Case Of Antonio Umbilical Hernia Surgery †MyAssignmenthelp.com

Question: Discuss about the Case Of Antonio Umbilical Hernia Surgery. Answer: Description I was assigned to a patient named Antonio who underwent the umbilical hernia surgery and is prescribed by the physician for the administration of deep venous thrombosis prophylaxis. I was working with the patient for postoperative care and was supposed to give medication through subcutaneous injection. Medication involves anticoagulant heparin 5000units as mentioned in the patients drug chart (ampules contained 25000units/mland volume 0.2 ml). I had donned my gloves prior to injection, after performing five moments of hand hygiene. Before injecting I had wiped the skin of the patient with alcohol and left for 30 seconds to dry. After injecting on the abdomen through syringe I had kept it for less than 10 seconds. Later I have disposed the injection without re-sheathing. I had pre-planned the steps to be followed and was mindful enough to follow the guide. Therefore, I could well perform the given assessment, even though nervous initially. Feelings Before performing the skill I was too nervous. I had administered the injection too quick as per my peer feedback. It may be because of my nervousness. It made me feel anxious about the outcome of the injection on the patient. It made me doubtful about the impact of the medication, on the recovery of the patient. Heparin was important for the patient as it prevents the harmful blood clots inside the veins after the surgery. Proper medication administration ensures a smooth blood flow through the vessels (Pourghaznein et al., 2014). If I had not injected properly, the blood clots would remain in the veins, causing post operative complications. Learning this skill was important for me as it was an integral part of my profession as per the nursing and midwifery council's (NMC) Standards for Medicines management (Nursingmidwiferyboard.gov.au, 2018). However, I regained my self-confidence as I have received positive feedback from my teacher. As per his feedback my injecting skill was very fast and I have performed the assessment very well. I was confident while performing the assessment according to my teacher. I plan to be more confident next time. I believe the positive outcome was due to adherence to clinical guidelines. Evaluation The positive outcome of the skill assessment is the learning the right technique of the administering medication subcutaneously. Mastering the skill requires professional judgment and sound knowledge of anatomy. It worked well as I have learnt about the four considerations while injecting the medication. It includes technique used, route of administration, equipment used and site of administration (Pourghaznein et al., 2014). I had used 45 degrees angle and introduced the needle at raised skin fold. However, to ensure the efficacy of medication in subcutaneous layer, 90 degree angle is preferable (Cross et al., 2017). I have performed well because the wiping skin with alcohol ensured aseptic technique. Immediate disposal of injection was necessary to prevent needle stick injury and exposure to blood borne infections (Pourghaznein et al., 2014). However, I should have kept the injection for 10 seconds before removing. This aspect did not work well although administration was successfu l. Analysis As I was analysing the future practice needing this skill, I had realised that the nurses are responsible for safe medication and adopting the right injecting skills will prevent complications. A poor competence of this technique may lead to intramuscular administration of the injection and reduced absorption of the medication (Pourghaznein et al., 2014). I realised that I need to master this skills even more and required further practice. It is because; I am responsible to adhere to NMC Standards for Medicines management (Nursingmidwiferyboard.gov.au 2018). Nurses can make rational decisions using evidence based practice. Nurses must continue with lifelong learning to know what is safe for patients (DiCenso, Guyatt Ciliska, 2014). Therefore, I should also learn the right technique of injecting the medicine such as the appropriate angle. The patients history may influence the injection decision. It includes body mass index, renal impairment, age, sex and presence of any other comorb idity. The