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Reflection on a clinical skill

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Introduction

This essay will discuss a clinical skill in which I have become competent in practising, as 'developing the ability to perform practical skills safely is necessary for all nursing students' (NMC, 2002). I will reflect on this skill and discuss how I achieved this level of competence and how it influenced the individualised care the patient was given. The clinical skill I have chosen to focus on is the dressing as part of treatment for healing of pressure ulcers. I have chosen to do this, as in my first clinical placement this was a skill I found interesting and I was involved in. I therefore researched the topic of pressure ulcer management and treatment. A pressure ulcer is defined by the European Pressure Ulcer Advisory Panel (EPUAP) as 'an area of localized damage to the skin and underlying tissue caused by pressure or shear and/or combination of these' (EPUAP,2003). The patient was an elderly woman who had been on the ward for a few weeks. Over this period of time she had developed a pressure ulcer on her left heal, approximately 2cm round. I was asked to assess the patient's pressure ulcer and determine which stage it was in. ...read more.

Middle

I removed the dressing pack from its outer packaging and placed it on the trolley, taking care to maintain sterility (Nicol, M et al, 2004), and opened the pack to reveal its contents. Inside was a yellow waste bag which I placed to one side. I was advised to use alcohol-hand rub to cleanse my hands before starting the hands on procedure. My mentor was talking me through the procedure step by step, this gave me the confidence that I would be able to do the job to the best of my ability, but also if something were to go wrong she was there to reassure me. My mentor asked me to open the yellow waste bag and put my hand inside so that the bag acted like a glove and remove the previous soiled dressing. This was to reduce the risk of cross infection and to prevent cross contamination of the environment (Dougherty and Lister, 2004).I then opened the glove pack, taking care not to touch the outside of the gloves as they were sterile and I put them on. Hollinworth and Kingston (1998), state that a sterile technique helps prevention of transmission of micro-organisms. ...read more.

Conclusion

The purpose of this clinical skill for my patient was to create an optimal healing environment for this pressure ulcer, by producing a well vascularised, stable wound bed with minimal exudates (Dowsett, C, 2002). This is because the maintenance of skin integrity and management of acute and chronic wounds is a major component of nursing care (Bryant, 2000) and the care should be aimed to relieve the pressure as well as minimizing the symptoms (Dougherty and Lister, 2004). My level of awareness concerning evidence based practice, and its importance, has been enhanced with the use of critical reflection. My competence, within this clinical skill, has been further developed through the research I undertook to increase my knowledge and awareness surrounding this subject and I therefore realise that any procedure that I participate in, I must evaluate my performance and the effectiveness of the treatment ensuring I implement any necessary improvements to ensure patients receive the best possible care. This has also highlight to me the importance of adapting the care to the individual patient according to their needs. I now feel that my personal and professional development is progressing and I would feel confident to inform and deliver evidence-based care on pressure ulcer management and treatment. ...read more.

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