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Prelude to the medical error case study
Prelude to the medical error case study
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Sterile Dressing Change Reflection
Throughout the sterile dressing change competency I felt that I adequately prepared and knew what I was doing. I felt a little off since I was being recorded and was not performing my skill on a real person. Regardless, I still feel that this competency overall went well. I feel that I could successfully perform a sterile dressing change in a hospital setting and not cause harm to my patient. Upon reflection, I realized I definitely still have a lot of room for improvement. I found that by being able to watch my recording I could see more clearly my strengths and weaknesses throughout this competency.
Three Strengths
One of my strengths of this competency was that I overall knew the steps and assessments for this skill. This made it so that I could easily move along without having to think back and remember what to do next. I did open my sterile cup before I had opened my needle and flipped it onto the gauze, but I quickly realized I had made an error and corrected this. I feel that I successfully maintained a sterile field and tried very hard to keep my arms at a correct level. I dropped my arm once, which I didn’t realize but saw during the video when I re-watched it. Another strength was that I had my sterile field set up so that I could easily navigate. I had my table and bed
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I dropped my arm once, uncapped my syringe early, had difficulty putting my gloves on, and had trouble removing my needle cap. Although I felt that I struggled in these areas, I am confident that I can make necessary changes to improve these parts of my sterile dressing change. Regardless of the difficulty I had while putting on my gloves and uncapping my needle I remained calm and kept a sterile field. In the future I will strive to be less nervous and keep my focus. Keeping my arms up and out needs to be practiced more and I need to be more conscious of it as
As a nurse we are responsible for the safety and overall health promotion of our patients. Competency in the nursing field is what ensures patient safety and decreased hospital acquired injury. Continued competence ensures that the nurse is able to perform efficiently and safely in a constantly changing environment. Nurses must continuously evaluate their level of skill and find where improvement needs to be made in order to keep up to date with the expected skill level set by their
Goldman, M. A. (2008). Pocket Guide to the Operating Room. Philadelphia, PA: F.A. Davis Company.
Proper PPE use not only lowers transmission of disease, but can lower the risk of blood contact during surgery. A study has been performed to evaluate the use of double-gloving during surgery and its effect on dexterity and sensation (Fry, 2010). Fry defined sensitivity as “the ability to discriminate and interpret a stimulus applied to the fingertip” and manual dexterity as “the ability to move the fingers skillfully and to manipulate small objects with the fingers rapidly and accurately” (Fry, 2010). The Purdue Pegboard was used to evaluate the sensitivity and dexterity of volunteers using no gloves, one pair of gloves, and two pairs of gloves. Fry’s group concluded that double gloving has no significant impact on sensitivity and dexterity.
Yacopetti, N., Davidson, P., Blacka, J., & Spencer, T. (2013). Preventing contamination at the time of central venous catheter insertion: a literature review and recommendations for clinical practice. Journal Of Clinical Nursing, 22(5/6), 611-620. doi:10.1111/j.1365-2702.2012.04340.x
It is of my opinion that proper technique and knowledge of manual handling is vital for my health and to my long term ambitions with regards to progression in the Care Industry.
While on the unit I made sure to use my time wisely, I completed my assessment in a timely manner, advocated for pain medication, checked on fellow nursing students, and kept patient’s rooms organized and clean. Professionalism was also exhibited in my clean outfit, with my hair back, name badge on, nails cut, and appropriate footwear and clinical tools on hand.
Today I was able to watch a vac dressing being placed on a patients wound. I had little knowledge about the vac dressing before going into this situation, it was interesting to see the situation in a real life situation first before doing research on it. There were two doctors in the patients room who were setting up the vac, one of the doctors was very good at explaining what they were doing and explaining how the vacuum dressing works. When they began to remove the old dressing I was surprised at how much packing the wound had. It wasn’t until all of it was removed that I noticed how large the wound actually was. We were able to get a nice view of the wound while the doctors were examining it. As they began to repack the dressing they
One day, this writer happened to see another nurse changing a Peripherally Inserted Central Catheter Line dressing. As a nurse leader, this writer asked the nurse why she is changing the dressing. The caregiver explained dressing changes can prevent infection to the site and there are lot of patients readmitted because of central line infections and subsequent complications. This nurse demonstrated good kn...
