NPU3505 Nursing Reflective Practice Case Study Answer

Reflection

Write a word reflection on the topic specific to your unit (see Instructions tab).  

• If you do not pass your Reflection you will be required to complete the Reflection Revision page.  
• You can copy and paste the sections of your first reflection that were assessed as 'satisfactory' into the Reflection Revisions.
• You will be required to revise those sections of your first reflection that were assessed as 'unsatisfactory'.
• If copying and pasting from elsewhere, highlight the text and use the Remove Format icon on the toolbar (Letter 'T' with a small 'x' next to it) this will ensure accurate word counts, no hidden characters and consistency in each block for your assessor.  Show Me How - see bottom of this page.

Description

In this reflective piece, I will describe an experience that highlighted the importance of keen observation and timely intervention in patient care using Gibb’s cycle of reflection. The incident revolves around the aftermath of an iron infusion procedure, where I encountered a patient whose condition took a turn for the worse.

Feelings

Upon discovering the patient's deteriorating condition, I felt a mixture of concern, self-doubt, and responsibility. I questioned whether I had missed any cues during the procedure that could have forewarned us of potential complications. The sense of responsibility weighed heavily on me as I realized that recognizing these subtle signs could have potentially changed the outcome for the patient.

Evaluation

I conducted a rigorous evaluation of my conduct throughout the iron infusion procedure and subsequent monitoring phase. It dawned on me that despite the procedure's apparent success, I might have unwittingly disregarded pivotal cues indicating the patient's deterioration. This realization strengthened the significance of post-procedure vigilance, underscoring its equivalence in importance to the procedure itself. The encounter served as a poignant reminder that comprehensive comprehension of potential risks, even in seemingly routine medical interventions, is imperative. As healthcare providers, we must recognize that diligence in observation extends well beyond the procedure room, directly influencing patient safety and well-being (Michalak & Kotomska, 2021).

Analysis

Notably, the iron infusion procedure was deemed successful, which initially conveyed a positive outlook. This conforms to the nursing standards established by the Nursing and Midwifery Board of Australia (NMBA), which emphasize the necessity of accurate recording, effective communication, and continual assessment to promote patient safety and optimal results (NMBA, 2020). The medical staff's adherence to these norms, which demonstrated their dedication to patients' wellbeing, may be responsible for the procedure's initial success.

The positive development, however, is clouded by the fact that the patient's condition worsens after the treatment. Here lies the critical negative aspect: a lapse in post-procedure vigilance. The assumption that procedural success guarantees a smooth recovery is a potential pitfall, aligning with the NMBA Standard 8 which emphasizes continuous patient assessment to identify any deviations from the expected course (Australian Commission on Safety and Quality in Healthcare [ACSQHC, 2023]). This lapse may stem from a false sense of security or an inadequate appreciation of potential risks.

Higham (2019) emphasises that continuity of care is vital in post-procedure monitoring. The negative outcome in this scenario resonates with their findings, underlining the significance of sustained vigilance. To rectify this, healthcare systems must integrate structured post-procedure monitoring protocols and prioritize ongoing assessment. Embracing the NMBA's standards and fostering a culture of meticulous observation will ensure that positive outcomes extend beyond the procedure room, mitigating the risk of unforeseen complications Sutherland-Fraser et al., 2021).

Supporting evidence from medical literature emphasizes the significance of robust post-procedure monitoring. According to a 2017 study by Means et al., post-procedure surveillance is crucial for the early identification of problems and rapid care, which enhance patient outcomes. Additionally, the World Health Organization's recommendations for patient safety emphasize the need for healthcare professionals to receive ongoing education and training to ensure the provision of safe and efficient care (World Health Organisation, 2023).

Conclusion

Recognizing the deterioration of the patient's post-iron infusion was an eye-opening experience that reminded me of the multifaceted nature of patient care. It reaffirmed the idea that every patient's journey is different and could be complicated by unforeseen difficulties. In order to give my patients the best care possible going forward, I'm committed to honing my observation, critical thinking, and quick response skills. I'm resolved to use the lessons I've learned from this introspective activity in my profession for the benefit of my foreseeable patients because it has revealed the way to growth.

