Evidence of Learning and Achievement in Practice Essay

Evidence of Learning and Achievement in Practice
Introduction My reflection focuses on the role I took as an operating department practitioner (ODP) at a general theater. I was also circulating patients who came into the theater.
For purposes of completing this project, I will refer to the two patients as Patient A and Patient B. The reflection is presented based on Gibb’s Reflective Cycle (Gibbs, 1988). The reflective cycle comprises of five stages of reflective wringing, and these include the description, the feelings, the evaluation, conclusions, and the action.
Under the description, the paper will focus on factual information as it relates to my experience as an operating department practitioner in a general theater. The information under this section will encompass how I interacted with other healthcare practitioners, the supervisors, and the patients that I served in the capacity.
The second section focuses on feeling and in this section, I will focus on how I felt after serving with other healthcare practitioners in the general theater and the hospital environment in general, most important in this section will be the description of what I felt I learned from the engagement.
The third section focuses on the evaluation of the entire engagement. I will link the evaluation to theoretical frameworks in healthcare and how they applied to the engagement at the general theater.
The fourth section will be conclusions on the entire reflection process. Under this section, the focus will be mainly on the major notes that caught my interest throughout the entire engagement as an operating department practitioner who interacted with various stakeholders in the general theater setting.
Lastly, this reflection will focus on the lessons that I take home and the actions that will follow the experience. Most importantly, I will focus on anything that I felt I should revisit concerning class work as well as any improvements that I should make if given another chance to serve in the same capacity.
Description Being a student operating department practitioner is one of the engagements that I have always wanted to be in as it provides someone with ample experience in the theater environment.
The simulation helps in linking theoretical concepts in the application setting. This information was my main theme in the entire process of interacting with the general theater setting. As a student, I worked with two patients.
My role was to advocate for the rights, privileges, and freedoms of the patients with whom I was working. My duty from the healthcare setting perspective was to ensure that the patients were accorded the right pre-operative and post-operative care while at the hospital.
With that in mind, I was in close contact with all other stakeholders in the general theater setting. One of the most important things that came out of the process was the understanding of the theater process as a multi-disciplinary approach to healthcare.
There were various tasks that I was required to complete while serving as a student operating department practitioner. The tasks included ensuring that the patients had basic items, such as warm blankets and food, especially before the surgery commencement. I was charged with ensuring that before a patient was taken to the anesthetic room, the intubation table was properly set, arm rests were in place, and that all other requirements such as a warm blanket, gamgee, sand bag, and pillow were properly in place. I was required to ensure that the fluid and monitoring equipment were properly installed and that they were in a manner that did not only ensure the safety of the patients but also ensured their comfort as they underwent the procedures.
At the operating table I ensured that there were enough practitioners to safely position the patient on the operating table and ensure that the patient’s dignity was maintained. The anesthetist took responsibility for the patient’s upper body including the head, neck, and airway. The anesthetist also co-ordinated other members of the multidisciplinary task force. My role in the handling of the patient included ensuring that the patient was properly covered, that she was properly placed on the operating table with all the necessary padding and pressure gels, and that every other person in the task force was carrying out their duties as required. Most importantly, I also ensured that the patient was not handled in a manner that would increase risk factors for infections.
From my observation as an operating department practitioner (ODP) and in the service of Patient A, I can comfortably say she was served with dignity and her rights were not violated. Quality care was provided both at the preoperative period, perioperative, and postoperative period. To the greatest extent possible, the patient was comfortable through the entire process and all resources required for the process were available.
One important issue that is usually forgotten is the issue of preventing infections in the operating room (Health Professions Council, 2008). As the Operating department practitioner (ODP), I also instituted the required procedures of ensuring that a case of infection in the operating room did not take place. I encouraged all the practitioners to wash their hands with soap before and after interacting with the patient. The practitioners wore gloves when serving the patients and at the same time. The equipment and tools used in the operating room should be sterilized to ensure the safety of the patient and to prevent infection (Bingham, Lloyd-Thomas & Sury, 2008). This happened to be the most important activity that I would undertake during the entire engagement as a student operating department practitioner (ODP).
Moving on to Patient B, I was serving in a circulating role. I ensured that the operating room had been cleaned and had all the required equipment and instrumentation for the procedure. Some of the key activities in service of patient B included the adjustment of temperature in the theater to 22 c and humidity between 41%. I ensured that a warming device was used to cover the patient and that monitoring of temperature was closely tracked. Considering the potential morbidity associated with hypothermia and hyperthermia, it is important to monitor body temperature and to institute measures to maintain temperature as close to normal as possible (Townsend et al. 2004).
After ensuring that the patient was properly placed on the operating table, I helped the scrub nurse with gowning and gloving. I followed aseptic technique and opened relevant sterile packs, pouring lotions, and I did the first swab, instrument and needle count with the scrub person, so it was recorded on the board. Following these procedures is critically important in ensuring that the surgical process is flawless and secondly, in ensuring that infections in the theatre are prevented.
