Reflection Of Reflection On Practice

When the word reflection is mentioned, the first thought is a mirror-like image of yourself. This is to define your own perception of the acceptable and poor quality within yourself. Taking action of the weaknesses and developing my skills to improve me around everyone, (Stadter, 2015).

Hospital data on the use of restraint can also be analyzed to improve patient outcomes and satisfaction. This information could be scrutinized to determine if restraints were truly warranted in that particular situation, or if another method could have or should have been utilized first. Documentation should also be examined to determine if the patient was adequately cared for during this time period. In my hospital, the patient must be released from the restraints at least every two hours, and must be toileted at that time. The nurse must also do range of motion exercises with the extremities affected by the restraints. The skin and circulation should be assessed at this time. Every hour, the nurse is required to check the pulses in the extremity affected by the restraint. The nurse’s documentation should reflect that all of these assessments were performed and the appropriate precautions were taken.

A restraint is any physical or chemical measure in the healthcare setting to keep a patient from being free to move (Craven, Hirnle & Jensen, 2013). Nurses are presented with dilemmas in deciding whether to use restraints to protect the patient from falls, harming themselves or others, suppress agitation and to facilitate treatment. Improper usage and misconceptions of restraining can have negative consequences including physical and psychological issues. Physical and psychological disadvantages from restraining could include low blood pressure, decreased circulation, thrombosis, constipation, urinary incontinence, depression, fear and increased confusion (Yeh et al., 2004). Educating nurses may reduce restraint usage by increasing

Patients that we received often wants to either harm themselves or others, and these patients are also considered violent which lead to the frequent use of restraints and seclusion. Using these methods represent a danger to not only staff but also for the patients. Many injuries occur during these confrontations. The need to minimize the use of restraints and seclusion on the unit is necessary for patients and staff safety.

J’s scenario is pressure ulcer. From analyzing Mr. J’s case one can see the correlation between the use of restraints and pressure ulcers. Obtaining data listed on the Braden Scale such as moisture, mobility, activity, and nutrition are important when assessing for pressure ulcer risks. Once the collected data indicates the patient is high risk then the established pressure ulcer protocol needs to be followed. Nurses will need to minimize friction, support bony surfaces, manage moisture, and maintain adequate nutrition to advance quality patient care. The other nursing-sensitive indicator in this case is restraints. As I have mentioned earlier the use of restraints in Mr. J’s case seems appropriate as he pose great fall risk which may further complicate his current health condition. However, it is important to perform a complete assessment on the parameters for restraint such as cognitive functioning, history of dementia, physical impairment, and drug interactions to determine the need for restraints. When restraint is clinically indicated, and the benefits outweigh the risks then protocol for restraints has to be followed. Once the patient is restrained, it is standard practice that restraints are to be removed as soon as possible, and the patient in restraints will need assistance to change position every two hours. B) To improve quality patient care throughout the hospital, the quality improvement department should scrutinize, and keep track of the

This movie, The Classroom, which was very interesting to watch, discusses all that goes on in the school system, the good and the bad. But it also shows how things at home can affect the way the student acts during the school day. This movie definitely makes you look at students that act out differently, instead of punishing them maybe we should all look deeper into the issue and find a way for the student to thrive and use school as an outlet.

Argument from health professional is that the use restraint is very vital to their security especially in situations where a patient poses the risk of being a menace to himself or others around them (Psychiatric Times, 2015).A study has showed that the act of violence and aggression against patients and nursing staff is unbelievably rising, with about ' more than half of NHS staff nurses 'being violently assaulted by patients in ‘2013-14’ (Nice, 2015). Even though, most of these attacks do not normally result in major injuries, they have caused staff to experience severe anxiety, emotional traumas and in some case ‘post-traumatic stress disorder’ (City University, London, 2009). Against these facts, it is believed that the use of restraint, especially in an Acute setting, is essential and ethical (Psychiatric Times, 2015). However, research has shown that there is a correlation between staffs reaction towards mental health patients and the violent and aggressive behaviour exhibited towards them. This typically occurs when patients feel they are being patronized, not made aware of what is going on around them and not treated well( Glover, 2005). With recent records of excessive and abusive use of restraint, there have being

making Practice-Based Learning work Reflection on PRACTICE A resource commissioned by the Making Practice Based Learning Work project, an educational development project funded through FDTL Phase 4 Project Number 174/02 and produced by staff from the University of Ulster. www.practicebasedlearning.org Author Patricia McClure School of Health Sciences, University of Ulster www.practicebasedlearning.org contents Reflection on Practice 02

When the word reflection is mentioned, the first thought is a mirror like image of yourself. This is to define your own perception of the good and bad quality within yourself. Taking action of the weaknesses and developing my skills to improve myself around everyone, (Stadter, 2015).

While the use of physical restraint on elderly patients is necessary in specific situations, the practice should be very limited at all times. Although it will continue to be used worldwide, measures must be taken by all healthcare providers to gradually minimize the use of restraints in healthcare facilities, reduce the risks that are associated with the practice, offer reasonable alternatives for patient care, and ensure the safety of the patients as well as their caregivers.

Using Gibbs’ (1998) model of reflection, updated by Bulman (2012), reflect on a challenging experience from your practice and analyse the strategies used to manage it.

A load of research has been done on learning and reflective practice and its effectiveness on the practitioners and one of the first people to research reflective Practice was Donald Schon in his book “The Reflective Practitioner” in 1983. Schon was an influential writer on reflection and had two main ways of identifying reflection and they were reflection in action and reflection on action.

Professional knowledge is no longer viewed as just consisting of a standardised, explicit and fixed knowledge base. It is now seen as knowledge which exists in use, is ethical in its use and is changed by experience.

"…reflection in a mirror is an exact replica of what is in front of it. Reflection in professional practice… gives back not what it is, but what might be, an improvement on the original…" Biggs (1999).

Reflection is considered as a vital element of professional practice as it precedes to insight and then subsequent change in practice. The hypothesis of reflection is not new as it can be tracked as far back in the 5th century by the influential Greek philosopher, Socrates and to the 1930s primarily focusing on John Dewey’s work. Dewey is one of the founders of learning from experience. He theorised reflection as ‘active, persistent and careful consideration’ (Dewey, 1933) initiated by a specific situation which was opposing, perplexing or uncertain. One of its most common use today is coming up with a thought, an idea, or opinion made or an observation made as a result of concentration, suggesting in essence a way of thinking in which one looks back and meditate upon (Agnes, 2004).