Action Plan

I now understand the essentiality of comprehensive post-procedure vigilance due to possible delayed adverse reactions. This experience underscores the imperative of understanding all potential risks, regardless of the procedure's routine nature. Moving forward, I'm committed to translating this insight into a practical action plan. Firstly, I will deepen my knowledge of iron infusion complications and their post-procedure manifestations. In addition to this, I will strictly adhere especially to NMBA Standards (8.04-8.09), which deal with the recognition of acute deterioration and escalation of appropriate care (ACSQHC, 2023).   Moreover, I'll actively seek mentorship and engage in post-incident discussions to enrich my clinical judgment. Regular participation in relevant training and workshops will further refine my ability to identify deteriorating patients. By amalgamating these strategies, I aim to enhance patient safety, ensuring a well-rounded and vigilant approach to patient care (Gilan et al., 2022).

STAR Selection Criteria 

Utilising the clinical example in your Part A reflection, write a selection criteria specific to your unit (see Instructions) using the STAR framework. Write your STAR selection criteria in paragraph format.

• OPENING - Brief statement to demonstrate you understand the question.  NOTE: THIS SHOULD BE POSITIVE
• SITUATION- Where did you do it? (location)
• TASK- What did you do? (the task)
• ACTION- How did you do it? (the method) and Why did you do it? (the purpose or the value you brought)
  • The action area of your example/experience will be up to 70% of your answer.
  • Focus on action verbs and ‘I’ to demonstrate what actions you undertook.
• RESULT- What were the results? (positive outcome and what you learned)
• STANDARDS - Now link your STAR clinical example to the RN Standards for Practice.

Opening: Displaying a profound grasp of the significance of vigilant observation and prompt intervention in patient care, I participated in a clinical experience that underlines my unwavering commitment to these principles. Situation: This incident unfolded within our hospital's infusion therapy unit, where I encountered a patient following an iron infusion procedure. Task: My responsibility encompassed post-procedure monitoring and assessing the patient's condition. Recognizing the potential risks even after a successful procedure, I aimed to ensure holistic care beyond the immediate intervention. Action: Employing a proactive approach, I meticulously tracked the patient's vital signs, discerning any deviations from the baseline. I maintained open communication with the patient, gauging their comfort and addressing queries. This approach was anchored in the NMBA standards, which emphasize the significance of ongoing assessment to detect deviations (NMBA, 2023). This encounter ingrained the crucial lesson that vigilant observation, especially post-procedures, is pivotal for patient safety. The positive outcome served as a tangible application of the NMBA standards, ensuring patient well-being.

Result: Through my proactive approach, I detected subtle indications of the patient's deteriorating state. The swift intervention led to prompt medical attention, effectively sidestepping potential complications. Standards: My adherence to the NMBA standards for continuous patient assessment, timely intervention, and effective communication resonates with the Registered Nurse Standards for Practice (NMBA, 2023). This experience underscores my ability not only to meet but exceed these standards, contributing to the unit's excellence in patient care.

References

Australian Commission on Safety and Quality in Healthcare. (2023). Recognising and responding to acute deterioration standard. https://www.safetyandquality.gov.au/standards/nsqhs-standards/recognising-and-responding-acute-deterioration-standard

Gillan, P. C., Delaney, L. J., Tutticci, N., & Johnston, S. (2022). Factors influencing nursing students’ ability to recognise and respond to simulated patient deterioration: A scoping review. Nurse Education in Practice, 62, 103350. https://doi.org/10.1016/j.nepr.2022.103350

Higham, H. (2019). Situation awareness in medical practice (Doctoral dissertation, University of Oxford). https://ora.ox.ac.uk/objects

Kumar, A., & Brookes, M. J. (2020). Iron therapy in inflammatory bowel disease. Nutrients, 12(11), 3478.  https://doi.org/10.3390/nu12113478

Means, G., End, C., & Kaul, P. (2017). Management of percutaneous coronary intervention complications. Current Treatment Options in Cardiovascular Medicine, 19, 1-14. https://doi.org/10.1007/s11936-017-0526-6

Michalak, A., & Kotomska, M. (2021). Patient safety in the operating theatre. Polish Journal of Public Health, 131(1). https://web.p.ebscohost.com/abstract

Sutherland-Fraser, S., Davies, M., Gillespie, B. M., & Lockwood, B. (2021). Perioperative nursing: an introduction. Elsevier Health Sciences. https://books.google.co.in/books?hl=en&lr=&id=8z48EAAAQBAJ

Vincent, J. L., Einav, S., Pearse, R., Jaber, S., Kranke, P., Overdyk, F. J., & Hoeft, A. (2018). Improving detection of patient deterioration in the general hospital ward environment. European Journal Of Anaesthesiology, 35(5), 325. https://doi.org/ 10.1097/EJA.0000000000000798

World Health Organisation. (2023). Patient safety. https://www.who.int/teams/integrated-health-services

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