7023PHM Advanced Clinical Skills
Question:
Write a report on the Removal of Active Surgical Drainage Tube.
Answer:
Description
I was required to remove an active surgical drainage tube from a patient after surgery. Before that, I was to identify the indication and the appropriateness of the procedure. I then recognized the correct patient for the procedure. I developed a therapeutic relationship with the patient by introducing myself and explaining the method of removing the surgical drainage tube. Therapeutic relationship improves the quality of medication towards the patient (Pazargadi, Fereidooni Moghadam, Fallahi Khoshknab, Alijani Renani, & Molazem, 2015). I gathered the necessary equipment for the procedure and ensured an appropriate administration of analgesia. I proceeded to position the patient appropriately and performed the five moments of hand hygiene.
I then put on the non-sterile gloves, released the suction set up, and removed the dressing. I cleaned the region around the drainage with 70% alcohol before removing the Drainage tube. I then dressed the site using appropriate and sterile techniques. Afterward, I cleaned, replaced, and disposed of the drainage tube. I then documented the relevant information about the entire process in the hospital computer. I then assessed the outcome and recorded my findings.
Feelings
During the process of removing the surgical Drainage tube, I fell short of confidence and was nervous in the early stages. However, I realized that the procedure removes blood and other tissue fluids that can gather at the surgical site. Failure to remove the Drainage tube can result in other infections (Dougherty, & Lister, 2015). I also felt that I had to apply the appropriate aseptic technique when removing the dressing. As an RN, I have to uphold hygiene at all times to ensure that my patient is safe from contamination. I also thought that I had to follow the procedure to end up with desirable outcomes. Therefore, I was careful when removing the drainage and dressing the surgical site. Every nurse should master the skill of removing a surgical drainage tube; since the technique is applicable worldwide (Crisp, Douglas, Rebeiro, & Waters, 2016). Therefore, it was essential that I regain the confidence to ensure that the procedure is a success. I carried out a thorough assessment of the patient, a move that impressed my supervisor.
Evaluation
Successful removal of active surgical drainage tube is a procedure that every nurse should master. During my experience, a majority of the processes went well apart from a few. I identified the correct patient and also succeeded in building a therapeutic relationship. I was also successful in gathering the required equipment and performing the five hand hygiene. I also succeeded in injecting the patient with the analgesia. Furthermore, I successfully released the suction set-up during the procedure. Releasing the suction minimizes the chances of tissue damage during the removal of the drainage (Christelis et al., 2015). The removal of the Drainage tube and dressing the area went as I had planned. The cleaning of the site using 70% alcohol was successful as medical attention proceeded. The cleansing of the site keeps it away from bacterial or viral infections (Conti, Katzap, Poli?de?Figueiredo, Pagnussatti, & Figueiredo, 2018). Additionally, the cleaning makes the suture visible easing its removal. However, documenting the information on the entire procedure did not go as I had planned. The power outage occurred when I was almost through with entering the information on the computer. However, apart from the power blackout, the other procedures went well. The hospital should have a power back-up to ensure complete documentation of activities in the hospital.
Analysis
When focusing at my experience, I acknowledged the essence of observing the correct guidelines and procedures during the drainage removal. Recent research has indicated that caregivers should understand and successfully perform the post-operative process to ensure patient safety (Pearce, 2017). I first reviewed the essence of identifying the correct patient for the procedure and maintaining a therapeutic relationship with the patient. Identification of the right patient eliminates the chances of medication mistakes. The establishment of a therapeutic relationship improves the outcome of the medical attention. Furthermore, explaining the procedure to the patients enables them to make informed decisions. The patients can also offer their opinion on treatment when the nurse encourages them to be free with the caregiver.
The process of releasing the suction and removing the dressing was successful due to my undivided attention towards offering quality treatment. The proper suction release protects the tissues from potential damage as the operation continues. The seamless removal of the dressing ensures an easy time for drainage removal (Jarvelainen, Cooper, & Jones, 2018). I succeeded in cleaning the drainage; since I used 70% alcohol during the procedure. The cleansing procedure prevents the infection of both the patient and the caregiver with germs. I also applied the relevant dressing on the removal site due to the importance of proper dressing in the removal of the drainage.
