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3875NRS Transition To Practice

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3875NRS Transition To Practice

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Course Code: 3875NRS
University: Griffith University

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Country: Australia

Question:
Discuss about the Reflection in Learning and Professional Development.
 
 
Answer:

Introduction
The concept of nursing is not new and has been there in the healthcare practice for a long period of time.  The nurses play an integral role in the health and social care industry and have contributed to the overall provision of health and social care facilities to a large extent. It could be said that the success of a health and social care organisation relies on the efficiency of the nursing staffs and the practitioners (Kvas & Seljak, 2014 p, 78). Nursing is a demanding profession takes significant toll on the bodies of the nurses and throws number of challenges to the individuals. Every day in their life is a challenge which needs to be met with equal skill and potential which would help them to provide the best possible care for the patients. The Nurses play a crucial role in the effective provision of health and social care services but they also significant issues in their daily professional life. These issues are related with their workplace and also hinders their overall service provision (Becher & Visovsky p, 76). The purpose of this study is to understand a crucial issue facing nursing in the health and social care and discuss the related theories to address that issue. The nursing profession faces significant issues nowadays which clearly affect their overall performance. The present study discuss a key issue with the help of practical reflection using the Gibbs Cycle (description, feelings, evaluation, analysis, conclusion and action plan) which would help to achieve objectives of the study.
 
Issue of safe medication administration
The main issue that would be discussed here is safe medication administration in health care organizations. I am working for a health care organization as a nursing professional and from the very first day the importance of safe medication administration has been identified by me and my colleagues. We as nursing professionals have the duty to administer the right medicine to the patients (Blair, 2013). Medication error is a common problem in health care profession and often takes place as a result of same name of medicines or similar packaging. More over medication errors have also been noticed regarding medicine that not commonly used or prescribed. Other important medication error that I have noticed in this field is due to allergic reactions of patients towards certain medicines. So here the main issue has been discussed along with the factors that lead to such errors. The Gibbs reflective style would help me describe, feel, evaluate, analyze, conclude and come up with an action plan for the issue of medical errors so that safe medical administration can be achieved.
The description segment gives the exact description of the issue which helps to get a proper idea of the problem. The description section is important as it helps to make sure the incident is understood and accordingly it would help to follow the next sections and come to an effective conclusion. And develop a strong action plan. The feelings are extremely important to be understood and what goes on in a particular scenario largely helps to make moves in the future issues and hence the feelings stand to be important (Blair, 2013).
Description -Safe medical administration is an important issue in the health care profession and when safe practices are compromised with these lead to adverse impact. I have come across cases where medication errors have led to harmful impact on the health of the patient as well as death of patients due to overdose or wrong medication. These cases are witnesses of unsafe practices which could not justified in the medical profession (Howatson-Jones, 2016). 
Feelings- Whenever I have come across such cases I have always felt that we should be more careful while administering medication and should not allow anybody or anything to distract us so that we can do our duty responsibly and will caution. In my profession I have once come across an adverse drug event (ADE) that led to physical harm. The child was given a medicine which he was allergic to. However the allergy associated with the specific group of drug was clearly mentioned in the brief sheet but was not read by the medical practitioners and administered him the drug which later on led t severe physical reactions and the child had to shifted to an ICU. Thus I feel that the procedures and protocols should be stricter so that these type of errors are less in our profession.
Evaluation- the Evaluation of the situation helped me to understand that safe administration of drugs is very important in medical profession. Although the incidents that took place were harmful for the patients but at the same time they helped me and my colleagues to learn that safe medication administration is important. We have also learnt to study patient’s medical history where ever we join a new shift.  Medication order sheets and medication administration records are used for safe medical practices (Blair, 2013).
Analysis- I have understood that medication error is a common problem due to distraction and lack of concentration. Lack of training is also an important factor that leads to unsafe medication practices. Many a times I see nurses do not use the medication order sheet or study the medical history of the patient while administering drugs. It should be the duty to verify medication order before giving medicines. Written or typed orders are important to follow since they can help in reducing medication error.
 
