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NURSING 7105 Acute Care Nursing I

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NURSING 7105 Acute Care Nursing I

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Course Code: NURSING7105
University: The University Of Adelaide

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Country: Australia

Question:
Critical Reflection 
Wirte an essay on Coroner recommends changes after blood mix-up patient death.
Answer:

Introduction:
Blood mix up is one of the most dreaded medical errors that causes various terrible consequences for the patients (Murphy, Waters, Wood & Yazer, 2013). The lack of responsibilities and negligence is the main perpetrator of these errors that eventually lead to extreme results for the patients. Although, in certain cases, even the extreme occupational stress, low staff ratio and Burnout is one of the significant causes leading to such Medical Services as well. However regardless of the causal trajectory the impact of medical errors especially the ones that are associated with proper patient identification and blood sample documentation leads to costing the innocent patients of their lives (Shekelle, 2013). This essay will attempt to reflect on a clinical incidents that resulted in an unfortunate death of a patient caused by a single medical error in blood sample documentation and patient identification taking the assistance of the Gibbs reflective cycle.
Description:
The case study for this reflective assignment is focused on the saddening story of Ms Ruth Stoll who had to give up her life for the callous mistakes that have been made from the staff of the Clinpath laboratory. Exploring more on the scenario, Ruth had been a heart patient who had needed to undergo a surgery and visited the Clinpath lab to get a blood test done to understand whether or not she needs transfusion before the surgery. However, the nursing professional who had been attending the patient to draw up blood sample was also attending another patient at the same time who came for a blood test. Due to the extreme negligence and lack of responsibility from the nursing professional she mislabeled the blood samples. Ruth faced a terrible untimely death 6 days later when she was going through the transfusion before the surgery 6 days later, she died due to receiving wrong group of blood. Furthermore, the case study also states that the patient has gone to the lab with her husband and her sister in who had not been allowed inside the room when the blood samples were being drawn. Hence, the coroner investigating the cause of death recommended for such serious patients to always be accompanied by their family members to ensure that such mishaps can be avoided.
Feelings:
This is the section of the Gibbs reflective cycle where the nursing professional is needed to explore the impact of the experience on him or her, and the exact feelings generated in the nursing professional (Wachter, Pronovost & Shekelle, 2013). In this case, I would firstly have to mention that I had been deeply saddened and shocked to get to know of this extremely terrible incident. Nursing is a professional where the professional roles and responsibilities are associated intricately with moral responsibilities and humanity. I have always believed that being in the capacity to save lives or even aid in the process of recovery and care for a human being, it is my moral responsibility to be as careful and vigilant as possible to ensure that someone’s life should not be under any risk for a fault on my ends. I felt absolutely aghast at the how nurse might be living with herself after committing such a heinous mistake that led to the death of an innocent patient.
Evaluation:
Evaluating the incident that caused the death of Ruth, it has to be mentioned that this incident and the cause that propelled it had been avoidable. First and foremost, proper patient identification and documentation of the patient information is a crucial requirement of the nursing responsibilities as per the NMBA practice standards (nursingmidwiferyboard.gov.au, 2018). In this case, the practicing nurse did not employ enough attention or focus on the patient and her proper identification and the documentation procedure, which can be considered primary error committed by the nurse. Secondly, according to the standard 7 of the NSHQS standards, proper management of blood and blood products, it is extremely necessary to maintain the safety of the patients with respect to blood and blood products for the ones that are receiving transfusion (safetyandquality.gov.au, 2018). Exploring further, this standard states that the nurses are required to focus effectively on optimizing and conserving the blood products taken from the patient which will help in reducing the unnecessary risks of adverse events. Similarly, According to the standard 2 of the NSHQS, the care providers are required to allow the patients and her family members to be partnering with the care professionals so that they can participate in designing and evaluating the care. In this case the family members of the patient had not been allowed to be inside the room when the blood was being drawn from the patient, which is another error committed that violates the NSHQS standards (safetyandquality.gov.au, 2018).
Analysis:
In order to analyze the impact that the error that has been committed, it has to be mentioned that the blatant disregard towards the health and safety standards of the Australian health governance. As mentioned by Green (2013), the most of the most of the medical errors are avoidable if adequate care is taken to ensure double checking each care activity and maintaining a strict set of protocols. In this case, even the management of the lab failed to have any supervision overlooking the care activities of the staff. From this entire experience I have learned that patient identification, documentation and safe maintenance of blood products can easily be implemented while adhering to the practice guidelines and being extra vigilant of my own practice. I have also learned that the impact of reflective journal is an effective technique to reduce chances of error which I will be implementing in the future practice (Starmer et al., 2014).
Conclusion:
On a concluding note, this has been an excellent opportunity for me to explore the impact of a medical error and how it can even result in a saddening result such as the death of a patient. This experience has also helped me the impact of the position I have in ensuring the health and safety of the patients and how each of actions is intricately linked with life and death of the patient. Hence, in the future, I will be extra careful to ensure that my care skills and competence are adequately developed and continually improving.
Action plan:
Human beings are not above of making errors, however avoidable mistakes should be taken into immediate consideration so that the patient safety and welfare is not affected by any manner (Makary & Daniel, 2016). I believe that I am accountable for my own actions and negligence is not my flaw. However, I will be taking additional efforts to ensure patient safety by adhering to practice standards and undertaking a reflective practice (Husebø, O’Regan & Nestel, 2015).
References:
Green, S. F. (2013). The cost of poor blood specimen quality and errors in preanalytical processes. Clinical biochemistry, 46(13-14), 1175-1179. Doi: 10.1016/j.clinbiochem.2013.06.001
Husebø, S. E., O’Regan, S., & Nestel, D. (2015). Reflective practice and its role in simulation. Clinical Simulation in Nursing, 11(8), 368-375. Doi: 10.1016/j.ecns.2015.04.005
Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the US. Bmj, 353, i2139. Doi: 10.1136/bmj.i2139
Murphy, M. F., Waters, J. H., Wood, E. M., & Yazer, M. H. (2013). Transfusing blood safely and appropriately. BmJ, 347(F4303), 1-12. doi: 10.1136/bmj.f4303
Nursing and Midwifery Board of Australia. (2018). Registered nurse standards for practice. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
Safetyandquality.gov.au. (2018). National Safety and Quality Health Service Standards. Retrieved from https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-Standards-Sept-2012.pdf 
Shekelle, P. G. (2013). Nurse–patient ratios as a patient safety strategy: a systematic review. Annals of Internal Medicine, 158(5_Part_2), 404-409. DOI: 10.7326/0003-4819-158-5-201303051-00007
Starmer, A. J., Spector, N. D., Srivastava, R., West, D. C., Rosenbluth, G., Allen, A. D., … & Lipsitz, S. R. (2014). Changes in medical errors after implementation of a handoff program. New England Journal of Medicine, 371(19), 1803-1812. Doi: 10.1056/nejmsa1405556
Wachter, R. M., Pronovost, P., & Shekelle, P. (2013). Strategies to improve patient safety: the evidence base matures. Annals of internal medicine, 158(5_Part_1), 350-352. DOI: 10.7326/0003-4819-158-5-201303050-00010

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