Venepuncture and Cannulation Essay

Introduction: The Use of Driscoll's Model of Reflection in Analyzing Patient Care

In essence, to assist me during my practice particularly from the first employment to the second as an assistant practitioner in the endoscopy unit, I will use the Driscoll's model of reflection. Apparently, this model is known to take the shape of three stages in helping analyze the practice. What has taken place; through the provision of a clear description of the whole event, what one has learned; this is often done through providing an account of one felt at the time and what one has learned after revisiting the entire experience. Finally, there has to be a proposed planned action particularly for the future and how the plan is going to implement what has already been learned from the experience. Primarily, this paper will be discussing various aspect of patient care which happened at the time I was an assistant practitioner in endoscopy unit in my placement. To do this, I had to get maximum consent from the patient to make sure that confidentiality is maintained. This was possible by making them aware of the reason I was to use their information as strictly articulated by the NMC code of conduct.

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Description of the Venepuncture and Cannulation Procedure

In regards to the practice I attended, I am going to be using Driscoll's reflective model. The first stage would be to describe exactly what happened during the experience. At first, I had no clue of how venepuncture and cannulation procedure is performed but then realized that it was not that hard. Apparently, venepuncture and cannulation are also referred to as the overall insertion of a peripheral venous catheter (Kalliath, O'Driscoll, Gillespie, & Bluedorn, 2016, pp.35). Notably, this is a fairly forthright medical procedure. To complete this procedure, it does not require any technical preparation as I learned when I participated in the practice as an assistant practitioner. The nurses did this by first assembling the necessary materials while I assisted in preparing the insertion sites. While this procedure requires a basic preparation as well as a precaution, the medical practitioners protected themselves from a direct contact with patient's body fluids. Additionally, the patients were also protected from injuries or rather infection. To do this, the clinic practitioners used apparatus such as tourniquet, non-sterile gloves, sharps container, venous access device, paper tape, transparent dressing, and alcohol or antiseptic solution.

Another task the practitioners had to do was to choose a favorable size of cannula they would use during the whole procedure. This was done keeping in mind that the amount of fluid entering the vein was determined by the size or the gauge of the needle (Smith). In this light maximum flow was attained by using a larger gauge needle. I watched closely as the practitioner chose a 22 gauge needle which was small compared to the 14 gauge needle that they considered large (Krum & Driscoll, 2013, pp.334). The main reason why they chose the 22 gauge needle was to fulfill the purpose of the procedure. When assessing the children, nurses used the small needle. Before the process begun, the practitioners and the assistant practitioners had to engage patient in a discussion to get a rather informed consent from them (Phillips, Collins, & Dougherty, 2011). This process was done verbally and was used in building up a good rapport with the clients, therefore, allowing room for less traumatic experience. In most cases, medical practitioners introduce themselves to their patient, verify the specific identifications of their patient before starting the entire procedure, and then explain the whole procedure that will take place to this patient.

Importance of Hygiene and Infection Control in Cannulation and Venepuncture

Primarily, all the medical practitioners ensured that they followed a proper hygiene practice before starting the whole procedure and coming into contact with the patients. This was done by washing hands as well as putting on the gloves. It is important to minimize the chance of exposing patients to infections while inserting the cannula (Dojcinovska, 2011, pp.68). Additionally, it is essential to use proper protective equipment which will not only protect the clinicians but also the patients. I realized that the most preferable patient's arms were the non-dominant arms. Essentially, practitioners placed the tourniquet on the arms (Lawley, Clare, Deakin, Goulding, Yen, Raisen, Brandt, Lovell, Cooke, Clark, & Dougan, 2015, pp.6895). This is often done above the cannulation site. One of the things I realized was that the practitioners ensured that they tightened the tourniquet to highlight the patient's vein. Alcohol wipe or the antiseptic solution were used to clean the patient's skin to make sure that all the available pathogens were removed this is helpful as it prevents the skin of infections as well as reducing stinging (Johnston, Smith, Hiratsuka, Dillard, Szafran, & Driscoll, 2013, pp.20960).

While in the room and the patient well set for the procedure, the cannula needles were inserted at the right angle (Tomey, 2016). The procedure was undertaken while the cannula was held in front of its wings. Additionally, the pointer and the middle finger were placed in the back of the thumb (Witt, 2015, pp.91). The needle was then held in a stationary position as the plastic components that made up the cannula were advanced to about 2-3mm inside the vein (Sullivan & Garland, 2017). The main aim of this act is to make sure that the plastic sheath gets into the vein and keep it right there as the needle was removed (Tomoaia-Cotisel, Scammon, Waitzman, Cronholm, Halladay, Driscoll, Solberg, Hsu, Tai-Seale, Hiratsuka, & Shih, 2013, pp.S115).

