience, including; description, feelings, evaluation, analysis, conclusion, and action plan (Li et al., 2020). This reflection is essential to me as it relates to the challenges that can occur if proper measures are not taken during patient care. The patient’s fall would have been prevented, and in this case, the event made me more self-conscious of my necessary interventions when dealing with patients in the course of my career practice.
Action Plan
I will ensure I perform a full and proper patient assessment in the future. I will check their mobility status before allowing them to perform standing or walking activities. I will provide my patients with instructions or equipment to help them prevent falls. If the patient is not safe showering on their own, yet they feel they can, I will communicate with them effectively concerning the situation and make them know them know that their safety is my greatest issue of concern (Meekes et al., 2022). I will also reassure my patient that they will resume showering as soon as they become more stable and not in a position to experience fall incidents.
Gibb’s Reflective Cycle on Medication Error
Description
The incident occurred in the ward that involved a patient aged 75 who had diabetes. The patient needed to be administered insulin at 1 am. Under the supervision of the registered nurse, I was requested to administer 24 units of insulin which I did in the presence of the registered nurse. I checked and administered the units of insulin as instructed. I left for a while, but on returning to the ward to check the patient, I realized the patient’s glucose level had drastically dropped from 15mmol/l to 3.7mmol/l. I immediately informed the registered nurse, and we proceeded to check the medication chart. We realized that we had administered 24 units of insulin to the patient instead of 2.4 units.
Feelings
The occurrence of the event was greatly disturbing and depressing to me because of the medication error. The event made me realize how important it is to double-check the medication chart before administering it (Mazhar et al., 2018). At one point, I felt greatly disappointed by the supervising registered nurse, and I realized that I had a greater responsibility to ensure that the medication error did not happen. Medication errors related to insulin administration would result in serious consequences and I felt that the related event would have been life-threatening to the patient.
Evaluation
On evaluating the incident, I would say what went well is that the challenge was experienced under the supervision of the registered nurse; hence I would not take the entire fault for the event. Additionally, after realizing the mistake, I immediately informed the registered nurse that the patient had been checked in time to prevent dire consequences. What went wrong was that the patient suffered the effect of the medical error. According to Di Simone et al., (2018), reading the medication chart incorrectly or making medication errors increases the chances of morbidity and mortality in parents. The event of overdosing the patient with insulin was a bad experience that would have resulted in major complications.
Analysis
Analyzing the event shows that accuracy is essential while administering insulin to diabetes patients. Correct procedures should be carried out while performing medicine administration. The incident occurred due to the incorrect checking of the medication chart to ensure the appropriate amount of medication was given to the patient. Medication errors frequently occur due to knowledge deficiency, lack of proper checking of dose, or distractions (Schroers et al 2021). Other challenges of medication error may occur due to communication challenges.
Conclusion
The administration of the right medication to patients is of great significance. Administration of the wrong insulin dose may adversely affect the patient. Proper checking of the medication chart is essential to ensure the right dosage amount is administered to the patient (Kuitunen et al., 2021). Nurses must double-check the dose before administration, even when they feel confident about it (Schroers et al., 2022). Procedures and healthcare policies demand nurses to read medication orders keenly, and sticking to these policies may prevent medication errors.
Action Plan
In the future, I will always remember the importance of administering the right dose to the patient to avoid the consequences of making medication errors. I will keep the competence standards required to give quality care to my patients. When administering medication, I will ensure I double-check the medication chart and the dose to ensure high levels of accuracy in the administration process. I will also ensure I create awareness among my fellow colleagues on the importance of administering the right dose to avoid medication errors.
Gibb’s Reflective Cycle on Wound Dressing
Description
At an event in my placement during my first year, I was working under the supervision of my mentor in the care of an eighty-five-year-old Mr. X, who had undergone leg surgery. I had been requested to remove the wound dressing so the doctor could assess how the wound was healing. I used a non-touch procedure to remove the dressing and clean the wound. The doctor had been examining another patient’s wound, and when he came, I realized that he had come straight to Mr. X without using alcohol gel or washing their hands. I also noticed that the doctor was wearing a long-sleeved sweater, and I was concerned that the cuffs might be contaminated. I thought for a moment of asking, but by the time I gathered enough courage, the doctor had already examined Mr. X; hence it was too late.
