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    Reflection

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    elizavirani
    This reflective writing discusses an incident where the author encountered a patient with diabetic ketoacidosis who had become hypoglycemic due to improper monitoring of an insulin infusion. The patient showed signs of hypoglycemia like confusion and low blood pressure, but the previous staff had not checked the patient's blood glucose as required by the insulin infusion protocol. This led the author to realize multiple issues: lack of staff knowledge about insulin protocols, failure to observe signs of hypoglycemia, and lack of oversight by team leaders. The author emphasizes the importance of training all staff on insulin protocols, disease pathophysiology, and signs of complications. Team leaders must also ensure proper monitoring and take action when issues arise. This incident highlights the need

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    Reflection

    Uploaded by

    elizavirani
    292 views4 pages
    This reflective writing discusses an incident where the author encountered a patient with diabetic ketoacidosis who had become hypoglycemic due to improper monitoring of an insulin infusion. The patient showed signs of hypoglycemia like confusion and low blood pressure, but the previous staff had not checked the patient's blood glucose as required by the insulin infusion protocol. This led the author to realize multiple issues: lack of staff knowledge about insulin protocols, failure to observe signs of hypoglycemia, and lack of oversight by team leaders. The author emphasizes the importance of training all staff on insulin protocols, disease pathophysiology, and signs of complications. Team leaders must also ensure proper monitoring and take action when issues arise. This incident highlights the need

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    This reflective writing discusses an incident where the author encountered a patient with diabetic ketoacidosis who had become hypoglycemic due to improper monitoring of an insulin infusion. The patient showed signs of hypoglycemia like confusion and low blood pressure, but the previous staff had not checked the patient's blood glucose as required by the insulin infusion protocol. This led the author to realize multiple issues: lack of staff knowledge about insulin protocols, failure to observe signs of hypoglycemia, and lack of oversight by team leaders. The author emphasizes the importance of training all staff on insulin protocols, disease pathophysiology, and signs of complications. Team leaders must also ensure proper monitoring and take action when issues arise. This incident highlights the need

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    292 views4 pages

    Reflection

    Uploaded by

    elizavirani
    This reflective writing discusses an incident where the author encountered a patient with diabetic ketoacidosis who had become hypoglycemic due to improper monitoring of an insulin infusion. The patient showed signs of hypoglycemia like confusion and low blood pressure, but the previous staff had not checked the patient's blood glucose as required by the insulin infusion protocol. This led the author to realize multiple issues: lack of staff knowledge about insulin protocols, failure to observe signs of hypoglycemia, and lack of oversight by team leaders. The author emphasizes the importance of training all staff on insulin protocols, disease pathophysiology, and signs of complications. Team leaders must also ensure proper monitoring and take action when issues arise. This incident highlights the need

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 4

    1 Reflective Writing

    Reflective Writing

    Anita Virani

    Post RN Year 3

    Ethical and Professional Development In Health Care

    Sir Amjad Ali

    1
    2 Reflective Writing

    On 19th May 2011, I had a clinical rotation in Medicine Unit. I was assigned on a

    55 year old male patient with the diagnosis of Diabetic Ketoacidosis. Patient was

    currently admitted with hyperglycemia, high blood pressure, febrile episodes and

    Shortness of Breath. Patient was on 2 liters oxygen by nasal prongs. IV insulin infusion

    was at 8 units per hour was in progress. While doing physical assessment of the patient, i

    observed that patient was drowsy, lethargic and diaphoretic. Glasgow coma Scale was

    6/15. Vital signs were recheck which was 90/60 mm Hg. Upon checking stat reflo of the

    patient, the reading appeared to be 30 mg /dl .I immediately hold the Insulin Infusion.

    25% dextrose IV push of 100ml was administered as per physicians order. Normal Saline

    Boluses was also initiated. On inquiring, it was found that previous staff did not check

    reflo for a single time in whole shift.

    Several thoughts provoked in my mind during this incident. Complications of

    hypoglycemia including seizures, cerebral injury, dementia etc. were revolving in all over

    my mind.

    This incident occurred due to multiple reasons. Firstly, staff was unaware about the

    insulin infusion protocols. She did not give importance to check reflo according to the

    protocol. Lack of knowledge regarding insulin infusion protocol was missing. Secondly

    staff did not observe initial sign and symptoms of hypoglycemia which were confusion,

    delirium, altered mental status, and decreased blood pressure etc. Thirdly, the role of

    team leader was missing here.

    2
    3 Reflective Writing

    In my perspective, importance of dealing with Insulin infusion protocol should be

    trained to every staff and its monitoring should be checked on ongoing basis by Incharge

    Nurse, Team Leader or Management. Insulin infusion protocol suggests checking reflo

    on hourly basis. After checking reflo, infusion is tapered off or increased as per

    requirement given in protocol. Apart from that, disease process and its pathophysiology

    should be discussed in ward session to aware staff regarding early signs and symptoms of

    disease so that they make take initiative in preventing patient from fatal events.

    The classic signs of hypoglycemia alarms early intervention which can reduce the

    chances of complication caused by hypoglycemia. Untreated hypoglycemia from too

    much insulin can lead to loss of consciousness and coma. Severe hypoglycemia is a

    medical emergency that may result in seizures and permanent damage to the nervous

    system if not treated. Unconsciousness due to hypoglycemia can occur within 20 minutes

    to an hour after early symptoms and is not usually preceded by other illness or symptoms.

    Twitching or convulsions may occur as well. Early signs if hypoglycemia includes paler

    face , tachycardia, confusion, delirium, altered state of consciousness. Its frequent

    occurrence is problematic because hypoglycemia can lead to seizures, brain damage,

    depression, and cardiac arrhythmias which can be fatal as well. Additionally, the role of

    team leader should be highlighted in ward. Team leader should perform on going round

    to identify various mishaps and should take prompt action in any misconduct. Team

    leader is the one who has the responsibility and hold over all staff

    On sharing this incident with my classmate, she appreciated me in acknowledging

    this incident .This incident is a learning point for other staff and health care team

    3
    4 Reflective Writing

    members to closely monitor patients with Insulin Infusion. My classmate also appreciated

    me in highlighting complications of hypoglycemia.

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