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Being a professional nurse requires commitment, diligence, and competency to ensure the highest quality care for the patients (Asensi-Vicente et al., 2018). The patient requirements are highly varied and require core understanding established through strong communication, theoretical, and practical skills to achieve favourable outcomes (Gorgich et al., 2016). In this document, I aim to reflect on one of my past incidents as a student nurse in a clinical setting where I was working in association with my seniors on a critical case of Mr. Benjamin (Pseudonym). I have chosen the Gibbs reflective model to complete my reflective framework that will be sectioned into description, feelings, evaluation, analysis, conclusion, and an action plan (Porter et al., 2018). I have chosen the Gibbs model of reflection as it concisely segregates the different sections in reflective practice and helps in the development of insightful analysis.
I was extremely elated to have joined a clinical care facility as a student nurse as this was my first experience in a work setting. As a student, learning new skills and gaining more knowledge has always been one of my keen interests as it has helped me advance in my career and provide me crucial insights and information that has been highly helpful. In the clinical setting, my role was to assist the senior nurses and help them in taking care of critical patients to ensure their well-being. Initially, I was trained through verbal teachings and was asked to observe the seniors and learn from the experience.
Eventually, my responsibilities shifted to keeping notes of the patients and helping the senior nurses in medication management and regulation of the care needs of the patients. One day, I was running late and had rushed to the care setting. Upon arrival, I was told that one of the patients, Mr. Benjamin has been requesting to see me for some purpose. Upon reaching, he told me that he wanted me to give him his medication as prescribed to the doctor as I have been taking care of his medications in the meantime and he trusted me. I was about to provide him with the medication when one of my senior nurses stopped me from making this medication error and told me that I had accidentally taken the wrong dosage as his medications had been changed by the physician yesterday upon some improvements. I collected the new handover that the senior nurse had carried. I apologized for my ignorance and provided Mr. Benjamin with the suitable medication after crosschecking with his charts.
When I realized that I had taken the wrong dosage of the medication for Mr. Benjamin I was a little confused as the medication appeared to be adequate to me. However, when I was told of the change, I realized my mistake and ignorance to have not taken the handover of Mr. Benjamin from the nurse in the last shift. When the senior nurse corrected me, I felt extremely glad as a medication error had been avoided that could have been extremely fatal for the health of Mr. Benjamin. I felt responsible and hence apologized for my mistake and corrected his medications.
As a student nurse, I had been trained adequately and provided the necessary information to work in the clinical setting to ensure patient safety and beneficence in my course of action. When I realized that I had mistakenly taken the wrong dosage of medication, I felt extremely responsible for this ignorance. As a nurse, it is an essential duty to take the handover from the nurse in the last shift to ensure the progression of the health improvement and changes in the health condition or medication of the patient (Gholipour et al., 2016). I realized that I should have asked my senior nurse about the improvements or changes associated with the patient. Medication errors could have been fatal for the health condition of the patient as the different dosage might have triggered certain biochemical changes in the patient’s body. I also felt extremely glad as I was interrupted by the senior nurse and this error was avoided.
Through the intervention of the senior nurse, I learned the importance of guidance and collaboration in the nursing practice. Collaborative efforts are essential in the nursing practice as the system as a whole, functions towards a central goal of ensuring the well being and beneficence of the patient (Marvanova & Henkel, 2018). Medication error could have resulted in the breach of the code of conduct of nursing and also of the core principle of “non-maleficence” and “beneficence” of the patient. Conservation of the principles of the code of ethics and the nursing principles ensures that the patient receives the highest quality care and can achieve the maximum health benefit in the care setting (Nursing and Midwifery Board of Australia, 2018). I evaluated that it was an exhibition of irresponsible behaviour on my part that could have impacted the health of the patient. I was glad to have supervisors and senior nurses to have assisted me in this course for the effective management that prevented the medication error.
The World Health Organization has identified medication error as one of the major challenges associated with patient safety and wellbeing. Medication errors are a serious problem in healthcare settings. A medication error has been defined as “failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim” (Gorgich et al., 2016). The medication error is one of the serious problems in healthcare settings as it can lead to major errors and healthcare problems even when it is highly preventable (Khalili et al., 2018). Reporting of the medication errors is extremely important as it helps in the prevention of fatal situations by the inclusion of corrective measures. The reporting of the medication, therefore, becomes crucial to avoid and to correct such incidences (Ferrah et al., 2017). Prevention of medication errors is therefore extremely important. The nursing and the Midwifery Board of Australia has established a professional code of conduct for the nurses to ensure the highest quality care for the patients. The principle one of this code asserts the patients must receive complete care with legal and obligatory regulations that ensure the well being of the patient (Nursing and Midwifery Board of Australia, 2018).
The medication errors in Australia have been a significant concern and have indicated that about 2%-3% of the hospital admissions are concerned with medication-related issues (Government of Australia, 2017). In numbers, it can be estimated that annually, about 230,000 admissions are associated with medication errors that can be simply be avoided and result in the annual health costs of about $1.2 billion (Government of Australia, 2017). The WHO also identifies that medication errors are common in the transfer of care and the shift of duties in practice (Ferrah et al., 2017). To minimize these incidences in Australia, the government has developed the Australian Commission on Safety and Quality in Health care that focuses on the coordination and development of the safety and quality practices in the healthcare to prevent the medication errors (Government of Australia, 2017). To achieve this goal, the commission works in close regulations with the clinicians, patients, and policymakers associated with the healthcare system.