Feelings
I felt alarmed due to this event as I had expected the doctor to undertake hygiene measures during patient care. However, I felt intimidated as the doctor had more experience than I had, and I was worried and did not want to embarrass him. I consequently did not want the patient to be concerned if I confronted the doctor. Later, I spoke to my supervisor concerning the incident, and she suggested we speak to the doctor together. My mentor called the doctor’s site and enquired about her hand-washing practice. The doctor looked shocked and admitted that he had been very busy and had not thought about it. My mentor discussed with the doctor the importance of not ignoring such simple but important care procedures, and the doctor assured her that the incident would not happen again.
Evaluation
The event was a great deal to me, and I regretted not challenging the doctor before he examined Mr. X. I was pleased that the doctor responded positively to the inquiry and feedback provided by my mentor. I noticed later that he was keen and changed his practice after the incident. This event taught me the significance of acting assertively with other colleagues regardless of their position to ensure I safeguard the patient and provide them with quality care.
Analysis
According to (Gillespie, et al., 2020), hand hygiene, especially when dealing with wounds, is essential to reduce and prevent cross-infection. Studies have also shown that healthcare professionals do not disinfect their hands as much as they should during patient care (Choi, 2019). Transmission of infections is possible via uniform and dressing, and healthcare professionals must review dressing policies. Nurses are supposed to minimize and identify risks to patients they are dealing with.
Conclusion
Looking back at this event, I see that I should have acted sooner and challenged the doctor to ensure they observed care practices before handling the patient. The lack of washing hands would have resulted in the risk of infection to the patient (Yoon et al., 2019). After the discussion with my mentor, I realize that I need to always build my confidence and challenge colleagues for the well-being of the patient. Additionally, I realize to be supportive of a colleague and understand the pressure they might be facing. Still, they ensure that even with the challenge, they can maintain quality patient care.
Action Plan
In the future, I have goals to develop my assertiveness while working with others, regardless of their level. I will always understand the wellness of the patient is key and the purpose of giving quality care to the patients. I will learn and discuss with mentors how best to achieve these strategies and learn how to work best as a team.
References
Choi, K. S. (2019). Virtual reality wound care training for clinical nursing education: An initial user study. In 2019 IEEE Conference on virtual reality and 3D user Interfaces (VR) (pp. 882-883). IEEE. Web.
Di Simone, E., Giannetta, N., Spada, E., Bruno, I., Dionisi, S., Chiarini, M. & Di Muzio, M. (2018). Prevention of medication errors during intravenous drug administration in intensive care units: a literature review. Recent Advances in Medicine, 109(2), 103-107. Web.
Gillespie, B. M., Walker, R., Lin, F., Roberts, S., Eskes, A., Perry, J. & Chaboyer, W. (2020). Wound care practices across two acute care settings: A comparative study.Journal of Clinical Nursing, 29(5-6), 831-839. Web.
Kuitunen, S., Niittynen, I., Airaksinen, M., & Holmström, A. R. (2021). Systemic causes of in-hospital intravenous medication errors: A systematic review.Journal of Patient Safety, 17(8), e1660. Web.
Li, Y., Chen, W., Liu, C., & Deng, M. (2020). Nurses’ psychological feelings about the application of Gibbs’s reflective cycle of adverse events. American Journal of Nursing, 9(2), 74-78.
Liu, W. Y., Tung, T. H., Zhang, C., & Shi, L. (2022). Systematic review for the prevention and management of falls and fear of falling in patients with Parkinson’s disease. Brain and Behavior, e2690. Web.
Mazhar, F., Haider, N., Ahmed Al-Osaimi, Y., Ahmed, R., Akram, S., & Carnovale, C. (2018). Prevention of medication errors at hospital admission: A single-center experience in elderly admitted to internal medicine.International Journal of Clinical Pharmacy, 40(6), 1601-1613. Web.
Meekes, W. M., Leemrijse, C. J., Korevaar, J. C., & Stanmore, E. K. (2022). Implementing Falls Prevention in Primary Care: Barriers and Facilitators.Clinical Interventions in Aging, 17, 885. Web.
Rashid, A. (2019). Yonder: Difficult patients, fall prevention, hormonal contraception, and laughter therapy. The British Journal of General Practice, 69(682), 245. Web.
Schroers, G., Ross, J. G., & Moriarty, H. (2021). Nurses’ perceived causes of medication administration errors: a systematic qualitative review. The Joint Commission Journal on Quality and Patient Safety, 47(1), 38-53. Web.
Yoon, C., Gong, H. S., Park, J. S., Seok, H. S., Park, J. W., & Baek, G. H. (2019). Two-layer wound sealing before surgical hand washing for surgeons with a minor cut injury on the hand.Surgical Infections, 20(5), 390-394. Web.