After this, the practitioners removed the tourniquet from the arms of the patient. Additionally, the needles were removed from the base containing the cannula (Marquis & Huston, 2014). This allows the blood to flow steadily into the cannula hence there is less chance of air going into the vein in case something was injected through the cannula.

To complete the process of cannulation, the cannula was secured with a proper dressing. Apparently, this was done with the help of a transparent dressing, as well as a tape, which was used to secure the venous device to the skin (Melhuish & Payne, 2016, pp.20).

Learning and Personal Development through the Reflective Experience

At this point, Driscoll's model allows me to analyze my whole feelings and the things that I learned during the practice. Through this experience, I have attained a lot of confidence particularly in what I had learned in my first placement (Dougherty, 2011, pp.281). However, while at the clinic one of the medical practitioners asked me to attend to one patient something that made me anxious. Apparently, this is because initially I had no direct contact with a patient and this was actually my first time to be in a caring environment. Despite the fact that I had a lot of knowledge in the overall requirements as well as the personal qualities especially in promoting the dignity and autonomy, I had not put them to practice before. These values were essential especially in assisting with personal care in lectures at the university.

During this particular event, I learned specific steps that involved cannulation and venepuncture and the need to implement every procedure in case a patient needs to undergo a transfusion or removal of fluid in their bodies (Hyde, Legal, & Professional Issues, pp.5). At first, I was not aware of the level of hygiene that this process involved but then realized the importance of infection control that was required. The clinic practitioners later explained to me the importance of disposing of the equipment I used such as gloves in an orange bag and then wash my hands using soap thoroughly before leaving the site. Noteworthy, due to the ineffectiveness of the alcohol gel at removing pores, I was informed not to use it. Notably, infection control is a common term that is often applied in protecting people against infections. In the healthcare facilities, this term is also used to make sure that patients are prevented from those infections that are related to the healthcare and avoid transmission of the same from one patient to another.

Future Implementation and Improvements in Cannulation and Venepuncture Practices

In the near future, if I were to perform cannulation and venepuncture, I believe I would be more focused and confident because I know the importance of preventing infections and a proper control of the procedure such as wearing gloves and protective gear. I as well learned the importance of obtaining blood from patients according to national occupation standards. On the evaluation of my overall experience, I believe that my communication skill on my first and second placement has hit a notch higher (Jarman, Hirsch, White, & Driscoll, 2017, pp.146). I now feel very comfortable particularly communicating with various people in helping them build a close relationship with regards to cannulation and venepuncture practices as it is important when delivering patient care. I have a strong belief that I communicated very efficiently with the clients and therefore created a good rapport.

At this point, I intend to reflect on the overall aspect of care that I found in the clinic. During my first days in the clinic, I had to take close observations that included respiratory rate, the pressure of blood for each patient, and their temperature before and after the procedure. These observations needed to be taken frequently during my practice. In my advance days in the clinic, observations were taken at least 4 to 8 hours depending on the overall need of the patient (de Verteuil, 2011, pp.131). Nonetheless, if the patient were seen to be at risk, the medical practitioners informed me to increase the level of observation.

While undertaking the observations it is vital to make sure that the patient's Early Warning Score chart is made available because it is the place where all the required observations will be recorded. In most cases, these assessment tools have various sections that are related to the type of observation one is taking (Hart, 201, pp.108). Every section consists of a color code that indicates whether the taken record is a no, mild, low, or rather of high concern. It was, therefore, important to record all the observations down keeping in mind that anything that was not recorded down did not happen in the first place. Nonetheless, all information had to be eligible and correct by the time the official document was filled. The details contained in the document include the date and time of commencement (Phillips, 2011, pp.16).

The first time I assisted in recording the observation I was a little bit nervous because it was my first time to take them. Additionally, I was unsure of how a patient was supposed to be approached keeping in mind that I had not created a close relationship with them. In the beginning, I found it difficult recording some measurements such as temperature. However, I had to ask my mentor for the necessary advice and confirmed that I was on the right track something that gave me a lot of confidence.

Conclusion

As an assistant practitioner, I had to record each result as soon as it had been measured. I did this to ensure I do not forget or mistake it for other readings. It was also important to check if the patients had any other parameter when recording the measurements. Patients were given parameter sets in case they had no specific EWS parameters (Cherry & Jacob, 2016). When all the records had been taken, I was directed to confirm if the patients had an early warning score or not. In case there was an early warning, it was prudent to inform the medical practitioners as it was an indication of something serious. On my second placement, I had gathered enough confidence in performing a full procedure on cannulation and venepuncture. I now understand all the steps that are required to prepare the patient for a successful cann...