Module Title PLE 2.3
Cohort September 2012
Assignment Title PLE 2.3 Reflection
Assignment Date 18th April 2014
Word Count 1591 words
PLE 2.3 Reflection
Scottish Patient Safety Programme
and the Early Detection of the Deteriorating Patient
The aim of this reflection is to discuss patient safety in an acute setting according to the Scottish Patient Safety Programme. I will be using a model of reflection, Gibbs Reflective Cycle to structure my essay (Gibbs 1988 cited in Paterson and Chapman, 2013). In accordance with the Nursing and Midwifery Council identifiable information will not be written, maintaining confidentiality (NMC, 2010a).
Health Improvement Scotland coordinated the Scottish Patient Safety Programme created to improve the safety of patients across Scotland (NHS Scotland, 2010a). Four groups were created to manage patient safety, one of which was established to supervise care within an acute adult setting (NHS Scotland, 2010a). During my practice learning experience a male patient was brought into the accident and emergency department following a serious assault, he had suffered severe lacerations to his head, face and hands. Prior to arriving, ambulance staff did not call to warn nursing and medical staff. As a result, the team were unprepared and the patient was brought into the wrong area within the department. The patient should have gone straight into the resuscitation area where the appropriate equipment is available, in case of patient deterioration (Brooker and Nicol, 2011).
On arrival nursing staff initiated SBAR with ambulance staff. SBAR is a communication tool which stands for situation, background, assessment and recommendation; providing a structured way to retrieve all vital information triggering a relevant response (NHS Scotland, n.d.b). An A to E assessment was commenced as soon as the patient arrived within the department (Brooker and Nicol, 2011). Prior to patient contact, appropriate personal protective equipment (PPE) was put on by all staff. PPE should be worn when in contact with bodily fluids to protect both staff and patient (NHS Education for Scotland, 2013). In this case the patient was bleeding heavily. Vital observations were checked on arrival and continuously throughout treatment to establish the patient’s condition using the National Early Warning Score (NEWS). NEWS is a scoring system used to establish deterioration early (Fisher and Scott, 2013). As the patient had suffered head trauma, consciousness was established by use of the Glasgow Coma Scale (Le Roux, Levine and Kofke, 2013).
Good communication skills were used to determine if the patient had any pain, to identify injuries that could not be seen. The patient identified pain in his neck. To prevent further injury appropriate moving and handling was carried out to rule out lacerations to the patients back. When safe to do so, a Computerised Tomography (CT scan) was carried out...