During a nurse’s every day practice they have a responsibility to identify risk factors and implement strategies to prevent adverse outcomes from occurring to patients.
The main thrust of the written clinical report is that you identify an issue or some aspect of nursing care or patient management (femoral sheeth removal) etc within your current clinical placement (coranory care unit) where patient outcomes could perhaps be improved through some changes/additions to current practice (i.e. this would be the Recommendations section). So you need to identify what you’ve directly observed (under ‘Background’) (blleding post removal) that could perhaps be done better or slightly differently to improve patient outcomes (and also supported by the relevant literature on the topic).
My topic is femoral sheeth removal and bleeding. I have noted alot of bleeding in the coranary care unit post femoral sheeth removal. Currently patients have digital pressure applied for 20 mins and need to lie supine for an hour but there still seems to be alot of bleeds post this.

In other wordsthe intention of the clinical report is to provide information to support an argument for improving current patient outcomes (bleeding post femoral sheeth removal) by implementing some changes/new practices related to patient care. Some of these recommendations may relate to staff, patients and procedures.

Also, in regard to referencespeer reviewed from relevant journal articles is preferable. You can mainly incorporate these into the ‘Analysis of the Data’ section of the report. References must not be older then 10 years