1803NRS Foundations Of Professional Nursing Practice
Question:
NMBA Registered Nurse Standards for Practice
Details
Using the GIBBS Reflective Cycle (Gibbs, 1988), reflect on this nursing-related event.
Students will write an appropriately structured essay that includes the following:
1. A comprehensive description of the critical incident.
2. An explanation of how the event made you feel and why it made you feel this way.
3. Evaluate the consequences of this critical incident for the health consumer (patient and their family).
4. Analyse the implications of this critical incident for your future nursing practice.
5. Identify and discuss new knowledge gained from this incident.
6. Develop an action plan to enhance your own learning from this incident.
Answer:
The Registered Nurse Standards for Practice, set in place by the developed by ACQSHC (Australian Commission for Quality and Safety in Healthcare), outlines the fundamental requirements for nurses to engage in safe and effective care practice for ensuring better patient outcomes. Reflection on knowledge and skills is critical in this regard. The aim of the present essay is to carry out a critical reflection on an event related to the nursing domain that has been reported previously in media with the help of NSQHS (National Safety and Quality Health Service) standards. The article selected is titled as ’Coroner recommends changes after blood mix-up patient death’ and the NSQHS standard selected is Standard 2- Partnering with Consumers for this assessment item. Gibb’s model of reflection is used for presenting the essay in a logical and systematic manner.
The article titled ‘Coroner recommends changes after blood mix-up patient death’ published in the year 2003 reported that the South Australian coroner had recommended that relatives and carers are to be encouraged to have their presence with patients of cardiovascular system disorder prior to pre-surgery procedures. The recommendation had come forward after a misfortunate event was reported regarding the death of a 71 year old patient after receiving blood transfusion of incorrect blood group. Prior to the surgical procedure, the patient named Ruth Stoll had to present at the Clinpath Laboratories for providing blood sample in order to undergo a test for assessing the need of transfusion. Ruth presented at the laboratory with another patient Martha Kovendy. Ms Kovendy’s husband and Ms Stoll’s sister-in-law were waiting outside in the waiting area at the time of collection of the blood samples. The nurse responsible for taking blood samples had mislabeled the two tubes. As per the reported incident, Ruth Stoll was in need of a transfusion at the time of surgery but was provided with incorrect blood. This was due to the error made at the nurse’s end while labeling the two blood samples. Transfusion with incorrect blood group resulted in the patient’s death after six days of undergoing the cardiac surgery (mobile.abc.net.au, 2003).
The event reported was of much relevance to nursing practice and I feel sorry for such incidents that commonly occur across the country, most of which are unreported. I believe that the unfortunate event that has been reported could have been avoided at the very first place, eliminating the risk of undesirable outcomes for the patient. In my opinion, cardiac patients and those suffering from critical health conditions are often subjected to anxiousness, and are not in a position to communicate in a proper manner. The presence of care givers holds the potential to minimize the risk of confusion and errors (Conway et al., 2017). Partnership with healthcare consumers would ensure that safe and high quality care is presented to the consumers. As per the NHQHS standard 2, partnering with health care consumers ensure that benefits are brought about to patients and healthcare providers alike. The standard entails professionals to work with patients and their family members following the core principles of collaboration and participation (safetyandquality.gov.au, 2012). As per my understanding, when family members are involved in the care process of the distinct patients presenting with complex care needs, the benefits outweigh the risks of harms. Family centered and person centered care can be provided when such involvement is there, as opined by (Feinberg, 2014). The researchers had commented that there is growing evidence pointing out the need of partnerships between carers, families, consumers and patients. Increase in patient safety, patient satisfaction, and cost effectiveness can be enabled when carers are involved. In this regard Tobiano et al., (2015) had stated that operational benefits of delivering care are immense, including decreased readmission rates, decreased mortality, reduced hospital stay and better functional status. Operation benefits would involve better liability claims and lower care costs per case.
In the present scenario, the consequences of the error made by the nurse had an adverse impact on the whole, that is patient death. While the patient outcome expected out of a cardiac surgery could not be reached, the impact of the event on the family member was also noteworthy. Since Ms Stoll’s sister-in-law was present outside the laboratory in the waiting room, she was likely to suffer from regret that she could not aid in the process of blood collection. Analyzing the consequence on patient and family members, it can be stated that poor health outcomes for patients, and stress and emotional burden on families can be avoided by having proactive approach for healthcare partnerships (Black, 2016).
Analysis of the incident has a profound effect on personal nursing practice. Drawing insights from the incident I conclude that nurses have the responsibility of providing safe care to patients, which can be enable by involving families who are primary carers. As a nurse, I hold the responsibility of respecting the preferences of patients while planning a certain procedure. Involvement of family members of patients in informed decision making is crucial (Kearney-Nunnery, 2015). Supporting patients to raise voice against concerns regarding the process of care provided is also elementary (Porney et al., 2015).
The knowledge gained from the incident and subsequent analysis is immense. Partnership with care givers to patients, such as families can ensure that input for the respective individuals is guides better care delivery. Such inputs can lead to reduced length of stay at hospital, improved adherence to medical management regime, and decreased rate of readmission to care units. Leaders of health care units must implement systems for supporting such collaboration. Effective policies are to be set in place so that healthcare workers are obliged to follow the principles of care provider-consumer collaboration. The key understanding is that patients are to be placed at the centre of care in a more general manner.
At this juncture an action plan is being outlined for future professional practice. In future nursing practice, involvement of family members would be considered in patient care wherever possible. Special consideration would be given to ensure presence of family members at the time of collection of blood samples from patients. While articulating treatment plan to patients it would be elementary to have a family member present at the site. This would help in receiving input of the individuals, and the same is crucial since involvement of family focuses on adjustments in relation to diagnosis of the patient condition and clarification of treatment options (Black, 2016).
References
Black, B. (2016). Professional Nursing-E-Book: Concepts & Challenges. Elsevier Health Sciences.
Conway, P. H., Coyle, S., & Sonnenfeld, N. (2017). Partnership for patients: Innovation and leadership for safer healthcare. Journal of Healthcare Management, 62(3), 166-170.
Feinberg, L. F. (2014). Moving toward person-and family-centered care. Public Policy & Aging Report, 24(3), 97-101.
Kearney-Nunnery, R. (2015). Advancing Your Career Concepts in Professional Nursing. FA Davis.
National Safety and Quality Health Service Standards. (2012). Retrieved from https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-Standards-Sept-2012.pdf
Coroner recommends changes after blood mix-up patient death. (2012). Retrieved from https://mobile.abc.net.au/news/2003-03-12/coroner-recommends-changes-after-blood-mix-up/1816102?pfm=sm&pfmredir=sm
Pomey, M. P., Hihat, H., Khalifa, M., Lebel, P., Néron, A., & Dumez, V. (2015). Patient partnership in quality improvement of healthcare services: Patients’ inputs and challenges faced. Patient Experience Journal, 2(1), 29-42.
Tobiano, G., Marshall, A., Bucknall, T., & Chaboyer, W. (2015). Patient participation in nursing care on medical wards: an integrative review. International Journal of Nursing Studies, 52(6), 1107-1120.
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