Rolfe’s Reflective Model Sample

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A Reflective Essay using Rolfe’s Reflective Model to Reflect on your Role as a Student Nurse in Medicine Management

Introduction

The current reflective essay is based on my experience as a student nurse in the application of evidence-based risk assessment tool for quality care to patients of different critical intensities. Evidence based risk assessment tool is a technique used in the provision of quality care and healthcare support which comprises preventive measures taken for patients, or diagnostics and prognostic routes chosen and sometimes even in precision insurance medical decisions (James, 2013).

As per my understanding and my experiences from the evidence-based risk assessment tools, it helps reduce the associated risks to patients by minimising health impact, costs and issues related to legal and ethical concerns. Evidence based risk assessment tools as I have experienced help greatly in exploring the risk magnitude (RM) of different types of patients and assess the mortality prediction and predictable survival of the patient.

This aspect of the risk assessment was important for insurance approval for patients by the hospital. Again, in another aspect, these risk assessment tools also help in assessing the safety settings of the healthcare centre like risk assessment from patient fall evidence (Renfro and Fehrer, 2011; Waxman, 2010).

However, in nursing, I now believe that it is a very important tool for nurses to understand the patients’ conditions and help the specialists understand the patient’s condition or situation. In the following section, I have used Rolfe’s Reflective Model to present my experiences using evidence-based risk assessment tools while interning as a student nurse.

Rolfe’s reflective model

Part 1

During my experience as a student nurse, out of most tasks I was involved in during the short period, using the evidence-based risk assessment tool was the most critical medicine management process I had encountered. The medicine management system as we know in nursing is the critical process of assessing, controlling and monitoring the medication system for improved performance and quality care (Zipkin et al. 2014).

Evidence based risk assessment tool is an important part of medicine management because it involves assessing the risks of the patients based on evidence of the history of the patient or similar conditions in the past from another patient. The evidence based risk assessment tool also helps in the assessment of the condition of the patient like allergies to certain medications, the criticalness of the patients, the survival chances of the patient, and predicting the treatment efficacy for those critical patients only.

Another technical aspect of these tools is that the hospital setting has also used them for determining the insurance eligibility of patients, these tools have certain measures for each of the medical condition of the patient and using this knowledge and assessment the eligibility of the patient to avail insurance to reduce costs of treatment are used (Nelson et al. 2021).

The evidence.nhs.uk, (2020) or NHS has developed multiple evidence-based tools for risk assessment of the patients using sound methodological and procedural basis and investigative methods to assess the patients’ conditions and improve the provision of quality medical care. Since the NHS has made it mandatory for all healthcare settings to apply risk assessment tools for all types of conditions and settings thus it has become an important activity.

During my experience, I learned how to use and develop a risk assessment tool with the help of a head nurse and another midwife with whom I had to partner during my internship as a student nurse. They taught me how to use different types of tools and their applications. The nurses in the healthcare setting had a format for using the tools that allowed them to rate the patient’s conditions and gather information on the patient’s history.

It further helps the emergency doctors and other specialised doctors better understand the patients to have the correct route for prognosis and diagnosis. I believe with the help of this personal and in-depth association I gained some knowledge on how to investigate patient histories and conditions to effectively use the evidence-based risk assessment tools. This I can further relate to one of the cases that I handled. The case was the patient had a previous history of allergies from certain medications. This was put into the risk assessment tool that helped the doctor approach a different route for medication and treatment of the patient (Westbrook et al. 2011).

Part 2

My involvement as a student nurse in applying evidence-based risk assessment tools helped me gain knowledge on different aspects like how to investigate the patients and gain information on the patient conditions and history. In one of the areas of risk assessment i.e. to mitigate the fall risk of critical patients, I learnt to use the Morse Fall Scale and the Hendrich II Fall Risk Model that is generally used by the nurses in the hospital setting to reduce the cases of patient falls from trips and involuntary patient actions (Higaonna, Enobi, and Nakamura, 2017).

While using the Morse Fall Scale and the Hendrich II Fall Risk Model, I learnt that these risk scoring tools have different categories that can be used to understand the condition of the patient and based on the risk score the patients are given more care and assistance to ensure that there is low risk to fall. For instance, I understood that these tools use and gather information on the patient’s conditions like confusion or disorientation and depressive state and dizziness of the patient and types of drugs like consumption of benzodiazepines and others.

