Critical Reflection: Clinical Skill Assessment

Each year, roughly 1.5 million adverse drug events (ADEs) occur in acute and long-term care settings across America (Institute of Medicine [IOM], 2006). An ADE is succinctly defined as actual or potential patient harm resulting from a medication error. To expound further, while ADEs may result from oversights related to prescribing or dispensing, 26-32% of all erroneous drug interventions occur during the nursing administration and monitoring phases (Anderson & Townsend, 2010). These mollifiable mishaps not only create a formidable financial burden for health care systems, they also carry the potential of imposing irreversible physiological impairment to patients and their families. In an effort to ameliorate cost inflation, undue detriment, and the potential for litigation, a multifactorial approach must be taken to improve patient outcomes. Key components in allaying drug-related errors from a nursing perspective include: implementing safety and quality measures, understanding the roles and responsibilities of the nurse, embracing technological safeguards, incorporating interdisciplinary collaborative efforts, and continued emphasis upon quality control.

Patient information, drug instruction, communication amongst medical staff member, drug labels, patient literacy and the nurses knowledge of the medication are just to name a few. It only takes one of these aspects to be incorrect for a medication error to harm a patient, causing life changing or even life threating complications. Other circumstances that may contribute to medication errors include fatigue and staffing shortage. Nurses reported that fatigue, stress and understaffing increased the risk of making a medication error. Anderson, (2010). Majority of clinical staff work 12 hours shifts. Due to patient acuity and inadequate staffing, workload and hours many times are increased. sleep deprivation has been shown to be a major factor in medication errors. The diminished hours of sleep effect clarity of thought causing room for errors. Novice nursing has also been a component of many medication errors. Unexperienced nurses are overwhelmed with the increased workload and new responsibilities, which places them in danger of making these dangerous inaccuracies. While rushing to pass meds in a timely manner, critical medication errors reportedly made. Actively adhering to the five rights of medication administration measures while distributing patient medication can inherently cut down on errors made in the nursing

Medication errors are preventable and cause great harm to the patients and their families. Every year in Australian hospitals, medication errors occur as nurses do not follow the 9 rights of medication administration. The 9 rights are right patient, drug, route, time, documentation, response, action and form (Fossum et al., 2016). Medication errors can be caused by

According to the Food and Drug Administration (FDA 2009), the wrong route of administrating medication accounts for 1.3 million injuries each year. An article published in September issue of the Journal of Patient Safety estimates there are between 210,000 and 400,000 deaths per year associated with medical errors. This makes medical errors the third leading cause of deaths in the United States, behind that comes heart disease and cancer. To prevent medical errors always follow the Three Checks and most importantly the Rights of Medication Administration. The “Rights of Medication Administration” helps to ensure accuracy when administering medication to a patient. When administering medication the administer should ensure they have the Right Medication, Right Patient, Right Dosage, Right Route, Right Time, Right Route, Right Reason, and Right Documentation. Also remember the patient has the right to refuse, assess patient for pain, and always assess the patient for signs of effects.

Medication errors are the leading cause of morbidity and preventable death in hospitals (Adams). In fact, approximately 1.5 million Americans are injured each year as a result of medication errors in hospitals (Foote). Not only are medication errors harmful to patients but medication errors are very expensive for hospitals. Medication errors cost America’s health care system 3.5 billion dollars per year (Foote).Errors in medication administration occurs when one of the five rights of medication administration is omitted. The five rights are: a) the right dose, b) the right medication, c) the right patient, d) the right route of administration, and e) the right time of delivery (Adams). Medication administration is an essential part of

The last week of classes for NURS1005 were a series of clinical skills activities. These activities refreshed the student’s minds on what they will be doing on placement and how to do it. We got assessed on three clinical skills; taking and recording vital signs, blood glucose levels and doing a urine analysis. I’ve chosen to reflect on taking vital signs and how I performed them. Reflection is a very important part of learning from experiences which is essential in nursing. Nursing practises continue to change and it is easier to go with and to add to that change if you are reflecting on your practise. This essentially makes nursing practises better for the patients. I have reflected on the process of how I took the vital signs during my clinical skills activities. I was very nervous but believe I performed them well due to how I was taught, what I have read and seen and the vital signs signified how my peer was acting which was healthy and within a normal range. Even though I felt I did them well, there were improvements that could and have happened since. Most of the improvements are minor in comparison to the strengths I have but it is important to recognise improvements when needed so you are giving the best and accurate care. I was aware of these improvements needed and tried to strengthen them during my clinical placement which helped me learn different ways of doing processes and also the rationale behind the processes.

