Reflective Practice Assessment Example

Please keep in mind that this is an example only.

Reflection (750-words, suggested word count provided for each section)

Write a 750-word reflection on the topic specific to your unit (see Instructions tab).

If you do not pass your Reflection you will be required to complete the Reflection Revision page.

You can copy and paste the sections of your first reflection that were assessed as 'satisfactory' into the Reflection Revisions.

You will be required to revise those sections of your first reflection that were assessed as 'unsatisfactory'.

If copying and pasting from elsewhere, highlightthe text and use the Remove Format icon on the toolbar (Letter 'T' with a small 'x' next to it) this will ensure accurate word counts, no hidden characters and consistency in each block for your assessor. Show Me How - see bottom of this page.

Description

What happened? Describe the event in detail, including who was there; what were you doing; what happened; in what context did it happen; what part did everyone involved play in the event.

During my last clinical placement on a general surgical ward, my patient exhibited signs of clinical deterioration due to sepsis. Upon entering the patients room, my preceptor and I noticed the patient was confused, short of breath, hypotensive (80/40 mmHg) and febrile (39.2C). As the patient was in MET criteria, I activated a MET call.

Word count: 55 (50 - 50)

Feelings

Describe own feelings, thoughts and perceptions. Think about how the event made you feel; how do you think the others involved felt; how were you feeling prior to the event; how do you feel about the outcome.

Before the walking into the patients room, I felt calm and confident. However, as soon as I realised the patient was deteriorating, I became nervous, overwhelmed and distressed as I knew prompt intervention was required to prevent further deterioration. Once the MET team arrived, I felt relieved as the patient received the appropriate emergency care.

Word count: 55 (50 - 50)

Evaluation

Evaluate the situation. What was good or went well; what was bad or what didnt go well.

Upon reflection, my reaction to the situation was normal as I had never managed a deteriorating patient before. While this was a stressful and confronting situation, it enabled me to apply the critical thinking skills I learnt during class. What went well was I immediately activated a MET call as soon as I noticed my patient was in MET criteria. Delaying escalation of care may have led to further deterioration. What didnt go well was I did not participate further in the MET call and just observed. The patient was very anxious during this event, and I could have reassured the patient to help relieve their anxiety.

Word count: 107 (100 - 100)

Analysis

Analyse the situation. What sense can you make out of the experience; if things didnt go so well how did you or others contribute to this; why did things not turn out as perhaps they should have done; what questions have been raised from the encounter.

Recognising that the patient was clinically deteriorating and rapidly responding by escalating care to the MET team assisted in preventing further deterioration. The patient exhibited hypotension, fevers, and confusion, which are symptoms of sepsis (Goulding, 2023). These symptoms occur in sepsis as the body has an overwhelming response to an infection, resulting in several pathophysiological states including: reduced vascular tone leading to hypotension, an immune system response leading to fevers and hypoxemia leading to confusion and multiple organ failure (Swift et al., 2022). If my preceptor and I delayed escalation of care, the patient may have had negative health outcomes. This corresponds to National Safety and Quality Health Service (NSQHS) Standard 8, Recognising and Responding to Acute Deterioration as my preceptor and I detected our patients deterioration and escalated care to enhance health outcomes (Australian Commission on Safety and Quality in Healthcare [ACSQH], 2021). Additionally, I practiced in accordance with the Nursing and Midwifery Board of Australia (NMBA) Registered Nurse Standards for Practice Standard 1, which involves critical thinking and analysing nursing practice by effectively thinking critically during the event to recognise my patients clinical deteriorating (NMBA, 2023).

The patient was anxious during the MET call. As everyone was busily performing tasks, no one communicated with the patient. Patients are often understandably anxious in unfamiliar and stressful situations. Smith (2023) found that critically unwell patients feel less anxious when they are provided with reassurance during a MET call. Providing reassurance may be achieved by actively communicating with the patient (Robertson et al., 2022), which is something within my scope of practice that I could have done during this event. I could have calmly explained what is happening, empathetically answered their questions and engaged in shared decision-making. Communication that involves sharing decisions about care and effective communication that supports effective partnerships is promoted in both NSQHS Standard 2, Partnering with Consumers as well as NMBA RN Standard 2, which involves engaging in therapeutic and professional relationships (ACSQH, 2021; NMBA, 2023).

