Teamwork and Collaboration
Effective collaboration among nurses is among the crucial attributes necessary for patients’ wellbeing. As the patient was admitted to the hospital with COPD, my mind went to all the lessons I had learned about the condition and oxygen therapy. Working as a team is essential in the medical profession as it limits the probability of making mistakes that would lead to fatal injuries and, sometimes, death. Although I was ready to intervene, I felt nervous, not sure whether the patient needed long-term oxygen therapy or an immediate intervention for the situation at hand. Being a PRN nurse, and in consultation with my colleagues, I moved in to administer oxygen therapy to raise the patient’s oxygen saturation to an acceptable level. At this point, I was motivated by the need to offer prompt assistance that would restore the patient’s breathing condition.
Following the COPD and oxygen recommendations for patients with breathing difficulties and hypoxemia, I perceived that the patient did not have an acute illness. Therefore, I used a venture mask to deliver oxygen at 24% following a rate of 2-3L/minute. According to Branson (2018), such a situation required the oxygen saturation to be raised to 88-92%. I evaluated the effectiveness of my approach by measuring the final oxygen saturation levels and observing the patient’s physical appearance in regard to breathing. I included my colleagues in the evaluation to determine whether the patient needed additional treatment. After the intervention, the patients’ air saturation rose to 90%, and they ceased having shortness of breath. Since the final condition was within the recommended range, my intervention was successful.
Safety
A nurse’s responsibilities include ensuring patients’ safety in the hospital by effectively applying their knowledge and the available systems. In my learning process, I was taught that hospital falls are among the most prevalent causes of injuries, which should be prevented through a collaborative effort of all personnel. When I met the patient a year ago, I witnessed an elderly woman who had fallen, sustaining serious back injuries. This time, I knew that I had to support the patient at all times to prevent such incidents. As the patient was admitted, I felt challenged because, having witnessed a patient’s fall, I was determined to make sure this particular patient was safe while at the hospital. In addition, I felt that I was playing a vital role in patients’ well-being by applying my knowledge and experience to prevent one of the most significant causes of injury.
Understanding a patient’s needs and continuous patient monitoring is among the best strategies for preventing hospital falls. I understood that the patient was forgetful, failing to ask for assistance. Therefore, I strategized an intervention plan by setting the bed and chair alarms for notifications. In addition, I followed her whenever she was going to the bathroom, ensuring she did not fall. According to Morris and O’Riordan (2017), preventing falls in the hospital setting calls for nurse-patient collaboration and strategic interventions by trained medical practitioners. I evaluated the effectiveness of my approaches by observing how many times the patient was to the bathroom each day and whether she fell or not. At the end of her stay in the hospital, the patient had recorded no falls and was more likely to call for assistance whenever she needed it, making my intervention successful.
Quality Improvement
The quality of care in health institutions calls for continuous monitoring of patients’ conditions and applying suitable methods for positive outcomes. As the diabetic patient was admitted, I thought about my previous experiences at two different hospitals where nurses violated the double verification rule for insulin administration. In this case, I was responsible for helping my patient maintain appropriate glucose levels, which was vital for their wound healing and ulcer treatment. I felt challenged, mainly because I had witnessed situations where patients suffered due to incorrect insulin dosages. Koyama et al. (2020) assert that double-checking reduces medication administration errors, facilitating patient recovery and wellness. I felt that I had to apply the knowledge gained from the course on quality improvement to change the narrative on patient wellness by ensuring that the recommended practices were followed.
Insulin and Heparin are significantly critical medications that require careful administration to prevent adverse effects on patients. From previous research, insulin medication errors reduce the chances of patient recovery, which worsens the condition, especially when the patient is suffering from other medical conditions such as ulcers (Koyama et al., 2020). In this scenario, my patient needed insulin at various points since I had to keep their blood sugar at the appropriate level. Whenever I was administering the dose, I called upon a second nurse to verify the dosages. This way, no errors were witnessed with the insulin administration, effectively aiding in my patient’s recovery. I measured the quality of my intervention by assessing the patient’s response to mediation over time. My colleagues also checked the insulin administered and gave recommendations for improvements whenever there was a need to change. Since the patient received the correct medication at all times, they recovered fully within the stipulated time, implying that the intervention was effective.
Patient-Centered Care
Excellent medical service requires patients to be included as partners in the process of providing quality care. Since patient experiences vary within the hospital setting, it would be essential to gather their feedback on services provided to develop strategies for improvement (Malfait et al., 2017). Bedside reports are the most effective way of gathering patient input. As I was starting my clinical with the bedside reports, I was thinking about all the people I would interact with and the best ways to approach them. I remembered an instance in another institution during my attachment where an elderly patient felt uncomfortable discussing her issues with me, arguing that I was too young to understand. This time, I felt confident that I would apply the knowledge gained throughout my course to motivate the patients to cooperate and give their input. I took the reports seriously because I felt they were an important step in my nursing career.
