HLT51612 Nursing
Question:
This paragraph highlights my experience of administering oral medication. In my clinical practical unit (CPU) I was asked to administer oral medication. I was confused about carrying out patient and drug checks and found it difficult to follow the procedures in order. Most of the times I would continue to gather the equipment and dispense the medicine into the serving cup prior to following the five-rights and hand hygiene. My major mistake was that I did not gather the equipment prior to the procedure which led to frequent interruptions. It seemed like an easy task but upon doing it I felt extremely confused and frightened. I felt nervous while looking for the medication in the MIMS. I was afraid of misreading the information.
I was paranoid of administering the patient with wrong medication. However, it gave me an opportunity to learn from my mistakes. It helped me gain confidence. From this experience I have learnt that nurses require to understand the medical chart and need to be aware of contraindications, dosages and side-effects of the medications that need to be administered to the patient. Ultimately, it is important for the nurse to ensure it is the correct patient, dose, drug, time and route (Nursing and Midwifery Board of Australia [NMBA], 2016 and Australian Commission on Safety and Quality in Health Care [ACQSHC], 2017).
To practice safe administration, I need to improve my skills by practicing effective communication and make myself familiar with using MIMS. It made me aware of the importance of five-rights. In my future nursing career I would make sure to be well-prepared before administering the patient with medication. I would make sure to follow the five-rights of drug administration and follow strict hand hygiene.
Answer:
Gibb’s reflection cycle is the model using which people reflect on the situations which led them learn important lessons which they could not learn in their normal life. There are six steps of the reflective cycle such as description, feelings, evaluation, analysis, and conclusion and action plan through which clinical experience of any particular situation could be explained that affected the learnings of the person positively or negatively (Potter, 2015). In my clinical practice unit, I was asked to provide my patient with oral medication. I will be, therefore, using Gibb’s Reflection cycle to explain my experience about clinical practice unit in the following section.
Drug administration is one of the major and crucial parts of the nursing profession. After the drug prescription and dispersions done by the pharmacist, it is the primary duty of the nursing professionals to provide the patients with correct drug so that quality care could be provided. While undertaking the CPU, all the student nurses were asked to form group and each group member was asked to chose one of the drug administration route for their CPU.
In this situation, I was observing each of my members CPU practice and was observing their drug administration techniques and their hygiene level. Most of the student nurses were following the five stages of drug administration, however few of them were lacking in few important steps. Sophie missed her hygiene steps whereas Sarah forgot to count the dose of medication dose.
While observing the situation, and continuing with my CPU, I was very confident and I was continuously observing all of the steps and stages of oral drug administration. With every student performing his or her CPU, I was becoming more confident and positive and was thinking that I will be able to perform my CPU properly without any mistakes. I was continuously repeating the steps of oral drug administration, patient identification and labeling and distribution or counting of drug prior to administration so that while performing the CPU I can follow the steps diligently.
While evaluation the scenario, I can say that due to the close observation and experience of others mistakes in their oral drug administration related CPU, I was able to concentrate on important steps such as patient identification, checking MRN number, observing the medication chart, taking care of hand hygiene and providing the patient with oral sip so that his or her ability to swallow the drug could be identified (Neuss et al., 2012). This was an important learning experience prior to my CPU as learning from others mistakes helped me to perform the oral drug administration related process with minimal mistakes. However, while performing I forgot few steps such as checking MRN number and using the hand sanitizer prior to drug administration. Therefore, while evaluation I will be using these two negative points to determine the success of my CPU about oral drug administration to my patient.
From this reflective study I was able to analyze that in the complete process, I was confident and determined that I will be able to complete my CPU without any mistake and I will be able to administer accurate and proper oral drug to my patient. To some extent I was able to complete the process without any issue (Ensign, Cone & Hanes, 2012). However; two mistakes affected my complete performance. These mistakes were effective as hygiene is one of the primary care measures which a nursing professional should undertake to protect their patients from nosocomial infection. Further, checking the patients identity or the MRN number allotted by the hospital management is also an important aspect as without watching the patients identity administration of drug is considered risky (Schiff, Jaffe & Freundlich, 2014).
While concluding, it could be said that I was able to remember all the major steps of oral drug administration and it helped me to understand my mistakes and loopholes which I will be taking care of in my future CPU or professional life. Further, I was able to figure out the degree of my mistakes and others mistakes in affecting the patient’s health and wellbeing. Therefore, in conclusion, I was able to perform my oral drug administration related CPU properly.
My action plan will be understanding the issues in my performance and find out the key points using which I can reinforce the correct knowledge and use them to practice more and more so that I can bring accuracy in my performance and I can understand the medication administration related issues and minimize the risk of mistakes in my further performances.
References
Ensign, L. M., Cone, R., & Hanes, J. (2012). Oral drug delivery with polymeric nanoparticles: the gastrointestinal mucus barriers. Advanced drug delivery reviews, 64(6), 557-570.
Neuss, M. N., Polovich, M., McNiff, K., Esper, P., Gilmore, T. R., LeFebvre, K. B., … & Jacobson, J. O. (2013). 2013 updated American Society of Clinical Oncology/Oncology Nursing Society chemotherapy administration safety standards including standards for the safe administration and management of oral chemotherapy. Journal of Oncology Practice, 9(2S), 5s-13s.
Potter, C. (2015). Leadership development: an applied comparison of Gibbs’ Reflective Cycle and Scharmer’s Theory U. Industrial and Commercial Training, 47(6), 336-342.
Schiff, M. H., Jaffe, J. S., & Freundlich, B. (2014). Head-to-head, randomised, crossover study of oral versus subcutaneous methotrexate in patients with rheumatoid arthritis: drug-exposure limitations of oral methotrexate at doses≥ 15 mg may be overcome with subcutaneous administration. Annals of the rheumatic diseases, annrheumdis-2014.
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