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The clinical skill this reflective assignment will refer to is the measurement of blood pressure which was one of the many skills I had to perform on a daily basis.

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Introduction

´╗┐Student number: 1103661 Assessment number F03314 Reflective skills report The purpose of this assignment is to reflect on a clinical skill which has been performed whilst out in clinical practice. The clinical skill this reflective assignment will refer to is the measurement of blood pressure which was one of the many skills I had to perform on a daily basis. Being on a rehabilitation ward for my placement gave me the opportunity to perform a variety of clinical skills. To help me reflect and explore my experience of undertaking my chosen skill, I will be using the Gibbs? model of reflection (Gibbs 1988). A reflective model such as this has been used because, as suggested by Hargreaves (1997), reflective models are a tool that is believed to result in both improvement in patient care and professional development. Gibbs model of reflection incorporates the following: description, feelings, evaluation, analysis, conclusion and an action plan (Gibbs 1988). Throughout this assignment I will be referring to the student guidelines relating to the maintenance of confidentiality, which states that all relevant information gained is accurate and used to the purpose of the assignment only, in this case all personal details of the patient I will be discussing which identifies her will be excluded from the text. Also In accordance with the Nursing and Midwifery Councils (2008) Code of professional conduct, confidentiality shall be maintained by not mentioning the name of my clinical placement or patient so I will be referring to the patient I performed my skill on by using a pseudonym of Patient X. ...read more.

Middle

After finding the brachial artery I placed the diaphragm of the stethoscope over the artery and held it in place with my thumb whilst my two fingers supported Patient X?s elbow. After ensuring that the valve on the bulb was closed I inflated the cuff to 20-30mmHg above the level I recorded when I performed the radial check to estimate the systolic blood pressure, for Patient X, I pumped the cuff up to 130mmHg as her radial pulse was no longer felt at 100mmHg. Once the cuff was inflated I opened the valve to allow the needle of the dial to drop slowly, approximately 2mm per second. Whilst observing the needle of the dial as it falls I was listening for Korotkoff sounds. The systolic pressure is the level where these are first heard and the diastolic pressure is the level where the sounds disappear. Blood pressure is measured in millimeters of mercury (which is written as mmHg) and it is recorded as two figures: systolic pressure: the pressure of the blood when your heart beats to pump blood out and diastolic pressure: the pressure of the blood when your heart rests in between beats. (www.nhs.uk). Patient X?s systolic pressure was 90mmHg and her diastolic pressure was 55mmHg which is classed as a low blood pressure. Individuals who suffer with Parkinson?s disease can experience problems with low blood pressure which is known as hypotension as a result of the symptoms of Parkinson?s and sometimes as a side effect of some of the drugs used to treat the condition. ...read more.

Conclusion

Being capable to perform a clinical skill in practice which was approved by qualified nurses has made me feel that my professional development is progressing and my awareness of evidence based practice has improved with the use of reflection. As a student nurse I have realised that reflection is essential to learning. I feel I have learned a great deal from my experience, it has had a considerable effect on my nursing practice. The experience has taught me to always keep high standards of care that are expected and to always be professional and organised when on clinical placements. Whenever I get the chance to use a manual sphygmomanometer when on placement I am always eager to do so to ensure I am developing the skill. I am now much more confident when using the manual equipment and I know I have the ability to perform the skills I require for my future placements. I am now well aware that I need to put into practice action plans. This is also complemented by the universities action plans and S.W.O.T analysis tools. Action to be taken includes keeping my clinical skills up to date and also pro-actively seeking advice from staff on all clinical placements to ensure I carry out each clinical skill effectively. According to the NMC (2008) you must work with colleagues to monitor the quality of your work and maintain the safety of those in your care. When on placement I must ensure I read clinical placement policies with regard to clinical procedures. ...read more.

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