Word count: 329 (300 - 300)

Conclusion

In this stage conclusions are drawn from the information that has already been analysed. It is here that self-awareness and insight into own and others behaviour expands. Think about what you or others have done to contribute to the outcome of the event and what could have been done differently.

In conclusion, experiencing the detection and management of my patients deteriorating condition showed me the importance of staying calm and focussing on applying my critical thinking skills and knowledge learnt during class. While I was nervous, I was able to identify acute deterioration and escalate care with the assistance of my preceptor. Upon analysis of this experience, I learnt the significance of providing reassurance to patients and how to perform this crucial aspect of nursing. Reflecting on my strengths and weaknesses, and critically analysing this event has enhanced my knowledge of how to effectively manage a deteriorating patient.

Word count: 98 (100 - 100)

Action Plan

Develop a plan of action for the future should a similar situation occur again. Think about whether or not you would act differently.

Should a similar situation occur again, I will continue to recognise and respond to acute deterioration promptly and appropriately. I will continue to expand my knowledge about managing acute deterioration by reading documents related to NSQHS Standard 8, Recognising and Responding to Acute Deterioration and applying the quality standards in my practice. Additionally, if a similar situation occurs again in the future, I will provide reassurance to my patient if it is safe to do so. To further learn about providing reassurance, I will review the literature (including current research and textbooks) pertaining to methods of reassurance that are effective in the clinical setting. I will make a list of these methods and bring it with me to my future clinical placements so that I can rapidly refer to it. Additionally, I will gain more experience in the clinical environment by actively participating and reflecting on future clinical placements. This will also assist in increasing my confidence when managing a deteriorating patient.

Word count: 162 (150 - 150)

References

Once your references have been entered (each as a separateparagraph) highlight all the text and click on the Paragraph Indent icon on the toolbar and select Hanging Ident from the drop down list.

Australian Commission on Safety and Quality in Healthcare. (2021). National Safety and Quality Health Service Standards. Retrieved from https://www.safetyandquality.gov.au/publications-and-resources/resource-library/national-safety-and-quality-health-service-standards-second-edition

Goulding, E. (2023). Nursing management of sepsis: Evidence-based guidelines and protocols. Journal of Best Nursing Practice International, 1(2), 5-22. https://doi.org/1.1234/J.NBPIA.2023.1234567

Nursing and Midwifery Board of Australia. (2023). Registered Nurse's Standards of Practice. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

Simon, P. & Garfunkel, A (2022). Systematic review of emotions of critically unwell patients during MET calls and methods to reduce the negative emotions to facilitate positive healthcare outcomes. Journal of Fabulous Evidence-Based Nursing Practice in Emergency Nursing, 1(2), 5-22. https://doi.org/1.1234/J.NBPIA.2022.1234567

Smith, S. (2022). Systematic review of emotions of critically unwell patients during MET calls and methods to reduce the negative emotions to facilitate positive healthcare outcomes. Journal of Fabulous Evidence-Based Nursing Practice in Emergency Nursing, 1(2), 5-22. https://doi.org/1.1234/J.NBPIA.2022.1234567

Swift, T. (2022). Detailed pathophysiology of sepsis: A in-depth review of the existing literature. Journal of Amazing Evidence-Based Nursing Practice, 1(2), 5-22. https://doi.org/1.1234/J.NBPIA.2022.1234567

STAR Selection Criteria (250-words)

Utilisingtheclinical example in yourPart A reflection,write a selection criteria specific to your unit (see Instructions) using the STAR framework. Write your STAR selection criteria in paragraph format.

OPENING-Brief statement to demonstrate you understand the question. NOTE: THIS SHOULD BE POSITIVE

SITUATION-Where did you do it? (location)

TASK-What did you do? (the task)

ACTION-How did you do it? (the method) and Why did you do it? (the purpose or the value you brought)

The action area of your example/experience will be up to 70% of your answer.

Focus on action verbs and I to demonstrate what actions you undertook.

RESULT-What were the results? (positive outcome and what you learned)

STANDARDS-Now link your STAR clinical example to the RN Standards for Practice.