Patients taking benzodiazepines need special care and support because they risk falling when they move without the assistance of a nurse or other family member. Other information gathered from these assessment tools is the patient’s condition like the use of cane or sticks to move, medical condition of the patient, mental condition of the patient and others (Han et al. 2017).

I also discovered that these scoring tools have various classifications that can be utilised to comprehend the state of the patient and dependent on the danger score the patients are given more consideration and help to guarantee that there is generally safe to fall. I also discovered that these instruments use and assemble data on the patient conditions.

By considering these situations and patient scores, better care and support can be provided. Therefore, this process also helped me acquire information on various viewpoints like exploring the patients and gaining data on the patient conditions and history. Furthermore, considering the tools used in risk assessment are not limited to fall assessments but also enable ethical generation for patient treatment (Ondrusek et al. 2015).

In this regard, I can link my skill development experiences whereby I learnt that ethical provision of care is very important and this includes informing the outcomes of the risk assessment and the possible treatment and effectively communicating all the outcomes from the risk assessment of the patient to other specialists as well for effective treatment routes.

Linking my learning to that of Kaya, Ward, and Clarkson, (2019) current risk assessment practice in hospitals there is still a major gap in the risk assessment guidance for using tools to mitigate the risks of wrongful medication or wrongful diagnosis of the patients rising for poor assessment of patient conditions and risks.

Even though the National Health Service in England (NHS England) has developed multiple systems that allow the risk assessment for patients concerning patient compliances, ethical medical practices, treatment processes and patient care and improvement of the patient’s quality care.  There is a significant gap in the effectiveness of applying these tools.

It may be because there are different tools that each of the hospitals uses. Like in my case, as I mentioned, the hospital used two different tools for fall risk assessment of the patients like the Morse Fall Scale and the Hendrich II Fall Risk Model. This resulted in different risk scores by different nurses or the authorised personnel.

Based on these aspects I can say that there is a significant gap in effective evidence based risk assessment tools as hospitals develop or adapt to existing ones based on feasibility and the risk assessment guidelines by the NHS England. Therefore, I believe that the Nursing and Midwifery Council must develop and upgrade its existing risk assessment tools meant for the nurses to use so that a single method of the risk assessment tool is used for different conditions of the patients and improve the patient care.

Applying singular methods or multidimensional risk assessment tools may improve the medical care and medical care support which involves preventive measures taken for patients, or diagnostics and prognostic courses picked, and now and then even inaccuracy protection clinical choices. Furthermore, using a multidimensional and unified use of the risk assessment instruments will help decrease the related dangers to patients by limiting wellbeing effects, expenses, and issues identified with legitimate and moral concerns.

These evaluation tools as I have encountered help extraordinarily in investigating the risk assessments of various kinds of patients and survey the mortality forecast and unsurprising patient endurance. This significant part of the medication the board since it implies surveying the dangers of the patients dependent on proof of the previous history of the patient or comparable conditions in the past from another patient.

The risk appraisal device likewise helps in the evaluation of the state of the patient like sensitivities to specific drugs, the criticalness of the patients, the endurance odds of the patient, and anticipating the treatment adequacy for those basic patients as it were. Applying unified, flexible and multidimensional risk assessment tools will help the nurses moderate the tools as needed for the different conditions of patients and mitigation of risks (Ondrusek et al. 2015).

Part 3

I believe I was limited to using only fall-related risk assessment tools like Morse Fall Scale and the Hendrich II Fall Risk Model. There are many other risk assessment tools developed for patients suffering from different conditions like patients with severe diabetic conditions and cardiac issues. There are different evidence-based risk assessment tools for these patients.

Therefore, I believe one of the most important skills and knowledge I need to gain is investigating and using them in other conditions. I also have to learn about the application of these tools using technical tools that help in the evaluation of the state of the patient like hypersensitivities to specific drugs, the criticalness of the patients, the endurance odds of the patient, and anticipating the treatment viability for those basic patients as it were.

Another specialised part of these apparatuses is that the emergency clinic setting has likewise utilised them for deciding the protection qualification of the patients, these devices have certain actions for every one of the ailments of the patient and utilising this information and appraisal the qualification of the patient to profit protection to diminish expenses of treatment are utilised.

For instance, the NHS has developed different risk assessment tools for patients suffering from psychiatric and other healthcare issues. I will learn and read these risk assessment tools and understand how they are used or the importance of these tools using literature studies. By interning more in the area of risk assessment for medicine management, it will help me to learn about different numerous other danger evaluation instruments produced for patients experiencing various conditions like patients with extreme diabetic conditions and cardiovascular issues and for these patients, there are diverse risk appraisal tools or measuring systems.