Outcome measures assess whether the interventions to improve medication safety practice will be successful. During the interview of the new employee, competency evaluation related to medication administration will be applied first. In addition, during the orientation for these new employees, adequate training will be provided to ensure the importance of preventing medication errors. They will be given a list of similar and look-alike medications and will focus on medications that cause the most adverse reactions when errors may occur. Then, after training and when staff start working, they will be supervised during their first few months. When they are not supervised, they will be assessed and evaluated for any errors. During this process,

As a leader in the workplace, medication errors mostly occur when the workplace is understaffed with a patient load of full nursing cares that require more attention and care than patients who are independent. Due to being understaffed with a patient load of 13 to 2 nurses, medication errors occur more often as nurses are being rushed to finish all cares within their work timeframe. To decrease medication errors it is important to implement more staff during medication rounds, thus giving nurses additional time to concentrate and assure that the correct medication and dose is being given to the right patient ( ). The 6 medication rights are important to implement into every workplace as it decreases the chances of administrating medication to the wrong patients ( ). The medication right include; ______________________________________________________________ ( ). Medication errors have important implications for patient safety and in improving clinical practice errors to prevent any adverse events (

The next time he decided that to administer insulin. Clinical assessors required to make professional judgements in interpreting what the minimum acceptable levels of competence are in respect to professional standards. These judgements are frequently made with in the role relationship of that of a mentor cum assessor to a student (Stuart 2005). As it is a skill involved, I found it was difficult for him to memorise all the step and rationales. I explained about my experience when I was a student nurse and concept of learning through practice. For students learning during clinical practice is a complex activity. The student has to contend and learn to deal with complex, unstable and uncertain worlds of practice (Schon 1987). With on going support I facilitated learning environment to practice the procedure under supervision

The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT

My interest in providing culturally competent care inspired me to become a nurse practitioner, but most of all the inspirations came from the wonderful diverse patients I have had the privilege to care for throughout my nursing career. My primary objective is to care for underserved population communities. In my career, I have seen lives been cut short that would have been saved if only they had made it to the hospital in time. But because of reasons including lack of health care access, knowledge how to access care, cultural and religious beliefs, language barrier, and fear of being judged by medical professionals led them not seek medical attention.

Medication error is one of the biggest problems in the healthcare field. Patients are dying due to wrong drug or dosage. Medication error is any preventable incident that leads to inappropriate medication use or harms the patient while the medication is in the control of the health care professional,or patient (U.S. Food and Drug Administration, 2015). It is estimated about 44,000 inpatients die each year in the United States due to medication errors which were indeed preventable (Mahmood, Chaudhury, Gaumont & Rust, 2012). There are many factors that contribute to medication error. However, the most common that factors are human factors, right patient information, miscommunication of abbreviations, wrong dosage. Healthcare providers do not intend to make medication errors, but they happen anyways. Therefore, nursing should play a tremendous role to reduce medication error

Every day there is a constant trust adhered to many different people in the profession of Nursing—the decision of what will help patients in terms of medicine, and the confidence to make these decisions. One false act or one slight misdiagnoses of medication to a patient could be the prime factor in whether the patient lives or dies. Nurses in hospitals across the country are spread thin, and thus makes the probability of mistakes higher. If a medicinal dose is off by even one decimal a patient could die, so the only real answer is for nurses to not be afraid to ask for assistance, always follow procedure and voice opinion is they feel something is wrong.

The clinical skill I have chosen to reflect on within this essay is the administration of Intramuscular (IM) injections. I have chosen this as within my first clinical placement this was a widely used method of drug administration and I became involved in the process of IM injections. I therefore researched the topic of IM injections and my knowledge within this area developed.

The topic of reflection is a potential drug error made whilst on my clinical practise placement. The area of drug administration is an important role for nurses and therefore I will incorporate research evidence, policies and guidelines surrounding drug administration, discuss how the area can be developed and applied in professional practise.