The wound scrubbing process is one of the most important stages in the prevention of infections. However, it is a painful process considering the need for the nurse to monitor changes in the wound as the scrubbing takes. Understanding this, a scrub practitioner checked the patient’s consent, patient’s wristband, and surgical side with the scrub practitioner, the surgeon, and the rest of the team. Operating room protocols on WHO checklist were read out loudly and the draping began marking the beginning of the surgical procedures.
After draping I adjusted the light and assisted with connecting the monitoring equipment, and positioning the diathermy machine and suction tubing around the operating table so that they did not compromise the sterile field. It is critical to ensure that electrical cables were secured by using trip-stop and this is a critical procedure in prevention of infections as well as accidents in the operating theatre (Pirie, 2010). I filled out the pathology form for the specimen ensuring that the form bore the patient’s label containing details of the patient’s name, address, date of birth, NHS number and patient number and surgeon consultant name, date, and specimen name are clearly written (Department Of Health, 2003).
During the surgery, anticipation of the needs of the surgical team is an important area for the prevention of infections. I counted needles, blades, and instruments and compared the count with what was written on the board. The theater practitioners should measure and inform the surgeon and anesthetist about blood and fluid loss by recording it on the board and I ensured that the procedures took place (Blunt, 2001). Once the operation was completed, the scrub nurse focused on dressing the wound considering the role of the wound dressing and the care that should be taken, which is very critical (Zimlichman, Henderson, Tamir, Franz, Song, Yamin, & Bates, 2013).
Like in the case of Patient A, I ensured that any chances of infection in the operating room were eliminated. All the stakeholders interacting with the patient are required to clean their hands, have their gowns on, and ensure that all tools are sterilized (Driscoll, 2000). The entire procedure was considered to be safe for the patient as well as the practitioners giving care to the patient. Notably, the circulating role ensures that all the infection-prevention protocols are followed. The holder of this role is involved in most of the cleaning, sterilization, heating, and lighting procedures that are essential in the process of preventing infections in the operating room (Polin, Denson, Brady, Papile, Baley, Carlo, & Byington, 2012).
Feelings The engagement both in the circulating role and in the capacity of operating department practitioner was very informative, educational, and imparted a lot of experience in me. I feel that this is an experience that every student in healthcare should go through. The engagement gave me the chance to employ academic and theoretical skills to the working environment. I was able to effectively assess the applicability of theories in the learning environment. Understanding the theoretical frameworks before interacting with the healthcare setting is important (Morison & Wilkie, 2004).
One of the most important observations that I made concerns the various procedures of preventing infections in the operating room. The prevention majorly focuses on the patient, especially when considered the patient has open sounds during the operating process. At times, the practitioners tend to forget the importance of cleaning their hands with soap and water or with alcohol-based cleaners when interacting with the environment (Scott, Earl, Leaper, Massey, Mewburn, Williams, 1999). Notably, the assumption that the practitioner does not need to clean hands simply because they have gloves is misplaced, and it is often overlooked (Weber, Anderson, & Rutala, 2013; Karki & Cheng, 201)). I had the chance to enforce the need to clean hands during the entire procedures.
I feel that there is the need to continuously remind the practitioners to clean hands. For instance, a practitioner receiving a call should be advised to clean hands before holding the cell and after holding the cell. If not so, the practitioner should not hold the cell at all and instead, another person should do so (Gunnewicht. and Dunford, 2004). This is because I realized this to be one of the potential areas of interest when dealing with infections in the operating room. No protocols are prohibiting the use of phones among various practitioners other than the surgeons (Gruendemann & Mangum, 2001).
Evaluation The evaluation of the pre-operative and the perioperative procedures in the general theater indicates that all the practitioners in the healthcare sector are aware of the need to maintain a clean environment when handling patients (Sehulster, Chinn, Arduino, Carpenter, Donlan, Ashford, & Wong, 2003; Wilding, 2008).
In fact, most or all the practitioners strive to ensure that infections in the operating room are prevented by controlling all variables that may lead to a possible infection. However, several incidences may result in unintentional infection (Quick, 2000; Lawrence, 2008).
One particularly important concern is the issue of distraction while in the operating room. Any distraction of even absent-mindedness is a potential cause of infections in the operating room (Cimiotti, Aiken, Sloane, & Wu, 2012).
Interruptions make the practitioners forget procedures that are not considered to be major. For instance, distracted touching of surfaces in the operating room including door knobs, the side of the operating tables, and even some of the equipment may be a major source of infection (Uckay, Hoffmeyer, Lew & Pittet, 2013).
At times, these surfaces are forgotten in the disinfection and sterilization processes and these result in the possibility of infections (Radford, County, Oakley, 2004). The process of cleaning a patient’s wounds is also a major consideration when dealing with the patient in both the preoperative and the perioperative environment (Ennis & Meneses, 2000).
Procedures followed in the handling of a patient’s wound may be a major cause of possible infections. Patients with an open wound at the preoperative stage need to be handled with a lot of care to prevent infections to the patient (Wilson, 2009).