I formulated a strategy to approach each patient appropriately based on their conditions. I was keen not to coerce the patients to speak on the personal issues they would prefer to keep private. I approached them by introducing myself, giving them the assurance that I was in a position to assist them. Consequently, most patients spoke about their histories, their medical conditions, and significant points they had gathered from the doctor. Malfait et al. (2017) argue that the meaningfulness of bedside reports is based on the extent to which patients participate in the exercise. I evaluated the effectiveness of my intervention by assessing patients’ willingness to speak and the amount of information they gave. I noticed that the patients progressively gained confidence, revealing more about the aspects for which they desired change within the hospital. This was vital for my understanding of patients’ needs and essential for formulating crucial improvement strategies.
Informatics
Technology has significantly altered information gathering, processing, and implementation for various processes in the hospital setting. Kleib et al. (2021) assert that integrating nursing information into technological applications is crucial for effectively managing health information. As I was starting my clinicals, I knew that computer charting was going to form a crucial part of my experiences. I was thinking of all the data I will need to collect and chart through the EMR. Since I had not interacted with the electronic system for hospitals before, I thought that it would be a significant challenge. Since the clinicals ushered me into the actual nursing practice, I knew that I had to pay attention and deliver the best output. Although I had the theoretical knowledge obtained from my course readings, I felt anxious about computer charting, wondering whether I would be able to perform as expected. Nevertheless, I was willing to learn by applying my knowledge and asking for guidance from my preceptor.
My approach in this scenario was to do a thorough assessment of my patients to understand them fully before documenting the information. I inquired from my preceptor, who explained the types of information that I needed to chart, giving reasons for each set of data. This guidance enabled me to understand the requirements better, saving me time and effort in the entire exercise. With time, I improved my charting skills, being able to capture most of the aspects required. I evaluated my intervention from the feedback given by my preceptor. Every time I submitted the charts to him, he would evaluate them and indicate points of improvement. Since the errors reduced with time as I became more efficient at charting, I realized that my strategy had been successful.
Evidence-Based Practice
Optimal health for nurses and patients requires an application of effective infection prevention measures in line with nursing expertise while considering patient needs. According to Bearman et al. (2019), it is impossible to achieve zero rates of the hospital –acquired infections (HAIs), but most of them can be prevented through effective health practices and the collaboration of all stakeholders. When I was starting my clinicals, I was thinking about possible routes of infection within the hospital setting. I was pondering about the interactions I have had with individuals who acquired infections at the healthcare facilities and wondering whether I would be better at preventing such illnesses. I thought that nurses have to be equipped with the knowledge and resources for infection prevention because I felt that it was the primary objective within the hospital setting. I found it crucial to sanitize often and wash hands with soap and water when handling patients.
Armed with the knowledge of infection prevention, I started my clinicals hoping to abide by set rules and minimize the probability of contracting HIAs. At the hospital, isolation signs were placed outside patient rooms, clearly indication what was needed to enter the rooms. Since the required equipment were provided, I ensured that I followed the recommended dressing and hygiene precautions when handling patients. I evaluated the effectiveness of my approach by how well I handled patients while minimizing the chances of getting infected. With time, I became better at protecting myself and the patients by advising them on the best approaches and observing the isolation signs. From the start of my clinicals to the end, I did not get infected within the hospital, indicating that my intervention was successful.
References
Bearman, G., Doll, M., Cooper, K., & Stevens, M. P. (2019). Hospital infection prevention: How much can we prevent and how hard should we try? Current infectious disease reports, 21(1), 1-7. Web.
Branson, R. D. (2018). Oxygen therapy in COPD. Respiratory Care, 63(6), 734-748. Web.
Kleib, M., Chauvette, A., Furlong, K., Nagle, L., Slater, L., & McCloskey, R. (2021). Approaches for defining and assessing nursing informatics competencies: A scoping review. JBI Evidence Synthesis, 19(4), 794-841. Web.
Koyama, A. K., Maddox, C. S. S., Li, L., Bucknall, T., & Westbrook, J. I. (2020). Effectiveness of double checking to reduce medication administration errors: A systematic review. BMJ Quality & Safety, 29(7), 595-603. Web.
Malfait, S., Eeckloo, K., Lust, E., Van Biesen, W., & Van Hecke, A. (2017). Feasibility, appropriateness, meaningfulness and effectiveness of patient participation at bedside shift reporting: Mixed‐method research protocol. Journal of Advanced Nursing, 73(2), 482-494. Web.
Morris, R., & O’Riordan, S. (2017). Prevention of falls in hospital. Clinical Medicine, 17(4), 360–362. Web.