I also cleaned, replaced, and disposed of the used equipment. Furthermore, I applied my assessment skills to evaluate the outcome of the procedure. The positive reaction of the patient assured me that the method was successful. Therefore, a caregiver who follows the standard operating procedures provides quality medical attention to the patient (Clayton, Isaacs, & Ellender, 2016). The only aspect that did not go according to plan is the documentation aspect. My supervisor was not convinced with my skills on that regard. Therefore, I resolved to improve on documentation to enhance the credibility of my skills and knowledge.
Conclusion
The reflective practice has assisted me to understand my strengths and weaknesses that I can polish to better my practice. Additionally, the reflective exercise, I have learned that I have excellent knowledge of the removal of the active surgical drainage tube. I also learned about the essence of the therapeutic relationship, and hand hygiene in nursing practice. Through the exercise, I have understood the suggestions that I should embrace to improve my skills and knowledge. I should upgrade my documentation skills after attending to the medical needs of the patient.
Action Plan
I performed well in removing the Drainage tube; however, I need to perfect my skills as a registered nurse. I intend to conduct additional research on the post-operation process. I also plan to improve my documentation skills after medical attention. In the procedure, I used 70% alcohol as the cleaning solution; thus, I intend to research other options. I felt nervous and short of confidence at the beginning of the process. I plan to improve on my confidence during medical attention. Evidence-based practice is essential for the safety of Australian patents (Leach, Hofmeyer, & Bobridge, 2016). Furthermore, caregivers should follow clinical procedures to eliminate medication errors (Twigg, & McCullough, 2014).
References
Christelis, N., Wallace, S., Sage, C. E., Babitu, U., Liew, S., Dugal, J., … & Myles, P. S. (2015). Enhanced recovery after surgery program for hip and knee arthroplasty. The Medical Journal of Australia, 202(7), 363-368.
Clayton, J., Isaacs, A. N., & Ellender, I. (2016). Perioperative nurses’ experiences of communication in a multicultural operating theatre: A qualitative study. International journal of nursing studies, 54, 7-15.
Conti, A., Katzap, R. M., Poli?de?Figueiredo, C. E., Pagnussatti, V., & Figueiredo, A. E. (2018). Disinfection of the peritoneal dialysis bag medication port: C omparison of disinfectant agent and disinfection time. Nephrology, 23(9), 863-866.
Crisp, J., Douglas, C., Rebeiro, G., & Waters, D. (2016). Potter & Perry’s Fundamentals of Nursing-Australian Version-eBook. Elsevier Health Sciences.
Dougherty, L., & Lister, S. (Eds.). (2015). The Royal Marsden manual of clinical nursing procedures. John Wiley & Sons.
Jarvelainen, M., Cooper, S., & Jones, J. (2018). Nursing students’ educational experience in regional Australia: Reflections on acute events. A qualitative review of clinical incidents. Nurse Education in Practice.
Leach, M. J., Hofmeyer, A., & Bobridge, A. (2016). The impact of research education on student nurse attitude, skill and uptake of evidence?based practice: a descriptive longitudinal survey. Journal of clinical nursing, 25(1-2), 194-203.
Pazargadi, M., Fereidooni Moghadam, M., Fallahi Khoshknab, M., Alijani Renani, H., & Molazem, Z. (2015). The therapeutic relationship in the shadow: Nurses’ experiences of barriers to the nurse-patient relationship in the psychiatric ward. Issues in mental health nursing, 36(7), 551-557.
Pearce, N. (2017). IAAS-a nurse’s perspective. Day Surgery Australia, 16(1), 9.
Twigg, D., & McCullough, K. (2014). Nurse retention: a review of strategies to create and enhance positive practice environments in clinical settings. International journal of nursing studies, 51(1), 85-92.
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