Order Description
This assessment develops individual skills for critical reflection and the application of clinical reasoning in practical situations. Students analyse a professional practice issue in relation to the context of nursing or midwifery that was discussed during group activities in the four workshops.
Details
Students draw on the National Safety and Quality Health Service Standards and the NMBA professional competencies and standards to develop a critical response to a clinical incident. Students self-select a clinical incident discussed in the workshops and write an individual critical reflection paper.

Case Study A. Incorrect administration of a blood product
This incident draws attention to checking procedure roles and responsibilities for blood products.
An 86 year old man was admitted with a fractured neck of femur, scheduled for surgery that afternoon. The patient’s international normalised ratio (INR) was elevated at 1.6, and the decision was made to treat this elevated level with a unit of fresh frozen plasma (FFP) prior to surgery. The medical officer (MO) went to the laboratory to collect the unit of FFP. On arrival the scientist pointed to where the FFP was located and requested the MO to sign the unit out of the laboratory in the blood register. The unit collected by the MO was allocated for another patient and labelling not yet completed. The MO signed the unit out against his patient details in the blood register without checking the product details matched. He then took the unit to the ward.
On return to the ward the MO handed the FFP to the nurse caring for the patient, who was unaware of the request for transfusion. The nurse noted the lack of paperwork accompanying the FFP and sent the patient services attendant (PSA), with the unit, back to the laboratory to collect the appropriate paperwork. The PSA returned and stated that there was no paperwork for this FFP unit and that it did not need to be checked, although the laboratory staff stated they did not speak to the PSA regarding the FFP.
The nurses on the ward took the word of the PSA that they did not need the paper work, and checked the FFP to the patient. The unit was group O, the patient’s blood group was group A, therefore making this an incompatible transfusion. The staff were unaware of this at the time as both medical and nursing staff were under the impression that O was the universal group for FFP as well as red cells. Later the laboratory staff noted the FFP for the patient was still in the fridge and when they checked the register realised the error. They immediately rang the ward; however the product had already been administered. As a result the patient had a mild rise in bilirubin, and his procedure was delayed as a precaution to monitor the patient for further consequences of the transfusion therapy.

Students analyse the clinical incident from the perspective of a new graduate registered nurse or midwife in the first twelve months of practice (see the framework in Chang & Daly, 2016, pp. 278-280). Use the following points to guide your answer:
1. Provide a concise description of the incident (i.e, what happened?)
2. Outline why you chose this incident and how it is relevant to your professional practice
3. Identify the relevant factors in the clinical context that potentially contributed to the incident (i.e., why did it happen…so what?)
4. If you were involved in a similar clinical situation in the future, what alternative actions would you take? (i.e., what would you do differently…now what?)
Support your answers with reference to the relevant clinical and professional standards that apply.
Student directions
The marking criteria and standards have been developed to guide you through the group assessment process. Please read the criteria and standards carefully. The paper must include in-text references and a reference list at the end of the paper in the APA style 6th edition. Minimum of 5 references.

Marking criteria and standards
1.Concise description of the incident. What happened? Concise, informative, insightful and complete description of the clinical incident. Rationale for selection and relevance to practice

2.Why is it personally significant? Provides a very clear and insightful outline of the personal reasons for selecting the incident, and demonstrates considerable insight into the relevance of the incident to the context of professional practice. Provides a very clear outline of the personal reasons for selecting the incident, and demonstrates thorough insight into the relevance of the incident to the context of professional practice.

3.Identifies the relevant contributory factors. Why did it happen?
Comprehensive identification of the relevant factors that potentially contributed to the specific incident.
Outstanding, clear, concise reasoning that is well matched to the context of the incident with considerable insight. Thorough identification of the relevant factors that potentially contributed to the specific incident.
Clear, concise reasoning that is well matched to the context of the incident.

4. Rationales for alternative action in a similar situation. What would you do differently?
Critically explores and effectively analyses alternative actions if placed in a similar situation. The answer is supported by clear rationales using a judicious selection of relevant references. Thoroughly explores and analyses alternative actions if placed in a similar situation. The answer is supported by a selection of relevant references.

5. Writing style and References. Outstanding, fluent, writing style and use of language. No errors in spelling, grammar, punctuation or writing style. Consistently accurate referencing, with all references correctly given, both in text and in final reference list according to APA style. A minimum of five references is provided and consistently used to support all answers. Excellent writing style and use of language. No errors in spelling, grammar, punctuation or writing style.
Consistently accurate referencing, with correct references given both in text and in final reference list according to APA style. A minimum of five references is provided and consistently used to support all answers.

The marking criteria and standards have been developed to guide you through the assessment process.

Title – Please title the critical reflection paper with the title of the case study you have chosen for this assessment. For example;
Title: Case Study A – Incorrect administration of a blood product.
Then after the title you will need to provide a question and answer format. You do not need to write out the questions in full for your assessment submission. You only need to provide your answers to each of the questions.
For example;
Question 1. Then you can start to write your answer here, OR,
Q1. Then you can start to write your answer here
Question 1. Provide a concise description of the incident (i.e, what happened?) This answer should be describing what the actual issues are at hand not simply restating the details of the case study.
Question 2. Outline why you chose this incident and how it is relevant to your professional practice (i.e. why is it personally significant?)
Question 3. Identify the relevant factors in the clinical context that potentially contributed to the incident (i.e., why did it happen…so what?)
Question 4. If you were involved in a similar clinical situation in the future, what alternative actions would you take? (i.e., what would you do differently…now what?)
Reference List :Support your answers with reference to the relevant clinical and professional standards that apply. The paper must include in-text references and a reference list at the end of the paper in the APA style 6th edition for all resources used in the critical reflection (a minimum of seven references is expected).
The suggested referencing conventions for citations from an NMBA
document, following the APA Referencing Style Guide for a government
report online are as follows:
First citation:
…this is supported by statement 6.2 (Nursing and Midwifery Board of Australia, 2016).
Subsequent citations:
…in value statement 4 (NMBA, 2008) it is shown that nurses…
Reference List:
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice
Nursing and Midwifery Board of Australia. (2008a). Code of ethics for nurses
Nursing and Midwifery Board of Australia. (2008b). Code of professional conduct for nurses
NB: Use the document dates on the NMBA website, not the ‘date of effect’
Where there are two documents by the same author with the same dates, use a, b, etc. as per above
You do not need to provide the retrieval date and url as all students should use the links to the NMBA professional standards.