Time out was done by the anesthesiologist, the circulating nurse, the surgeon, and the scrub tech all pausing before the surgery and verifying the patient’s name and date of birth, the procedure being done, the site and location on the body in which the procedure was being done, and documented the count of all the equipment the scrub nurse had before surgery to compare to after surgery. 5. The patient’s privacy was protected and respected throughout the whole surgical procedure. The staff was very professional and I felt I learned a lot from them during my OR experience. 6. A sponge count is when the scrub nurse counts the sponges that are unused before the surgery she relays this to the circulating nurse and it is documented. After the surgery the count is redone to make sure that there are no sponges left in the patient. 7. The circulating nurse documents the information and signs the chart in the operating room. From pre-op to the operating room the nurses in pre-op gave off report to the circulating nurse by SBAR. From the operating room to PACU the anesthesiologist went with the patient and handed off the patient’s condition and information to the nurse in there. 8. There were no ethical or legal issues that were raised during my observation in the whole surgical process. 9. I learned how the whole operating procedure works from start to finish, all the legal paperwork involved, and how the team interacts and helps each other out to give the patient a safe and
Although the importance of aseptic technique has been continually reiterated, I have realised its substantial role in the perioperative environment. Aseptic technique refers to the practice of creating and maintaining a sterile environment used for sterile procedures (Laws, 2010a). This is incredibly important as repetitive minor breaches of the sterile environment is one of the major factors increasing the risk of surgical site infection (Harrop et al., 2012).
I think it is different when practicing on a manikin versus actually doing it in real life. My instructor was able to give me some great feedback, as well as helpful tips that I will be able to apply during my next clinical rotation.
Certainly, I began with the goal getting of his vital sign and giving him a bed bath. Fortunately I had practice how to take a vital sign and giving a bed bath before my first clinical at the university skill lab and I had developed this confidence before my clinical tour. That day will be mastering the skill which I had just learned in manikins, and applying in real human with huge safety precaution. In between morning my instructor was giving me a brief before I getting to the patients room. From her experience she knew what kind of challenges and a patient behavior can be I face. As I proceeded to my own patient, I hit a roadblock that would give me a flat tire for the rest of the shift.
... in caring for the patient. While bed-bathing my patient I used my interpersonal, listening and communication skills. These helped me when I was talking and giving instructions to my patient. I discovered how important communication is in nursing between the nurse and the patient in order to understand each other fo example asking a patient for consent. Moreover, it is during bed-bathing that the nurse and patient can form a therapeutic relationship leading the patient to trust the nurse. During bed-bathing my patient I also checked to see the skin for example bruises and pressure sores. Since communication and listening skills are vital in nursing, I will, therefore, need to improve my skills so I can be a better nurse in the future. Moreover, next time I should not let my feelings get in the way when approaching a similar or same situation like this in the future.
1. In this class, I learned many personal care skills such as peri-care, assisting an individual to eat, dressing, and transferring them using lifts and slings. I faced a few problems while providing peri-care to an individual. In providing peri-care, a person has to clean up the genital area and also to change a diaper of a client. I found it very awkward at first because it was my first experience in my life to provide someone with a peri-care. I faced difficulties while changing the diaper of the client; I was confused which side of the diaper should be up and which should be downward. I also have to take care of not to use the same wipe again and again, also to change the gloves while providing peri-care in order prevent the risk of infection.
I went to the operating room on March 23, 2016 for the Wilkes Community College Nursing Class of 2017 for observation. Another student and I were assigned to this unit from 7:30am-2:00pm. When we got their we changed into the operating room scrubs, placed a bonnet on our heads and placed booties over our shoes. I got to observe three different surgeries, two laparoscopic shoulder surgeries and one ankle surgery. While cleaning the surgical room for the next surgery, I got to communicate with the nurses and surgical team they explained the flow and equipment that was used in the operating room.