Performing an effective assessment and applying critical thinking and clinical reasoning skills are vital in enhancing positive health outcomes in the management of a deteriorating patient. While I was on clinical placement on a general surgical ward, my preceptor and I conducted a systematic A to E assessment on our patient who had just underwent major abdominal surgery. We discovered that he was confused, short of breath, severely hypotensive and febrile. As the patient was in MET criteria, I immediately activated a MET call as per hospital policy. I used my critical thinking skills to recognise that our patient was exhibiting signs of sepsis post major surgery and applied my clinical reasoning skills to determine that I should escalate care promptly by activating a MET call. When the MET team arrived, I provided an effective handover using the ISOBAR handover format. They agreed with our assessment that the patient was deteriorating due to sepsis after a major surgical procedure and thus administered IV therapy, vasopressors and IV antibiotics. The patient was transferred to ICU for further management, and, after a rapid recovery, the patient was discharged home five days later. I learnt that an accurate assessment and application of critical thinking and clinical reasoning skills in recognising and responding to acute deterioration is crucial in preventing further clinical deterioration. During this event, I practiced in accordance with NSQHS Standard 8, Recognising and Responding to Acute Deterioration as my preceptor and I identified our patients deteriorating condition and rapidly escalated care to enhance health outcomes. Additionally, this links to the following NMBA RN Standards of Practice: 1.1, 1.6, 4.1, 5.1, 6.1.

Selection Criteria (STAR) Checklists

Selection criteria are used for the job application process to demonstrate application of knowledge in practice. When applying for a future role as a Registered Nurse or Midwife you are required to write a short statement against each criterion, which outlines how your current skills (clinical and transferable), attributes, clinical knowledge, and/orqualifications satisfy each criterion.

Use the checklist below to support the development of your selection criteria answers. This checklist contains elements (general and STAR) to develop an understanding of how to formulate your answer for each selection criteria question.

General Elements Completed

Analyse the question, and if appropriate, identify/break down each part of the question to be addressed. Identify a relevant clinical experience you have had that will demonstrate clinical knowledge and skills. Develop an opening claim that demonstrates an understanding of the selection criteria. Answer the selection criteria question using the STAR framework. Address the selection criteria question in 250 words, writing in the first person. Remember that addressing selection criteria is a professional style of writing for job applications. It is not academic style writing. If using acronyms ensure that they are clinically recognised and acceptable (e.g., BGL not BSL). There is no requirement to use the full word/s then the acronym in brackets. Review your answer to ensure that it is free of spelling and grammatical errors. Selection criteria

Demonstrated clinical knowledge and experience in the delivery of evidence-based nursing care within the practice setting.

STAR Elements

Completed

Situation Explain the situation concisely. Where, when and the context of your example. (e.g., is this a placement example on a particular ward, related to a simulation learning experience or a workplace example as an EN. Task Concisely explain the specific clinical task that you undertook. What needed to be done? Action Clearly demonstrate the delivery of evidence-based nursing care utilising a clinical experience that demonstrates competency. Demonstrate clinical reasoning, safe decision making and sound clinical judgement. Demonstrate patient safety and clinical governance (e.g., following policies and procedures, completing documentation). Result Clearly demonstrate the result of your actions. What outcome was achieved? Selection criteria

Demonstrated effective interpersonal, negotiation and conflict resolution skills with a clinical setting.

STAR Elements

Completed

Situation Explain the situation concisely. Where, when and the context of your example. (e.g., is this a placement example on a particular ward, related to a simulation learning experience or a workplace example as an EN). Task Concisely explain the specific clinical task that you undertook. What needed to be done? Action Clearly demonstrate the use of interpersonal skills. i.e., established and built rapport. Clearly demonstrate the use of negotiation skills, i.e., initiated, discussed, and agreed on solutions. Clearly demonstrate how to manage a conflict and deescalate a situation (i.e., listened, acknowledged, sat, separated, initiated, encouraged-LASSIE). Demonstrate how to maintain a safe environment. Demonstrate how to maintain/update documentation to record the incident. Result Clearly demonstrate the result of your actions. What outcome was achieved? Selection criteria

Demonstrated effective written and verbal communication skills within a clinical setting.

