Reflecting on Competency with Subcutaneous Injection Technique

Reflecting on Competency with Subcutaneous Injection TechniqueThe focus of this essay ordain be to select one clinical skill in which I am developing competence in and muse upon how to achieve the necessary level of competence for this stage of the programme. For the purpose of this essay I chip in chosen to focus on hypodermic injections technique as my clinical skill.The nursing and midwifery councils (NMC) Standards for Medicines management states that administration of medicine is not wholly a mechanistic task to be performed in strict shape with the written prescription other medical practitioner. It requires thought and the exercise of nonrecreational judgement. In decree to perform safe practice it is substantial to lead sound association of the anatomy, forbearing assessment and nursing interventions and methods use be shew base. (NMC 2007).My sharp-wittede for selecting subcutaneous injections (SC) was whilst on my first placement based on a surgical war d this was a widely use skill, which was performed on many occasions. This technique was mostly used for the administration of an anticoagulant medical specialty (tinzaparin sodium) also know as heparin, wedded to patients in order to forbid impairmentful blood clots forming in veins following an operation. Heparin works by changing the way blood clots, allowing blood to flow smoothly through with(predicate) the vessels. (REF)Whilst giving an injection was once the role of the doctor, since the invention of penicillin in forties it became the activity of the support (Workman 1999). Administering injections is an important part of drug administration and a regular, common place activity for the nurse which unfortunately can tardily become a complacent task the technique should be master with a sound knowledge base.Injections atomic number 18 used to distribute practice of medicine through a charterle or syringe. SC injections argon administered for versatile(a) reasons t hese include slow distribution into the body, good absorption due to intramuscular tissue containing small blood vessels and unable to take orally be practice medication would become inactive by stomach acid. Workman (1999) suggests taking quad considerations when administering injections the pose of administration, technique used, equipment used and the r let oute to be used.The choice of the site of injection is based on sound clinical judgement, best evidence and patient assessment (Potter 2010). Site selection is normally upper arm, abdominal cavity or thigh. (Lister Dougherty 2008) suggests upper arm as a most indulgent choice as they contain fewer large blood vessels and slight painful sensations, except in practice the abdomen is a to a greater extent common site for heparin as the throw together contains a thicker subcutaneous tissue (Hunter 2008).It has been expressed that rotation of sites can decrease the likely stumblebum of irritation and ensure improved absorp tion (Dougherty and Lister 2009). Traditionally the technique used when administering subcutaneous injections has been using a 45degree angle into a raise skin fold, however since the introduction of shorter needles and pre filled syringes this has been challenged and it is now urge oned that the injections are given at a 90 degree angle into a raised skin fold to ensure medication is given into the SC layer. (REF)The elbow room to which a medicine is administered determines the extent to which a patient gains clinical benefit. Nurses are responsible for the correct administration of prescribed drugs to patients in their care at all times. Standards for medicine management (NMC 2008a) Adopting a skilled injection technique may make the patients fuck off less painful and prevent supernumerary complications, whereas poor understanding of the technique could result in the injection be administrated intramuscular which could affect the rate of absorption and cause potential har m to the patient (Hunter 2008).SC injections involve depositing medications into the loose connective tissue underlying the dermis, this tissue is not a richly supplied with blood vessels as muscles are thus allowing the medication to be absorbed slowly. Prior to administering a SC injection the following precautions must be followed a patients pre-existing conformation must be assessed to prevent contraindications, patients prescription chart clicked to check correct route, correct dosage of medication, expiry date, bowl overs washed with gook and water to prevent infection, positive patient identification then temper the administration on the appropriate chart to avoid any gemination of patients treatment (Dougherty and Lister 2009)The Royal Marsden Hospital Manual suggests that before administering injections the skin should be cleansed with an alcohol wipe for 30 seconds and allowed to dry in order to prevent any contamination, However it has been questioned that the alco hol in the wipe was cause irritation to the skin or prolonged use may cause skin hardening (Hunter 2008). The local trust do not recommend the use of any skin preparation prior to administering SC injections, however aseptic technique to be maintained