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Improvement in Nursing Performance: Personal Reflection using Rolfe Model Assessment Answer

2.4 Assessment Details

2.4.1 Essay including a personal reflection

Format: Essay including a personal reflection

Length: 1,000 words

Curriculum Mode: Essay

Aim of assessment

Standard 1 of the NMBA Registered Nurse Standards for Practice outlines the requirement for nurses to use best available evidence for safe, quality practice and to develop practice through rellection on experiences, knowledge actions, feelings and beliefs (NMBA, 2016).

The aim of this essay is for students to describe, and reflect on, a nursing related event reported in the media and using the National Safety and Quality Health Service (NSQHS) standards developed by ACSQHC (Australian Commission for Safety and Quality in Healthcare) identify what nurses might do to improve their practice and reduce the risk of a similar errr.

Details

A copy of the article of the nursing related incident and NSQHS standard that you must base your essay on is available

‘on vUWS in the assessment 1 folder located in the assessments tab, Students will write an appropriately structured essay that includes and/or addresses the following points. A guide to

‘the number of words you may wish to use for each section is provided in brackets after each point

  • A concise introduction that identifies the incident to be discussed with background information, a thesis statement (a statement that tells the reader what you believe about the topic). and outline of the main ideas to be discussed in the essay (Approximately 150 words)
  • A comprehensive description of the nursing incident including an explanation of the nurse's role in the incident (Approximately 150 words)
  • Identify and explain the consequences of this incident for the nurse and the health consumer (patient and their family) (Approximately 150 words)
  • Identify and describe the nursing actions, through the development of a nursing action plan, that demonstrates how the nurses can improve their practice in a way that prevents the incident reoccurring (Approximately 250 words
  • What? What feelings did this event evoke (suggest) for you? So What? So what does this tell you about the nurse's actions in this incident (were they appropriate, were they correct, was it best practice?). What do you think the nurse might have been thinking when the mistake occurred?
  • Now What? Now what knowledge could the nurse have remembered and applied to ensure the incident didn’t occur. Is there additional information the nurse needs in order to be safe?
  • A conclusion that concisely summarises the main ideas raised in the essay, restates the thesis statement and concludes with a final statement (Approximately 150 words)
  • Appropriate use of language and conventions, and appropriate support of relevant academic resources, including appropriate NMBA and ACSQHC standards throughout the essay
  • Your introduction, main body and conclusion paragraphs in this essay must use 3rd person. However, your reflection paragraph may use Ist or 3rd person
  • Applies appropriate, academic resources and uses correct APA 6th style referencing both in text and on a complete reference list

Important Note: The marking criteria add up to a mark of 60. The assessment is weighted at 30%. Therefore, your mark out of 60 will be converted ta a mark out of 30% for your final grade

Answer

Approaches to Professional Nursing Practice

Introduction 

The fundamental objective of the essay is to improve nursing performance by using critical thinking skills. It will also reflect on the incident of Sydney, where an old grandmother died to a medical error by the nurse. The National Safety and Quality Health Services Standards aims to safeguard the community from any injury and develop the quality of health service. Critical reflection is necessary for all the nurses to improve their performance and provide quality care to the patients. NMBA standards outline that the nurses must use the best evidence for quality practices and develop practice through critical reflection on knowledge, experiences and beliefs. Thesis statement: "Critical reflection should become the part of all nurses to transform nursing practice." The paper will describe the incident, identify and explain the consequences, provide a nursing action plan for improving practice and give personal reflection using Rolfe model. 

Description of the nursing incident 

An incident that took place at St. George Hospital cause the death of an old grandmother named Nymphea Anderson. The nurse named Mavis Lopez had crushed three diverse oral medicines and inject into the IV-drip of the old lady (Bibby, 2015). Within a few minutes of injection, she was suffering from unadorned pain in both wrist and arm, and she expired at 10.35 pm due to a heart attack. The nurse had been suspect of murder over the death of the patient. The court heard in the trial that the lady arrived with various diseases and chronic problems at the hospital, and she was already at death's door. The prosecutor, Ms Cinque, evidenced that Lopez had injected the three medications to Mrs Anderson without consulting with any registered nurses. Medication safety of the National safety and quality health service standards need to be followed to ensure the nurse in administering medication safely (NSQHS, 2019). 

Identification and explanation of the consequences 

Negative consequences for the nurse are shame, guilt, face legal and ethical issues and self-doubt. Negative consequences for the patient and the family are death, loss of loved ones, and hard to overcome the situation. There may be positive consequences for the nurse, such as improve the performance, critically reflect on her knowledge and boost the major causes of medication error. 

The medicine error results in the decease of the patient and the family of the patient lose their loved ones, which is a devastating situation. The nurse was accused of wrong medication and sent to the trial room for investigation. She also suffered from guilt and self-doubt but experienced a lawsuit by the relatives of the patient for negligence. The career of the nurse might have been affected, and the license of the practicing nurse would be revoked (Von Colln-Appling & Giuliano, 2017). 

Nursing action plan to improve practice 

The nurses must take essential steps or strategies in order to improve clinical practice. The NMBA (Nursing and Midwifery Board of Australia) stated that registered nurses must use a number of thinking strategies and use the best evidence in making effective decision to provide quality and safe care to the patients (NMBA, 2019). The nurses should deliver individualized patient care in the hospitals that allow them to provide tailored care to the requirements of the patient when they are on the way of improving their health. Registered nurses could obtain an advanced nursing degree or continue to gain knowledge by taking educational courses as it helps in improving the nursing practice as well as patient care. It is also important for the nurses to respect all cultures and experiences that consist of response towards the role of the family (Kim et al., 2018). As per the standard 1 of NMBA, nurses should use ethical framework while making the decision for the patient. Moreover, the registered nurses might develop nursing practice through critical reflection on their actions, knowledge, beliefs and experiences. The nurses should comply with the medication safety standard of NSQHS to enhance practice in administering proper medication (NSQHS, 2019). 

Below are the five nursing actions that could improve practice and prevent reoccurrence of the incident of medication error – 

  1. Properly document the recording of administered medication and label the medication (Kozak, Melton, Gernant & Snyder, 2016)
  2. Learn the medication guidelines and regulations
  3. Follow proper medication administration procedure
  4. Develop communication skills to communicate effectively with patients
  5. Follow all standards of NMBA 

Personal reflection 

I felt that the healthcare system was not appropriate and did not comply with the standards of NSQHS and NMBA. This incident evoked the feelings of life-threatening for me when I heard the death of the patient due to a drug error. I felt unfortunate for the family members of the patient as they lost their loved ones. The incident tells me that the actions of the nurse were not appropriate. It was not the best practice of the nurse as she did not consult with any other registered nurse before administering medication to the patient (Skinner & Mitchell, 2016). The nurse might have been thinking of any other matter or did not consider patient care when she was medicating the patient. Perhaps the nurse was negligent in giving proper care to the old patient. The nurse should apply the medication safety standard of the NSQHS to prevent the occurrence of error. She must follow all the guidelines for administering medication. 

Conclusion 

The paper concludes that improper medication can result in the death of the patient in the incident that took place at St. George Hospital. In that incident an old lady died due to medication error and the nurse was accused of being administering the wrong medication. The nurses should critically reflect their knowledge, feelings and experiences to improve nursing practice as per the NMBA standards. Moreover, there were many negative consequences for the nurses and the family members of the patient such as shame, guilt, lawsuit, loss of loved ones and stress. Therefore, the nurses should follow all the guidelines and standards of the NSQHS and NMBA to improve the practice and prevent the error.

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