STAR Elements

Completed

Situation Explain the situation concisely. Where, when and the context of your example. (e.g., is this a placement example on a particular ward, related to a simulation learning experience or a workplace example as an EN). Task Concisely explain the specific clinical task that you undertook. What needed to be done? Action Clearly demonstrate verbal communication skills (i.e., how you talked, educated, discussed, explained, gained consent, etc). Clearly demonstrate written communication skills (i.e., how you completed documentation and what documentation was completed). Result Clearly demonstrate the result of your actions. What outcome was achieved? Selection criteria

Demonstrated an understanding of and commitment to the principles of quality improvement and risk management within practice.

STAR Elements

Completed

Situation Explain the situation concisely. Where, when and the context of your example. (e.g., is this a placement example on a particular ward, related to a simulation learning experience or a workplace example as an EN). Task Concisely explain the specific clinical task that you undertook. What needed to be done? Action Clearly demonstrate how you were involved in the improvement of health care delivery by implementing or participating in a safe quality improvement activity (e.g., conducting a survey, creating training information, involvement in an audit, reviewing data). Clearly demonstrate how to manage/mitigate risk to reduce harm with a focus on the safe provision of high-quality care. Link the experience to the NSQHS, organisational policies, procedures, and documentation tools/processes. Result Clearly demonstrate the result of your actions. What outcome was achieved?

Assessment 2 Reflective practice

Assessment Description Professional reflection

Value Pass/Fail (mandatory to pass)

Team or Individual Individual

Format Length: Part A- 750 words & Part B- 250 words.

Professional reflection asset in PebblePad.

Please refer to SNM Program Requirements and Assignment Presentation Guide 2021 for formatting guidelines.

Due Date and time Part A- reflection & Part B STAR selection criteria: Monday, 28 August 2023 (Week 6) at 0800 hours.

Revision of Part A and/or Part B: Monday, 2 October 2023 (Week 10) at 0800 hours.

How to Submit PebblePad Professional reflection asset.

Learning Outcomes 1, 3 and 5

Professional Competencies NMBA RN Standards 1 and 5

Marking Criteria Please refer to the Rubric information resource on PebblePad.

Feedback Feedback will be available via PebblePad.

Instructions

Part A- Reflection: Write a 750-word reflection on the following reflection topic:

Unit Reflective practice topic

NPU3505 Using an example from your previous clinical placement experience, reflect on your demonstrated ability to recognise and respond to a patients clinical deterioration.

Gibbs Model for reflective writing must be adopted to guide your reflection. Your reflection must include a minimum of three references demonstrating your application of the evidence-base to your learning experience.

Part B- STAR Framework to address selection criteria: Write a 250-word selection criteria statement. Selection criteria represent the skills and abilities, knowledge, experience, qualifications and work-related qualities a person needs to perform a role effectively. They set out the standards by which each candidate will be assessed. Using your reflective practice example from Part A, write a selection criteria response using the STAR framework to address the following selection criteria:

Unit Selection criteria to be addressed

NPU3505 Demonstrated effective assessment, critical thinking and clinical reasoning skills in the management of a deteriorating patient.

This assessment is completed in PebblePad. Search the resources for NPU3505 Reflective practice workbook resource. Review the instructions in the resource and complete your reflection in the Reflection tab. The assignment will be automatically submitted on the due date. If you have an extension- it will be automatically submitted on your extension due date.

Students who DO NOT pass either Part A or Part B of the assessment on first attempt will be afforded a second attempt. Students should review the feedback provided prior to the submitting their revised reflection and/or STAR selection criteria. If you are required to revise, complete the Reflection revision and/or STAR revision tab of the workbook. Students are recommended to attend a drop-in session offered by learning advisors between the due dates (see your unit Canvas site for drop-in session details). You can copy text from your original submission any section that was assessed as satisfactory (this will be noted in the Turnitin similarity report). The assignment will be automatically submitted on the due date. If you have an extension- it will be automatically submitted on your extension due date.

Many guidelines and resources on reflective writing and selection criteria are located on the Clinical Placement Canvas site under the menu item Reflective practice.