HLT54115 Nursing

Critical Reflection Essay

Introducation:

Critical reflection is useful to the nursing practice and any other medical practice. This is because of the fact that it helps bridge the gaps that exist in theoretical issues, research and practical areas in the nursing practice. This forms the basis of the reflective essay where a critical reflection on what transpired is done and evaluated with reference to the National Safety and Quality Health Service (NSQHS) standards that are used in Australia to manage public risks in various organizations. The NSQHS standards are 10 in number with the standards 1 and 2 covering overarching issues in safety and quality health service i.e. standard 1 for issues of governance for safety and quality health service in organizations and standard 2 covers the areas around partnering with consumers. In this essay we focus on standard 8 that deals with prevention and management of pressure injuries in reference to the ABC news case. Critical reflection is important in improving the quality of clinical nursing practice and also for optimal patient outcomes in hospitals. . In this critical reflection essay we look at an incidence reported by the ABC news of an elderly patient who died after minor wounds that he had at admission had escalated to a gangrenous state, causing his death.

This was viewed by the family members of the senior citizen as a case of neglect from the staff members of the facility. The matter had been referred to the Aged Care Complaints Commissioner who upheld it and directed the hospital management to retrain its staff members on wound care. This incident left me shocked and perturbed as the matter had taken a completely different twist. This is in regard to the   involvements of the Aged Care Complaints Commissioner’s  , the media attention around the matter and the support groups like Aged And Disability Advocacy (ADA Australia) where the matter had been forwarded but rejected on grounds that it did not merit the threshold for elder abuse as prescribed by the Law Reform Commission. This incident had positive outcomes to the nursing fraternity as it elicited fresh internal reflection among nurses on wound care cases in patients among others which eventually prompted for a retraining program on wound care. The negative outcomes included an injury on the reputation of the hospital staff and its management in the public arena. From this case I was able to learn how wound care is a critical component in the nursing practice and if not carefully handled can be debilitating and lead to death. I shall therefore enhance my knowledge in the area of wound care so as to be abreast with the best practices in this area. The actions I have in place geared towards accomplishing this include a thorough review on pathology of wounds and the guides in the NSQHS standards that deal with wound care related activities.

In the incident reported by the ABC news, Mr. Zdenek Selir an 88 year old man had been admitted to the Leamington nursing home after he suffered stroke in 2015. At this point of admission he had minor pressure wounds that escalated during his stay in the hospital. The wounds reached a point of becoming gangrenous and the family on noticing this took alternative measures to help the elderly relative by taking him to the Gold Coast University Hospital emergency centre. Here the wound photos were taken by the doctors and sent to the family members before the old man succumbed to death, possibly due to extensive infection into the major body organs via the gangrenous wounds.  This incidence left me quite perturbed as to how the hospital staff at Leamington nursing home could be so oblivious of the old man’s condition in the facility. I felt for the old man and his family members who had entrusted the hospital with his health. This matter had a negative outcome to both the patient and the nurses. The patient ended up losing his life in circumstances that are ordinarily manageable and should not have led to death. The nurses on the other hand were dealt with a big blow in the public arena through the media on just how reckless and oblivious they can be in their practice. This greatly hurt the image of nurses and other healthcare workers. The positive outcomes of this event were that it led to an eye opener on the need to retrain the nursing staff on management wounds that will go a long way to improve the quality of service delivered by the nurses to the patients. The only positive outcome on the patient side was the fact that his family’s complaint to the Aged Care Complaints Commissioner was upheld and could thereby be used to seek compensation and other sources of remedy available. Thus the case reported by ABC had both positive and negative outcomes with regard to the patient’s side and the nurses’ side.

I learnt from this case just how wound care and management is a critical component of the nursing practice. I also learnt the need to comply with the national safety and quality guidelines as outlined by the NSQHS. I therefore had an action plan that involves reviewing the pathology of wounds and also reading and understanding the various standards outlined in the NSQHS, delving into each and every guide provided in the document. This process will help improve my knowledge in nursing and ensure I deliver quality services. Hence the event was a resourceful learning tool personally and I believe to other nurses as well.

In order to enhance learning among the nurses, continuous retraining should be done through activities like continuous medical education (CME) and seminars on selected topics like wound care to keep them abreast with the latest best practices available in the market. Through this reflective process on the ABC news case I will be able to learn a lot on wound care and with such adequate knowledge I will be able to salvage such unfortunate cases in the future. Therefore as it can be deduced from the incident above, continuous learning and improvement in practice is crucial to the nurses and all the healthcare workers.

According to the guides of standard 8 of the NSQHS on prevention and management of pressure wounds and any other relevant standard and guides I shall forth-will endeavour to put these guidelines into practice to ensure I deliver optimally in my nursing practice. Thus safety, quality and treatment guidelines are to be like a companion to any practicing nurse and I will commit to this.

In conclusion reflective process is important to the learning process in the nursing practice and helps bridge between the theoretical aspects and practical aspects. It is also important that nurses undergo continuous retraining and education programs to help boost their competence.

Reference:

1. ABC news, 2016. Found at :https://www.abc.net.au/news/2016-09-27/man-dies-after-nursing-home-staff-fail-to-properly-treat-wounds/*******
2. NMBA, 2016. Professional Standards. Sydney.
3. ACQSHC, 2017. Sydney.
4. NSQHS, 2016. Sydney.
5. 5. Katzung B. et al. (2012).  Basic and Clinical Pharmacology 12^th Edition. San Francisco. Mc Graw Hill Education.