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Describe a situation you experienced in clinical practice, critically analyse this issue, reflect on this experience using the Gibbs (1988) reflective cycle (see below), make recommendations for future practice, and identify strategies to implement these recommendations. Examples of issues you may have experienced in clinical practice: poor sharp's disposal, safe medication administration; a new nursing management for a disease / illness; falls prevention; bedside handover; bullying; effective communication between health care professionals; complex wound care; an excellent learning experience with a buddy.
In this assignment, the issue of 'unsafe disposal of sharps' in nursing practice will be discussed. Sharps in clinical practice consists of all the materials that have sharp cutting points or edges which are capable of causing a piercing injury. (Clinical Waste Management Policy, 2016) Being a biomedical waste product, injuries from them can pose an occupational stress issue as well as large public health and issue. Health care workers many times expose themselves to such injuries during unsafe handling of the sharp wastes. Using Gibbs reflective cycle (1988), the issue of safe disposal of sharps will be reflected in context of describing the issue in detail, personal experience in clinical practice, its prevalence and impact on the nursing practice, critical analysis, evaluation, justification and further strategies of recommendations as part of action plan to address the issue in nursing practice in future.
Reflection in nursing practice is an important tool for assessing a particular situation during health care delivery. Gibbs (1988) reflective cycle provides a framework in which reflection of an issue can be done in the various components such as describing the issue, the feelings towards the issue, evaluating pros and cons, analysing the other possibilities, steps which could had been taken and plan of action in case of recurrence of the same issue.
In clinical practice, I have observed an episode of unsafe handling of sharps by nursing staff while providing medical care. The nursing staff disposed-off the intravenous catheter which was inserted for administering intravenous fluids without wearing gloves, recapping the needle of the catheter by bare hand and in this process the needle was pierced in one of the fingers accidentally. This situation prompted me to reflect on the issue of health hazards involved in the improper handling of biomedical sharp wastes. The issue made me feel quite concerned about the safety of the care provider. Since the risk of acquiring blood-borne infections associated with accidental exposure to contaminated needles and other sharps is reasonably high, this situation raised a feeling of anxiousness and uncertainty in my mind about the safety of the health care workers in health care delivery.
Exposed sharps carry infections from the patients who are suffering from hepatitis B, hepatitis C and HIV virus which may gain entry into the body with a slight pinprick. Recapping of needles provides protection from exposure to the infection to other people but it carries the additional risks of contracting the infection by the care provider through, an accidental finger prick. The immunity of health care providers also has an effect on the further development of the disease. As a nursing professional, I raised my concern towards the staff regarding unsafe needle handling, but the reply was more likely indicating negligence rather than lack of information. Going with the idea of reflection the other possibilities which I think would be helpful in this case can be are the disposal of the sharp by holding the barrel of the syringe wearing gloves and use of auto-disposable syringes that may lower the risk of transmission of bloodborne diseases among health care workers. Steps that can be taken when a similar situation arises may include reporting of the incidence to senior and management staff, to make suggestions for adequate training of the nursing staffs for strict adherence to safe sharp disposal and also putting forth a suggestion for the provision of auto-disposable syringes.
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