The use of drains is still an important aspect in the management of patients postoperatively. While drains serve an important function, also, they are associated with difficulties such as haemorrhage, muscle swelling, retrograde bacterial migration, and drain entrapment (Walker 2007). Hence, it is very essential for nurses to provide adequate monitoring and care of medical drains and provide actions to ensure avoidance of problems from arising.
While employed in the operative ward, I have already been exposed to patients with surgical drains. This actuality pushed me to learn more about surgical drains and to gain more competence in the management of the patients. In this essay, I'd be reflecting on my encounters as I proved helpful to achieve my learning results of becoming efficient with surgical drains. I'd be utilising Gibbs (1988) style of reflection which contains 6 stages, specifically: description, emotions, evaluation, analysis, summary and action plan.
DESCRIPTION
In the past, I have been exposed to patients in the surgical intensive care device with surgical drains. I have known how to monitor & care for the drains and have seen the cosmetic surgeons remove these drains. But, I have never tried eliminating operative drains before. Only surgeons and surgical resident doctors were allowed to remove drains in the united states where I have trained before. Thus, after i started my adaptation program in the surgical ward, I was impressed with how skilful the nurses are with surgical drain removal. This offered me the urge to become proficient with the good care of drains.
During the first week of the version program, I started out my quest for knowledge by doing a literature review about the indications, need for drains, the several types and the risks & complications involved with drains. I accumulated information from my coach about the hospital's protocol and strategies for the care and attention of drains as well as the several surgeons' tastes in the attention of their patients' drains. It had been then that I then found out that doctors always choose the drains of orthopaedic patients (hip and knee replacements) to be taken out after a day. As cited by Tucci, et al (2005), sealed suction drainage systems are generally found in orthopaedic surgery, the explanation for its use is to theoretically reduce wound haematoma and infection.
Knowing i had been well prepared with knowledge, I then focused on boosting my skills in this aspect. I performed hand in hand with my mentor as I noticed how she watched, re-vacuumed, and removed the drains. I seen the techniques and ideas that she utilised and mentioned the different materials needed for every procedure.
FEELINGS
When I already thought ready to remove the drain for the first time, I was being a bit anxious that I'd do something wrong especially that my mentor would be supervising me as I perform the procedure. I knew that point which i was ready knowledge wise and I exactly realized what I was going to do, but there is always that sense of nervousness when you take action for the very first time. My stress was lessened when my coach reassured me as she told me not to worry as she'll guide me all throughout the task.
I got all the materials ready and was all ready with personal protecting devices. After obtaining educated consent from the patient, I removed the drain with no difficulty while making sure that aseptic approach was discovered. Aseptic technique is very important to prevent operative site infections. According to the NICE suggestions (2008), the introduction of an SSI depends upon contamination of the wound site at the end of a surgical procedure and specifically relates to the pathogenicity and inoculum of microorganisms present, well balanced from the host's immune response. Thus, proper palm washing and maintaining sterility are incredibly important when managing drains.
Aside from getting rid of drains, I've gained more confidence in re-vacuuming drains, monitoring drainage end result, documenting and seeing out for problems. While taking care of these patients, I guaranteed that difficulties are prevented by providing health teachings about health, proper hand washing, measures to avoid complications and early on diagnosis of any issues.
EVALUATION
With the whole learning process, I could achieve my goal of attaining positive learning outcomes. I have been more proficient with handling medical drains. I've increased my knowledge and distributed these with my patients to allow them to have a safe recovery. I had been very willing with minimising complications and have been more watchful of the danger signs. I've known and utilized contamination control by heart as well.
There was one negative incident that occurred during my version experience. This occurrence made me more careful whenever I needed treatment of patients with drains. We'd an individual who underwent a major breast procedure who experienced four astra drains in situ. She developed a haematoma during our transfer due to fact that of her drains were all clamped from the prior shift. The medical expert himself discovered the nurse's mistake and noticed the haematoma as well. He had not been pleased with what took place and informed us to be very careful along with his patients' drains. We made a study and found out that the nurse who re-vacuumed the drains from the previous shift didn't unclamp the drains. We made an incident report and up to date the ward sister about the event. We regularly monitored the patient's haematoma and regularly massaged the affected area.
ANALYSIS
This occurrence made me understand how quickly difficulties arise when a single error is performed. It trained me to be more cautious when re-vacuuming drains. Ever since this incident occurred, I always double check that all the drains are unclamped and patent before departing the patient's rooms. I always check the wound & drain site for any haematoma or other unusualities as well.
CONCLUSION
Although it had not been my mistake that the drains were clamped, I possibly could still say that I really do have a mistake in that occurrence. If I might have inspected the drains and the wound initially in the beginning of the move, that haematoma might not have happened or if not, be minimised. I was too busy caring for other postoperative patients and maintained expressing to myself during that time that I'd check the drains & the wound after I am resolved with the other patients. EASILY could have handled my time well and spared a little of my time for you to determine that patient, the occurrence might possibly not have occurred. This incident offered as a lessons for me personally & the other staff nurses in the operative ward and taught us the importance of drains thus, they shouldn't be taken for granted.
ACTION PLAN
Based on this whole experience, I plan to widen my understanding of surgical drains by doing more research work about other styles of medical drains that we am unfamiliar with to improve my knowledge and to be prepared when the time comes that I would come across these kind of drains. I also plan to be always up to date with my knowledge by reading recent articles from publications or other sources and pick up any opportunity of participating training seminars/ trainings for carrying on professional development.
