INFECTION PREVENTION AND CONTROL LEVEL 2
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Author Archives: Micheline Atobrah
FIRE SAFETY LEVEL 1
DATA SECURITY AWARENESS LEVEL 1
ACUTE AND CRITICAL CARE IN ADULT NURSING
MAKING SENSE OF RESEARCH IN NURSING HEALTH AND SOCIAL CARE
RESEARCH METHOD FOR NURSES AND MIDWIVES
EVIDENCED-BASED PRACTICE FOR NURSES AND ALLIED HEALTH PROFESSIONALS
BUILDING ON YOUR SUCCESS
REFLECTION ON MALE CATHETERISATION
On this day I visited a male catheter patient with my practise supervisor. The patient was on long term catheter due to urine retention. His catheter is changed every twelve weeks so he was due for it to be changed. I first read his care plan. Introduction given and consent gained . I was to remove his catheter and re-catheterised him under the supervision of my practice supervisor. I gathered all that I will need and set my sterile area. I first opened my catheter pack and deflated 9mls of water from the balloon I then removed the old catheter and cleaned the patient. After washing my hands I had my sterile gloves on and with non touch aseptic technique successfully inserted a new catheter. A clear urine of 150mls came out into the leg bag. He was then made comfortable. The care provided was documented and dignity and privacy was maintained. All this was done under the supervision of my practise supervisor.
It was an opportunity for me to insert a male catheter. It helped me to practice the skill of male catheterisation. I am gaining confident in catheterising patients. This nursing care is relevant to the NMC (2018) code of practise effectively and preserve safety. Aseptic non touch technique was used and I successfully inserted the catheter under the supervision of my practice supervisor without any problem.
REFLECTION ON EPISODE OF CARE IN THE COMMUNITY
For my episode of care I did district nursing with my practice supervisor. On this day according to our handover we visited eight patients. All care was done under the supervision of my practice supervisor. The care of the patients were prioritised by checking the blood glucose level of the diabetics patients and administer their insulin. Consent is always gained and the reading of patients care plan before any nursing care maintaining confidentiality, dignity and privacy. Three of the patients were diabetes. One patient had libra on. Blood glucose was checked post breakfast and insulin given. I checked two of the patients their blood glucose before administering their insulin with pen insulin and insulated. Before I administered any medication I always abided to my six rights of medication administration, expiring date, batch number, allergies and my hand hygiene. The rational for checking the blood glucose is to know the level before administering the insulin. To know whether the patient is hypoglycaemia or hyperglycaemia. One patient had her tracheostomy neck strap changed. Myself and my supervisor washed the patient`s neck and changed the strap. The rational was to have the neck cleaned with clean strap provided as a routine. I administered enoxaparin injection to one patient to prevent blood clot. Together with my practice supervisor we undress and redressed the bilateral leg ulcers of a patient. The patients legs were swollen and exudated. We washed both legs and applied different dressings complying to infection control policy. The dressings applied were viscos paste, zetuvit pad, k-soft, k-lite and yellow line. The rational of the care of the leg ulcers was to help with its healing and to prevent any infection. We visited this patient who had pressure ulcer wound on the hand. The old dressing was taken off the wound cleaned and aquacel foam dressing applied. All pressure areas were checked and the patient was made comfortable. All care was delivered under supervision, documented on hard copy and emesis.
Effective communication always took place, person- centred as patients were always involved in their care and everything was evidence based.
What did you do well?
I checked patients blood glucose afterwards following the six rights of drug administration I administered their insulin as prescribed. Under the supervision of my practise supervisor rotating the injection areas to avoid build up of fatty tissue. The undressing and redressing of a patients bilateral leg ulcers. The administration of enoxaparin through subcutaneous injection.
What would you have done differently?
I was with my practise supervisor who monitored and supported me through out to make sure quality of care was delivered according to the NMC (2018) code and NICE guidelines.
Describe how you have begun to work more independently in the provision of care and the decision making process.
When we get to a patient after introduction, I get the blue folder and read the care plan. The care plan and my handover sheet enables me to know the care to provide for the patient. I am able to check the patient`s blood glucose level, administer the insulin as prescribed and document in patients notes. I am able to do all this independently under the supervision of my practise supervisor. I am able to independently undress leg ulcers and redress them according to the care plan. If the leg is dry, with no blisters or exudate together with my practise supervisor decide on new dressings to use as the ulcer is healed or is healing. A new care plan is then made for the patient or discharged from the district nurses.
What learning from this episode of care could be transferred to other areas of practice?
Checking of blood glucose level and administration of insulin as prescribed having in mind the normal and abnormal range.
Checking of care plan and gaining consent always before any procedure maintaining respect, dignity and privacy, person-centred and effective communication.
Assessment of pressure ulcers and its management to prevent infection and the use of right dressings to support its healing.
Administration of insulin with pen insulin and insulator.