In my clinical placement, even when I was taught and explained about the required protocols to be followed before administration of medication to the patient, I had demonstrated a reckless attitude in haste and was about to provide medication to the patient without taking the necessary follow up. I learned that it is important to follow the required protocols and steps that are a part of the nursing practice to prevent such errors and to ensure the beneficence of the patient and to demonstrate high-quality nursing practice. I also analysed that error on my part in the medication administration could have severe impacts on the health and the wellbeing of the patient. Therefore, it is crucial to demonstrate an alert, competent, and regularized behaviour in the care settings to ensure the wellbeing of the patient. Through this, I also learned that communication between healthcare professionals is extremely crucial as it helps in the transfer of information adequately and prevents the occurrence of such clinical errors in the practice.
Through my experience in the clinical setting, I would conclude that it was highly informative and helped learn the importance of adhering to the clinical protocols and verifying the medication and other interventions by effective communication with the other healthcare professionals involved. This would help in the elimination of confusion and prevent incidences like this in future. I also learned that collaborative effort is essential in nursing as when my senior nurse intervened and helped me correct the dosage that was prescribed to the patient, the error in the clinical setting was avoided. I learned that health care and nursing is an amalgamation of combinatorial efforts that ensure patient safety, wellbeing, and health improvement for the overall wellbeing and beneficence of the patient.
I will take this experience as a learning and ensure that such incidents are not repeated in future and I can provide the best care to the patient. To prevent such causal attitude to the occurrence of medication errors in future, I would like to ensure that I always communicate and gather the information about the patient from the nurse in the last shift or the senior nurses available with the patient. I will also like to follow and carefully read the ISBAR handovers that are provided before interacting with the patients to ensure the progressions and changes in the healthcare condition of the patient (Teal et al., 2019). As a care nurse, I will also ensure to participate and perform mandatory reporting to ensure that the nurses in the follow-up shifts also get the adequate information about the health condition of the patient and the progress reports of the same (Marvanova & Henkel, 2018).
I will also follow a more diligent and an alert approach and follow the suitable medication reconciliation procedures. I will also ensure that I double-check the medication prescription before the administration to ensure the safety and well-being of the patient (Natan et al., 2017). I will also ensure that I carefully look at the lookalike drugs and organize the medication in constructed charts to prevent the occurrence of such errors. In future, I will also ensure that I take the guidance of the senior nurses and my supervisors to cross-check in case of any ambiguities (Vrbnjak et al., 2016). I will also work on my personal skills like time management so that I don’t rush or perform any activity in haste so that all the tasks are performed with effective coordination and precise attention to prevent errors on my part (Teal et al., 2019).
This document presents a reflective analysis of one of my incidents at a clinical setting using a Gibbs reflective model. I have chosen this model to ensure the involvement of all the parameters associated with the incident for development of an insightful reflection. I was about to provide medication of the wrong dosage in a clinical setting when one of my senior nurses helped me correct the medication by providing the updated handover. In the course of this incident, I learned the importance of adherence to nursing and medication protocols that ensure following the necessary steps by checking and cross-checking the patient handovers to prevent medication errors. I also learned the importance of collaboration and communication to ensure in nursing to provide best care practice for the patient. I realized that the implications of these errors can be fatal and therefore they must be prevented. To prevent such errors, I will ensure that I work on my clinical nursing and personal skills to provide the best suitable care practice for the patients and ensure their wellbeing and beneficence as a competent nurse.
Asensi-Vicente, J., Jiménez-Ruiz, I., & Vizcaya-Moreno, M. F. (2018). Medication errors involving nursing students: A systematic review. Nurse Educator, 43(5), E1-E5.
Ferrah, N., Lovell, J. J., & Ibrahim, J. E. (2017). Systematic review of the prevalence of medication errors resulting in hospitalization and death of nursing home residents. Journal of the American Geriatrics Society, 65(2), 433-442.
Gholipour, K. H., Mashallahi, A., Amiri, S., Moradi, Y., Moghaddam, A. S., & Hoorijani, F. (2016). Prevalence and cause of common medication administration errors in nursing. Journal of Chemical and Pharmaceutical Sciences, 2016, 18-21.
Gorgich, E. A. C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint. Global Journal of Health Science, 8(8), 220.
Government of Australia (2017). Australia joins international push to halve medication errors. Retrieved from: https://www.safetyandquality.gov.au/media_releases/australia-joins-international-push-to-halve-medication-errors
Khalili, Z., Molavi Vardanjani, M., Shamsizadeh, M., Alimohammadi, N., Tohidi, S., Fallahinia, G., & Tapak, L. (2018). Medication errors in nursing students. Scientific Journal of Nursing, Midwifery and Paramedical Faculty, 3(3), 8-16.
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Natan, M. B., Sharon, I., Mahajna, M., & Mahajna, S. (2017). Factors affecting nursing students' intention to report medication errors: An application of the theory of planned behavior. Nurse Education Today, 58, 38-42.
Nursing and Midwifery Board of Australia (2018). Code of conduct.
Porter, J., Perkins, A. J., Lyons, J., & Sewgolam, S. (2018). Thinking like a nurse. The Road to Nursing, 117.
Teal, T., Emory, J., & Patton, S. (2019). Analysis of Medication Errors and near Misses Made by Nursing Students. International Journal of Nursing Education Scholarship, 16(1).
Vrbnjak, D., Denieffe, S., O’Gorman, C., & Pajnkihar, M. (2016). Barriers to reporting medication errors and near misses among nurses: A systematic review. International Journal of Nursing Studies, 63, 162-178.
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