past medication related factors and single checking of medicine must also be considered (Cross et al., 2017). According to Pourghaznein et al. (2014), there is a direct relation between the injection duration and injection site on pain and bruising of subcutaneous injection of heparin. Therefore, duration is an important factor for injection. Conclusion In conclusion, I need to change my learning style for new experiences and flourish on new challenges. Understanding the personal learning style will help develop the learning ability and partake in new opportunities during placement (Hallin, 2014). I need to identify my personal strengths and weaknesses as a nurse. It was because of this critical refection that I have identified the need of improved competence in subcutaneous injection skills in regards to duration of injection, the need to consider appropriate degrees of angle for injection, and other patient elated factors. Without reflection it would not have been possible to understand the importance of considering these factors for injection. Action plan I would improve my learning by observing role models as suggested by Liljedahl et al. (2016). I would observe my mentors carefully before taking my turn on injection activities. I would practice injecting the medication for 10 seconds and use an angle of 90 degrees. I will maintain a reflective diary to evaluate my performance, strengths and weaknesses as nurse. I would also collect feedback from my mentors and peers, on my improvement in this skill. According to Horton-Deutsch Sherwood (2017) nurses can become experts by reflecting on personal clinical encounters. It is useful to improve practice. Thus, I would learn safe medication practice and injection style. My strategy is to go for experimental learning as it is the strategic approach to learning while in clinical placement (Pai, 2016). Therefore, I would like to work with different patients and try to overcome my nervousness. It would increase my confidence for future practice. I would collect feedback from patent on affect o f my injection such as pain or any discomfort (Pourghaznein et al. 2014). References Cross, R., Bennett, P. N., Ockerby, C., Wang, W. C., Currey, J. (2017). Nurses Attitudes Toward the Single Checking of Medications.Worldviews on Evidence?Based Nursing,14(4), 274-281. DOI: https://doi.org/10.1111/wvn.12201 DiCenso, A., Guyatt, G., Ciliska, D. (2014).Evidence-Based Nursing-E-Book: A Guide to Clinical Practice. Elsevier Health Sciences. Retrived from: https://books.google.co.in/books?hl=enlr=id=bHqjBQAAQBAJoi=fndpg=PR29dq=Nurses+can+make+rational+decisions+using+evidence+based+practiceots=M3HmIgBoYMsig=c7gNVbCJHJMl7rxy5FbXRJFw270#v=onepageq=Nurses%20can%20make%20rational%20decisions%20using%20evidence%20based%20practicef=false Hallin, K. (2014). Nursing students at a universitya study about learning style preferences.Nurse education today,34(12), 1443-1449. DOI:https://doi.org/10.1016/j.nedt.2014.04.001 Horton-Deutsch, S., Sherwood, G. D. (2017).Reflective practice: Transforming education and improving outcomes(Vol. 2). Sigma Theta Tau. Retrieved from: https://books.google.co.in/books?hl=enlr=id=JMcmDwAAQBAJoi=fndpg=PP1dq=nurses+to+follow+reflective+practiceots=kpKQx7Rqf4sig=FCHWvaoAfHkP3yMXT0_yukjS--4#v=onepageq=nurses%20to%20follow%20reflective%20practicef=false Liljedahl, M., Bjrck, E., Kaln, S., Ponzer, S., Laksov, K. B. (2016). To belong or not to belong: nursing students interactions with clinical learning environmentsan observational study.BMC medical education,16(1), 197. DOI: https://doi.org/10.1186/s12909-016-0721-2 Nursingmidwiferyboard.gov.au (2018).Nursing and Midwifery Board of Australia - Professional standards. [online] Nursingmidwiferyboard.gov.au. Available at: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx [Accessed 25 Jan. 2018]. Pai, H. C. (2016). An integrated model for the effects of self-reflection and clinical experiential learning on clinical nursing performance in nursing students: A longitudinal study.Nurse education today,45, 156-162. DOI:https://doi.org/10.1016/j.nedt.2016.07.011 Pourghaznein, T., Azimi, A. V., Jafarabadi, M. A. (2014). The effect of injection duration and injection site on pain and bruising of subcutaneous injection of heparin.Journal of clinical nursing,23(7-8), 1105-1113. DOI: https://doi.org/10.1111/jocn.12291