The Significance Of Critical Reflection In Nursing Associate Practice

The research I have been focusing on is urinalysis and importance of this test in a clinical setting. Urinalysis, as the name indicates, is the analysis of urine. It should include physical, chemical, and microscopic examinations (Simerville et al. , 2005). The purpose of urinalysis is to detect any abnormalities that might have caused certain symptoms and illnesses, such as urinary tract infections, kidney diseases or diabetes. (Tasota, Tate, 2000).

As L. A. Wilson (2005, p. 51) suggests, it is an essential screening when assessing a patient. Working within the hospital environment, especially in my current placement on the assessment unit, has influenced my decision to expand my knowledge around this topic. It is due to routine nature of this test and importance of performing it accurately. By observing the procedure being carried out by my colleagues, I have noticed differences in their techniques and I was determined to find out about the correct way. Initially, during my research I felt unsure and slightly confused, but also interested and eager to proceed with my study. I was pleased to learn University systems, such as Moodle and PRIMO library, as they have turned out to be invaluable in my journey to expand my knowledge. I found them accessible and student-friendly, even though it took some time to become confident around them. Although some barriers, including finding relevant articles and comparing resources created fear of failure, they also stimulated me to persist with my research.

At times, I felt I didn’t understand the specific language and terminology used in certain journals, which resulted in researching even deeper. This experience has helped me to become more confident in university studies. I found the support from my tutors, colleagues and co-students has been exceptional and was available along the way. Another good thing about the situation was the fact that it allowed me to work on my time management. Knowing the course would be time-demanding, it was essential to plan my actions ahead and organising my time. By reading different articles and comparing findings, I was able to analyse authors’ perspectives and look for any shared views. Urine analysis can be performed using a dipstick method, which is the most common procedure. Urine sample is obtained and then using a dipstick with color-coded chart, the results are compared to normal quantities of certain elements (Yetisen et al. , 2013). Another way of examination is using laboratory microscopic test and urine culture test. These tests are more complex examinations and are often requested unnecessarily causing additional, but avoidable costs for organisations (Kayalp et al. , 2013).

To understand the urinalysis, practitioner must be able to know the specific elements of urine and their various functions (Tasota, Tate, 2000) and interpret the results (Whelan, Hughes, 2016). Urinalysis is a test to determine presence of leukocytes, protein, red blood cells, nitrites, glucose, bilirubin and urobilinogen. Urine analysis will also show pH of urine, which in normal adult is usually slightly acidic (values between 4. 5 and 8, but often around 5. 5-6. 5). More alkaline pH will indicate possibility of UTI, however should not be interpret individually, but along with other parts of urine (Boyd, Barratt, 2011). Another element called specific gravity gives the practitioner an idea about patient’s hydration levels and may help detect kidney dysfunction (Simerville et al. , 2005). Presence of ketones in urine specimen (ketonuria) is abnormal and it should prompt further investigations, as patient may have developed diabetes (Simerville et al. , 2005). Above elements of urine may be affected by various drugs and diet of the patient.

To correctly perform urinalysis, practitioner should ensure they use the correct method of collection and storage to acquire reliable results (Ince et al. , 2016). This supports other studies, where authors state that inappropriate method of urine collection, such as lack of use of PPE (Personal Protective Equipment) (Boyd, 2016) can contribute to contaminating the sample (Frazee et al. , 2015). Another source presents that obtaining urine into cardboard containers can mislead the practitioner as they falsely suggest presence of nitrites in specimen (Eley, 2015). This supports the theory that to obtain the most reliable results, it is advisable to use clear, sterile container (Whelan, Hughes, 2016). During the exploration of this topic, I felt there was a lot of different information I could gather and it made me aware what I had been doing incorrectly and how I can change my practice. My research prompted certain observations and allowed me to notice poor techniques. By reflecting on my previous practice, I will be able to take a leading role in implementing theory into practice (Caldwell, Grobbel, 2013).

According to A. Duffy (2013, p. 1401), verbal interactions with colleagues are beneficial to compare knowledge and perception of a certain situation. This means that if a similar situation arises when similar situation arises or I notice my colleague performing this task in an inadequate way, I will be able to challenge it and discuss the situation. I think the whole experience has taught me what I should improve in my approach towards future assignments. To be able to fully focus on the research it is necessary to organise all resources in folders to ensure all documentation is available and in place. Even though I believe my time management has improved since starting my course, there is still room for improvement. This is closely linked to better organisation and creating effective plan for studying. By reflecting on myself when I first started the course and looking art myself now, I am satisfied with my progress and I am able to state that improvements have been made. Working on confidence and being assertive are the areas that I feel I should focus on in the nearest future.

15 Jun 2020
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