and as with all patient contact gloves must be worn (Pratt et al 2007)Disposal of the used injection is extremely important to prevent needle stick injuries, a needle should never be re-sheathed the most frequent route of image to blood-borne diseases for health care workers is from needle stick injuries (Potter 2010).The clinical environment is a never ending source of potential accomplishment experiences that become more meaningful the more you participate. (Sharples 2009) The NMC pass on only accept that a nurse is competent if they are a competent learner (NMC 2004)Evidence establish Practice (EBP) is a systematic approach adopted by nurses to permit a rational decision making that facilitates achievement of best practices a good deal achieved by obtaining the strongest available evidence whilst applying patient care (Potter 2010). EBP is implemented because it allows the highest type of care and resulting in the best patient outcome (Melnyk and friecut-overholt 2011)The NMC (2008) states that patients hold in the rights to have a safe environment and staff has a duty to harbor patients in maintaining knowledge based practice and continuing with their lifelong learning.I realised in order to be able to become a competent nurse in the future I would need to choose the type of learner I am and be able to reflect upon this. If I am unaware of my strengths and weaknesses, it is more likely I volition be unable to help others (Burnard 1992).Self-awareness and analysis are key fragment in reflection, and reflection is an essential skill which needs to be acquired, highly-developed and maintained being self- aware allows us to take control of the situations we go ourselves in, thus becoming less vulner able (Wilding 2008).There are 4 different learning styles identified these are Activists, Pragmatist, Reflector and Theorist.Activists immerse themselves in new experiences, using their enthusiasm to flourish on new challenges. Pragmatists are thought to be practical, putting thoughts, theories and techniques into practice. Reflectors like to take a rate back and observe, collecting and analysing information about events and experiences, often slow to compass a conclusion. Theorists on the other hand have a determination to to favour the facts and are not content on things which dont seem rational (McGill and Beaty 1995)I discovered my learning style was the Activist, although I felt I possessed a few of the other characteristics in the other styles. I enjoy learning most by doing the task at hand and witnessing things rather than reading about them.Bremer (1984) advocates the preferred method of learning is by observing role models, this is often displayed whilst on placement ob serving mentors carrying out tasks before they allow the student to attempt it for themselves.According to Boud (1993) reflecting on private experiences plays a major factor in developing to a high level. Brenner (1984) agrees by suggesting nurses develop to become experts by taught knowledge, by applying the intuition and experience through work practice, however, not all nurses will become experts.In order to develop my learning fully I lived the need to start completing a reflective diary, recording experiences good and bad, strengths and weaknesses in order to improve my performance. Reflecting on experiences allows us to learn from them and how to improve on them to increase patient care. I am often told by nurses who have been qualified for many years that they often reflect on various situations and if they could have responded to a situation more differently and more effectively.Frazer and Greenhalgh (2001) states that faculty is the extent to which the individual can ap ply, adopt and synthesize new knowledge from experiences and continue to improve performance.The World Health Organisation (WHO 1998) identifies competence as the ability to carry out a certain professional wait on which is made up of a repertoire of professional practice.Schon identifies two particular(prenominal) types of reflection, a reflection on action and a reflection in action. Reflection in action takes place in practice and may influence future decisions and outcomes, whilst reflection on action traditionally occurs in educational settings either clinical areas or in the classroom (Hinchliff et al, 2008). Ghaye et al (1996) believe that without reflection it is almost impossible to improve in practice. mind your own individual learning style is extremely interesting and considered valuable in developing the ability to learn and partake in learning experiences, and especially important whilst on placement (Sharples 2009).By gaining personal perspicacity and understandin g it may help us understand others better (Burnard 1995)An essential part of learning is to seize any learning opportunity that may be endowed, a student must show willing, motivated and recognise they are responsible for your own learning. If you as a student present yourself as unmotivated, it will be unlikely that your mentor or others will be motivated to encourage your learning (Sharples 2009).Learn through observational learning on clinical placement and insightful learning in uniStrategic approach to learning(Kolb 1984)