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Reflection on Subcutaneous Injection of Heparin

This paper provides a reflection on simulation procedure on the administration of subcutaneous heparin using the Gibbs reflection model. In the stimulation process, I was the practice nurse while my friend was the assistant nurse. The procedure commenced by providing a brief description of the intended procedure to the assistant nurse followed by washing hands. After that, I introduced myself to the patient, communicated my intention and sought consent to proceed. After gaining the consent from the patient, I went ahead to confirm the patient details by asking the patient his name and asking the assistant nurse to confirm them from the treatment sheet. The information sought included the home address, date of birth and name. Together with the assistant nurse, we confirmed the dosage and the route of administration. After that, I gloved, identified and exposed the injection site, and swabbed the injection site with a spirit swab. After cleaning the injection site, I diluted heparin with dilute water and injected the drug subcutaneously on the upper outer quadrant of the thigh. Concurrently, I advised the patient to relax and take a deep breath. After injection, I cleared the medication trolley and documented the time of medication.

I was confident that I will be able to perform the effectively, however; I was anxious and cautious on the selection of the injection site. Despite the nervousness, I felt delighted for the ability to utilize all the six drug rights of drug administration and injecting heparin subcutaneously. On completion of the procedure, I believed that I had performed the procedure optimally.

On evaluation of the procedure, I noted several positive activities that I conducted in the recommended procedure. These included communicating with the patient and getting consent, observing the six drug rights and following the right injection model. I also made use of the assistant nurse in ascertaining the patient details and confirming the prescription details. Despite the positive activities, some negative actions emerged. I also documented the patient medication after completion of the procedure. Despite the positive actions, a few errors emerged during the administration procedure. For instance, I had not placed the gloves on the medication trolley, I used the same needle to dilute and inject the patient, and documented while gloved with the gloves used by injecting the patient. I also forgot to introduce the assistant nurse to the patient

All the errors culminated from inadequate preparation before the commencement of the medication procedure. Failure to review the medication protocol made me forget to place the gloves on the medication trolley. The failure to utilize the evidence-based practice can be attributed to the use of the same needle to inject water for injection to the vial and inject the patient. Injecting the vial make the needle brunt leading to traumatic injection on the patient tissues at the injection site. Documenting the medication procedure when gloved can also be blamed to inadequate knowledge on infection control. Failure to introduce the patient to the patient can alter patient comfort.

If I were to repeat the procedure, I could have utilized the six drugs administration rights again. I would also use the assistant nurse in checking patient detail and drug details. However, I would ensure that all the required equipment are placed on the medication trolley, used different needles for injection and reconstituting the drug and remove gloves before documenting.

Finally, I will embark on a literature search on drug administration and infection control to improve my competencies in drug administration. The procedure helped me to gain competencies and confidence in administering subcutaneous heparin and I will conduct several simulation procedures to gain proficient competencies administering on a real patient.