Notably, this should begin from the point of the patient’s entrance into the hospital setting. I was involved in the scrub process. During the process, one of the areas of interest ought to be the issue of other infections before the patient gets to the hospital (Townsend, Beauchamp, Evers, Mattox, 2004).
The nurse should watch out for a sign of infection to the wound at the point of scrubbing considering at this stage it is possible to overlook the signs of new infections.
Some areas to consider would be the body temperature of the patient as it might indicate possible infections (Aindow &Butcher, 2005). Various things went well throughout the engagements in the two roles herein explored.
The understanding of effective patient care was among the important lessons that came out clearly. The best thing to note is that the process is multidisciplinary and involves people from various departments (Hind &Wicker, 2000).
People skills are very important in ensuring effective patient care. There is the need to learn how to communicate with people at different levels of the organization. As a student in the general theater environment, one the challenges that I confronted was effectively learning how to remind a senior to clean his or her hands before interacting with the tools and instrumentation that will be used on the patient.
This was not the easiest task considering that majority of the practitioners have been in the industry for a long time and as the assumption goes, they ought to be the one’s instructing me.
However, I learned about the human aspects of every practitioner. I learned that out of the preoccupation with various issues in the operating room and other issues in mind; it is possible to forget some of the simple rules such as cleaning hands.
At times the practitioners will get away with it, but on other occasions, there may be infections that will force the practitioners to be keener. However, it is always important to avoid the latter, and a simple and kind reminder would suffice in preventing any complications for the patient (Ray, 1998).
Notably, this applies to following instructions from the surgeon with every practitioner being required to be very keen on ensuring that the best care is provided to the patients. The last major observation is the note that the prevention of infections ought to be a continuous process from the preoperative, perioperative, and postoperative environments.
On many occasions, the practitioners focus on the first two and give limited consideration for the postoperative stage. This is in light of involving other stakeholders in the care of the patient.
Research indicates that one of the major sources of infections would be during the postoperative stage where the family of the patient fails to pursue the requisite procedures of observing cleanliness when dealing with the patient (Meltzer, 2001).
It is the role of the healthcare professionals to remind the family members of the need to clean hands before and after interacting with the patients. It is the responsibility of the practitioners to ensure that the visitors do not pass infections to the patient and this is ensured through insisting on simple procedures when handling the patient.
Policy posters in the hospitals would enable the hospitals to deal more effectively with prevention of infections. Additionally, it is recommended that the patients are monitored closely, noting any changes in the body temperatures and the breathing cycles of the patient to track and identify any changes as quickly as possible.
Notably, postoperative infections can cause death and other undesirable implications, especially when considered that the patient is under medication and the assumption that drugs could be causing major changes to the patient.
Conclusion In concluding, this paper presents a reflection on experiences gained from a general theater setting. I interacted with the setting as a student operating department practitioner and in a circulating role. While in this engagement I served two patients by ensuring their safety and also ensuring that they got effective care. I conducted various tasks while at the hospital, and most of the tasks were geared towards ensuring the comfort and safety of the patients that I served. However, one of the most important engagement was in ensuring that the theater put in place safety measures that prevented infections on the patients and also on the practitioners at the hospital.
Prevention of infections in the operating room is one of the most important procedures (Nazarko, 2002). This should be followed by the preoperative, perioperative, and postoperative periods. Simple procedures such as cleaning of hands with soap and water or with alcohol-based cleaners are one of the steps that are well known by all stakeholders but one that is easily forgotten by the stakeholders.
As the reader will notice from the reflection, any distraction can lead to infections in the operating room, especially when considered that the practitioners may forget to clean their hands if distracted (Beckett, 2010).
Secondly, the use of phones can be a major cause of infections in the operating room and thirdly, the assumption that just because a practitioner has gloves they do not need to wash their hands is a major risk of infections in the operating room (Lay-Flurrie, 2004).
The last consideration on the cause of infections is the failure to include visitors in the requirement of clean hands and following the policies especially during the postoperative period (Royal College of Nursing, 2003).
The interactions with the nursing environment ensured that I learned the importance of communication skills and other interpersonal skills in the general theater setting. The environment uses multidisciplinary approaches to the provision of effective care and in communicating with all the stakeholders in the setting is important (Torrance, 1999). Additionally, it is important to consider the involvement of the family of the patient in ensuring that they prevent infections.
Action Considering the lessons learned from the engagements, there are various courses of action that I would pursue given another chance to serve in similar capacities. The institution of policies requiring the pursuit of hygienic procedures would be a major starting point for the engagement.
Notably, the practitioners are aware of the importance of these procedures but reminding them though posters would be an effective way of asserting the importance of these procedures. I would also use posters to ensure that all persons interacting with the patient understand that there is the possibility of infections and that they have a role in preventing them.
Lastly, I would ensure that the nurses attending to patients in the post-operative stages learn how to identify the possibility of infections and also learn how to differentiate the signs of infections from the side effects of the drugs administered to the patients.
These actions would help in improving the general environment of providing care to the patients (Wicker & O’Neil, 2006).

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