Consequently, I believe engaging more in learning these risk tools will improve my abilities and the information I need to acquire is how to examine and utilise them in different conditions. I need to find out about the utilisation of these instruments that assist in the assessment of the patient’s condition like hypersensitivities to explicit medications, the criticalness of the patients, the perseverance chances of the patient and expecting the treatment suitability for those fundamental patients figuratively speaking.

Another specific piece of these devices are that they have in like manner been used by the crisis facility setting for choosing the insurance capability of the patients, these gadgets have certain activities for all of the diseases of the patient and using this data and its evaluation, the capability of the patient to benefit security to lessen costs of treatment are used. As a student nurse, I plan to achieve these skills and improve through external engagement and internships at different clinical centres.

Conclusion

Evidence based risk assessment tool is the process of assessing the possible risks to patients and developing a route for the patients. There are different ways of providing care to patients and the main activity of the nurses in this case of using evidence based risk assessment tool is to gather first-hand information of the patients’ conditions, medical history like allergies and previous medications and health issues, as well as mental heal of the patients.

There are different types of risk assessment tools for different conditions of patients like psychological or cardiac patient risk assessment tools. In addition, these tools are also used to develop a predictive assessment of the patient’s survivability or death. Based on such outcomes, the route of medication and healthcare is decided. The nurses’ role in this aspect is to include these tools while investigating the patients’ conditions. This helps in effective medicine management by providing effective care and rightful medications and reducing risks of wrongful medications and others.

References

evidence.nhs.uk, 2020. Risk Assessment Guidelines. Available at https://www.evidence.nhs.uk/search?q=risk+assessment+guidelines.

Han, J., Xu, L., Zhou, C., Wang, J., Li, J., Hao, X., Cui, J., Shao, S. and Yang, N., 2017. Stratify, Hendrich II fall risk model and Morse fall scale were used to predict the risk of falling for elderly in-patients. Biomedical Research.

Higaonna, M., Enobi, M. and Nakamura, S., 2017. Development of an evidence‐based fall risk assessment tool and evaluation of interrater reliability and nurses’ perceptions of the tool’s clarity and usability. Japan journal of nursing science, 14(2), pp.146-160.

James, J.T., 2013. A new, evidence-based estimate of patient harms associated with hospital care. Journal of patient safety, 9(3), pp.122-128.

Kaya, G.K., Ward, J.R. and Clarkson, P.J., 2019. A framework to support risk assessment in hospitals. International Journal for Quality in Health Care, 31(5), p.393.

Nelson, A.J., Ardissino, M., Haynes, K., Shambhu, S., Eapen, Z.J., McGuire, D.K., Carnicelli, A., Lopes, R.D., Green, J.B., O’Brien, E.C. and Pagidipati, N.J., 2021. Gaps in Evidence‐Based Therapy Use in Insured Patients in the United States With Type 2 Diabetes Mellitus and Atherosclerotic Cardiovascular Disease. Journal of the American Heart Association, 10(2), p.e016835.

Ondrusek, N.K., Willison, D.J., Haroun, V., Bell, J.A. and Bornbaum, C.C., 2015. A risk screening tool for ethical appraisal of evidence-generating initiatives. BMC medical ethics, 16(1), pp.1-8.

Renfro, M.O. and Fehrer, S., 2011. Multifactorial screening for fall risk in community-dwelling older adults in the primary care office: development of the fall risk assessment & screening tool. Journal of Geriatric Physical Therapy, 34(4), pp.174-183.

Waxman, K.T., 2010. The development of evidence-based clinical simulation scenarios: Guidelines for nurse educators. Journal of nursing education, 49(1), pp.29-35.

Westbrook, J.I., Rob, M.I., Woods, A. and Parry, D., 2011. Errors in administering intravenous medications in hospital and the role of correct procedures and nurse experience. BMJ quality & safety, 20(12), pp.1027-1034.

Zipkin, D.A., Umscheid, C.A., Keating, N.L., Allen, E., Aung, K., Beyth, R., Kaatz, S., Mann, D.M., Sussman, J.B., Korenstein, D. and Schardt, C., 2014. Evidence-based risk communication: a systematic review. Annals of internal medicine, 161(4), pp.270-280.

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