Reflection

In my student career in bachelor nursing graduate entry, I still remember one of the
critical incidents happened in PPE3 when I acted as a patient to cooperate with my team
member to practise the administration a subcutaneous injection. Actually at the
beginning of the practice which she did such as assemble the equipment and check the
doctors order, ensuring the five rights, know the action, care consideration, safe dose ranges,
purpose of administration and adverse effects of the medications to be administered and explain to
the patient (Dempsey, Hillege & Hill, 2014, p.778) so smoothly, while an incident

happened after mentioning the patient, she forgot to perform the hand hygiene and
continued the next step to identify and touch the patient directly. Therefore, this
reflection will use the way of GIBBS reflective cycle to focus on this incident.

As a nursing student, after my team member forgetting to perform hand hygiene when
she finish the whole procedure, I felt guilty about this mistake which she made and I
should notice her about this important procedure at that time. The reason why I had the
sense of guilty was because as a nursing student, we should clear understand that many
of the germs causing these infections are transferred by hands when health-care
providers or visitors are touching the patient while providing assistance. Using proper
hand hygiene to keep hands clean is critical to reducing the risk of health careassociated infections in patients. The most common infections are urinary tract and
surgical site infections, pneumonia and infections of the bloodstream(WHO, 2012).

Hence it is important for every health-care provider to perform the hand hygiene in
order to avoid infections.

To evaluate the negative area of this critical incident of hand hygiene, undoubtedly if hand
hygiene practices are poor, microbial colonisation and/or direct transmission to patients may easily
occur (Queensland Health, 2013). While the positive aspect is after suffering this mistake, all of my
team members they knew about how significant of hand hygiene it was that hand hygiene must occur
at the start of and end of each shift, prior to and following each incident of patient contact,

or contact with any contaminated or organic material including body fluid, excreta, nonintact skin and wound dressing, equipment, before moving from a contaminated body
site to a clean body site during patient care, before donning gloves and after their
removal, before preparing medication or food, following use of the toilet, and prior to
and following meals (Smith, Duell & Martin, 2012).

To analyse the incident of the hand hygiene, I realized that hand hygiene is not only to
protect the patient to avoid the further infectious disease, but also the part of hand
hygiene is the maintenance of healthy and intact skin. Moisturising the hands
contributes to healthy skin (NHMRC, 2010, p.41) and restores moisture and oils that
repeated use of soaps or ABHR (Alcohol-based hand rub) remove.

The conclusion of my reflection, the else which I could have done about my nursing
practice is to take more notes in our memos and highlight about the mistakes which I

and/or my team members made and know about the adverse effects with the mistakes.
Thus, we would have a sense of the mistakes. Before taking practice action again, we
should review the mistake which we had made before. To obey the hand hygiene policy
strictly, and if there is something skipping such as perform the hand hygiene, we can
also mention our mates the positive and side effect of the hand hygiene to let them know
about how important of hand hygiene in a friendly way, and they would also have sense
of hand hygiene, so that the outcome would be changed into a positive result in the
whole incident with our help.

For the plan of my action about the hand hygiene in my future practice, first of all pay
high attention to hand hygiene and review the mistake of procedure in terms of to
maintain the interests of the patients. Smith, Duell and Martin (2012) recommend that
hand washing with soap and water be used every third time the hands are cleansed.
Secondly, all patients are welcome to query the procedure during the action I am doing.
This is the new knowledge I got when I searched the information about the hand
hygiene that NHMRC (2010, p. 42) emphasises that it is the patients right to question
health-care workers about their performance of hand hygiene.

My Profile URL Link: http://angelyunshanwang.weebly.com/ppe3-reflection.html

Reference

Dempsey, J., Hillege, S. & Hill, R. (Eds). (2014). Fundamentals of nursing and
midwifery: A person-centred approach to care (2nd Australian/New Zealand ed.).
Broadway, NSW: Lippincott Williams and Wilkins.
National Health and Medical Research Council (NHMRC). (2010). Australian
guidelines for the prevention and control of infection in health care. Commonwealth
of Australia.
Queensland Health. (2013). The effect of hand hygiene on healthcare associated
infection (HAI). Review from
http://www.health.qld.gov.au/chrisp/hand_hygiene/HH_HAI_fsheet.pdf
Smith, S. F., Duell, D. J. & Martin, B. C. (2012). Clinical nursing skills: Basic to
advanced skills (8th ed.). Upper Saddle River, NJ: Pearson.
World Health Organization. (2012). WHO highlights importance of good hand hygiene
for patient safety. Geneva: Author. Review from
http://www.who.int/mediacentre/news/notes/2012/hygiene_20120504/en/