The medical errors that I have come across are mostly cases of negligence and distractions and thus I feel that medical professionals should try to keep themselves concentrated when they are with patients and distractions in this field can cost someone their life. Identification of the patient also becomes very important since many medication errors take place when a right medication is administered to the wrong patient. Thus from my experiences feel that identifying patients identity from at least two identifiers would reduce the risk to a certain level (Howatson-Jones, 2016). 
Action plan – thus after identification of all the medical errors that I have come across in my professional life I would follow a robust action plan that would help me undertake safe medication practices. Some of the safe practices that would be involved in my action plan are obtaining accurate medication listing and ensure that medication list is available in patient’s medical record. In case of inability of the patient to participate in the listing of drug and food allergies the family members of the patients should be involved. I would also undertake a practice by sending the patient’s medication list and order of new medication to the pharmacy in order to be extra careful about the accuracy of the new medicine in comparison with the new medicine that has been prescribed (Bullman, 2013).
Prevalence of this issue
 Medical errors can be found in different parts of the world and is a matter of concern for the medical professionals. More and more settings are trying to implement ways of safe medication administration for the wellness of patients. The most common type of medication error that I have come across in my profession as a nurse is the administration of medicines that could have allergic reactions in patients without properly knowing their medical history. I work in the pediatric department in the hospital where we need to take care of children and thus have to be extra careful with drug administration since children do not have decision making power regarding medication and treatment like adult patients and they are also unaware of any allergy associated with any kind of drugs they are being administered (Howatson-Jones, 2016).   Medication error can happen in all setting and can also lead to adverse impact on the health of the patient.  Many of these medication errors are associated with oral or written miscommunication and hence safe practices should be undertaken while administering medication to patients of any age group since medical professionals are responsible for the health and wellness of the patients (Speroni, 2014). One thing that I have learnt during my college days is that in order to prevent medication errors medical professionals should be able to avoid distractions and interruptions when preparing or administering medication to the patients. Distractions are a major cause of medication error and do not allow professionals to concentrate on safe practices which is very important while administering medication. I have observed the issue of medical errors in my profession quite a few times which have led to critical condition of patients sometimes because of allergic reactions as medical history was not studied properly before administering medication and sometimes due to administration of wrong medication or overdoes due to distractions and lack of concentration while administering drugs to patients (Howatson-Jones, 2016).  The issue of safe medical practice thus is very important for me as I feel being a part of this respected profession that we are the life lines of patients and hence we need to be extra cautious with our practices and come up with safe medication practices so that patients do not suffer. Some of the safe practices that have been identified in the medical field to ensure safe medical administration are including equipment like patient medical record, Patient’s medication reconciliation form or listing, medication administration records. Health care settings are implementing rules like written or printed documents for prescription so that errors are limited. Patient verification, identification of medicine and food allergies etc are very important for safe medication administration (Bullman, 2013).
 
Clinical practice issue supported by literature
Promotion of a safe culture in health care profession is very important and health care industries around the world and most specifically in Australia has been focusing on building a safe culture with safe medication administration practices. An adverse drug event is harmful for the mental and physical status of a patient and hence needs to be avoided. Medication errors arise due to errors in medication administration. Thus when such error occurs it is a significant incident for the health care industry irrespective of the fact that any patient was harmed or not. Health care professionals need to avoid distractions to promote a culture of safety in the health care industry.
The report “Top Err is human: building a safer health system” by the US institute of medicine has been helpful in raising concern for patient safety in the health care industry across the globe. Many countries now promote the health and safety of patients in the health care industry with innovative practices that are helpful in minimizing certain risks associated with unsafe practices in the health care industry. In 2002 a resolution was adopted by the world health assembly urging the world health organization to loom for practices concerned with patient safety. More over in the year 2002 management of safety and quality in health was promoted by the European Health committee. The recommendations made hereby were helpful for prevention of adverse events in the health care industry (Bullman, 2013).
Safe medication is often compromised due to misunderstanding and confusion in the health care industry. It has been noticed in many cases that medical inaccuracies arise due to different terms being used for medication safety. Hence the use of specific terms for correct understanding of medication safety is fundamental in the health care industry. US national co-ordination council for medication error reporting defines medical error as “”A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice health care products, procedures, and systems, including prescribing; order communication; product labelling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use.”
Hence medication errors should be reported in order to control the situation and preventing the occurrence of such incidents.  European studies highlight that incidents of ADE vary from 2.1% to 19.8%. and 2.6 percent to 21.5% in pediatric wards. Several studies thus highlight the importance of medication error reporting system but unfortunately such reporting framework is not found in many European countries and other parts of the world (Speroni, 2014).
 
Recommendations
In order to mitigate this kind of issue at the workplace it is important to implement certain key strategies which are:

Train and develop the nursing staffs for promoting a culture of safety in health care industry
The Hospitals should implement proper risk assessment related to this issue (Jiao et al., 2015 p, 55).
Nursing staffs should be trained for reporting medical errors
The management should implement systems like double identification of patients, listing for medication and for medicine and food allergies of patients
Avoidance of distractions
Staffs should be trained to be concentrate on their work and ensure all the protocol of safety drug administration are fulfilled.

Conclusion
The present study has discussed the issue of safe medication administration which has been discussed in the form of reflective summary. The reflection states that medication safety administration is a growing concern worldwide and hence should be focused upon. Innovative ways and measures should be identified in order to undertake safe practices for medication administration. Thus this piece of work has been helpful for me to discuss an important issue in my workplace and highlight my action plans to deal with the issue as well as provide a robust understanding of the issue from different perspectives.
 
References
Blair, P. L. (2013). Lateral violence in nursing. Journal of Emergency Nursing, 39(5), e75-e78.
Bulman, C., & Schutz, S. (Eds.). (2013). Reflective practice in nursing. John Wiley & Sons.
Davies, S. (2012). Embracing reflective practice. Education for Primary Care, 23(1), 9-12.
Edward, K. L., Ousey, K., Warelow, P., & Lui, S. (2014). Nursing and aggression in the workplace: a systematic review. British Journal of Nursing, 23(12), 653-659.
Howatson-Jones, L. (2016). Reflective practice in nursing. Learning Matters.
Littlejohn, P. (2012). The missing link: using emotional intelligence to reduce workplace stress and workplace violence in our nursing and other health care professions. Journal of Professional Nursing, 28(6), 360-368.
Moon, J. A. (2013). Reflection in learning and professional development: Theory and practice. Routledge.
Speroni, K. G., Fitch, T., Dawson, E., Dugan, L., & Atherton, M. (2014). Incidence and cost of nurse workplace violence perpetrated by hospital patients or patient visitors. Journal of emergency nursing, 40(3), 218-228.

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