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Risk management plan for healthcare facilities
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The case study is about a 64-year-old man, Mr. Londborg with a history of seizure, who was admitted to the hospital due to difficulty breathing. The patient has hypertension and chronic obstructive pulmonary disease (COPD). During his visit in the emergency room, he acquired an infection and his routine blood work shows elevated creatinine, which can indicate kidney problems. The client’s problem with breathing and his kidney was resolved. Although, the overseeing physician did not prescribe a prophylaxis for DVT, know that the patient will be in bed and not moving. Unfortunately, the patient got a blood clot; it was treated, but it made Mr. Londborg stays in the hospital longer than usual. In addition, the patient takes a few medications for seizure, but during his hospital stay the nurse was not able to administer one of them because it was not available. The nurse did not notify the doctor or the pharmacy regarding the missed seizure medication. The patient was found unconscious on the floor by the hospital housekeeper. Mr. …show more content…
Londborg’s hospitalization is the lack of standard orders for admitted patient, lack of system alerts for medication that are missing or not given. And the lack of overall collaboration between all health care providers, including the physician, nurse and the pharmacy.
5. Identify at least one thing that went well during Mr. Londborg’s visit to the hospital?
Although, there are some issues that contributed to an extended stay during Mr. Londborg’s hospitalization, there are also some things that went well during his stay. First was that his breathing and kidney problems was resolved, and his DVT was treated right away. Also, the housekeeper was able to notify the nurses when Mr. Londborg was found unconscious on the floor.
6. Pretend you are the nurse manager on the ward where this adverse event occurred. How would you run a meeting to debrief team members in the days after Mr. Londborg’s
In July of 2010 in Miami, Florida, Richard Smith, a 79-year-old dialysis patient was admitted to the ICU after a dialysis appointment left him with severe shortness of breath. The following day after being admitted the patient complained of an upset and the doctor had prescribed him an antacid. Uvo Ologboride, the nurse taking care of Mr. Smith, gave him a deadly dose of a drug called pancuronium, which is a drug that induces paralysis, instead of the antacid. 30 minutes later the patient was found unresponsive, but they were able to revive him. Unfortunately when he was revived, he was left brain dead to which did not settle well with his family. When the patient son had came in he had found his father unconscious, unresponsive, and on a respirator. When looking over the chart to try and figure out what happened it had said his dad had just been resuscitated 10 minutes earlier and the nurse had pretty much told him to go and speak with the doctor. Upon speaking to the doctor he was told the nurse had given his dad the wrong medication which lead to his current state of his condition. The nurse was not able to be reached and spoken to about what happened on that fatal day but from what the doctor had explained was the nurse had grabbed a
Perhaps the greatest problem faced throughout this tale was that of miscommunication. The Merced Community Medical Center or MCMC for short was the place where Lia was being treated. This hospital was the Merced county's only hospital and unlike most rural county hospital it is state of the art, ."..42,000-square foot wing ... that houses coronary care, intensive care, and transitional care units; 154 medical and surgical beds...."3 This was a teaching hospital made up of interns mostly, but also with some great doctors like Peggy Philp and Neil Ernst. Peggy and Neil are married and have children. They graduated together at the top of their class, and have created quite a practice for themselves. Although MCMC is a great rural hospital, it also has the same problems as most rural hospitals do which is the health care crunch, where most of the money goes to the urban hospitals and then the leftover money is spread among th...
The Lewis Blackman Case: Ethics, Law, and Implications for the Future Medical errors in decision making that result in harm or death are tragic and costly to the families affected. There are also negative impacts to the medical providers and the associated institutions (Wu, 2000). Patient safety is a cornerstone of higher-quality health care and nurses serve as a communication link in all settings which is critical in surveillance and coordination to reduce adverse outcomes (Mitchell, 2008). The Lewis Blackman Case 1 of 1 point accrued
Besides being showcased to the public as a medical rarity by her physician, patient L faced a multitude of other various problems with the Sutter Davis staff. When she first arrived to the hospital, the woman working at the front desk greeted her poorly. Patient L was told by the woman that “’[she] had to wait her turn,’ even though nobody else was there.” In the middle of filling out some medical paperwork, a young child and his mother walked into the hospital about ten minutes after patient L did. Within minutes of walking in, the two of them were called upon to see a doctor. The two of them were helped before patient L was, despite the fact that she showed up long before them and was already waiting fifteen agonizing minutes with no one else ahead of
The patient presented with common signs of compartmental syndrome. The interventions suggested to the staff at the hospital were not fully completed. The interventions given during the case presentation consisted of assessing the six Ps, swelling, and vital signs. I took the vital signs of the patient and the nurse recorded them in their system. The patient’s blood pressure was not within normal limits, so the blood pressure completed manually. The manual blood pressure was still elevated. An increase in blood pressure can indicate pain, swelling, and impaired blood flow to the extremities. When I was with the nurse, she sent the patient for an x-ray. Furthermore, the nurse should have then assessed what the patient has been doing and done education with the patient to elevate the leg above his heart. Many people do not know the scientific rationale and positioning of elevating the extremity above the heart. The nurse should have also assessed the patients expectation of pain relief, since his current medication (Ibuprofen) was not working to his expectations. This is when we left the floor; therefore, I was not able to discuss the patient care with the nurse. The nurse simply asked the patient about some of the six Ps of compartmental syndrome and did not complete the assess...
In order behave professionally, first of all, one needs the willingness to learn and be self-aware. Self-awareness would allow the respondent to realise her limitation on “between the flags” policy and be willing to learn and improve her clinical knowledge. If she had done so, she would realise the importance of documentation and the urgent need to arrange medical review for Patient A, preventing her condition from further deteriorating instead of making assumption that urgent medical assistant was unnecessary as long as the continuous administration of antibiotics. Additionally, with a sound professional experience and knowledge, clinical reasoning skills are also essential in professional behaviour. If the respondent had used problem solving, critical thinking and intuitive thinking skills to recognise and respond on Patient A’s deteriorating condition, she would have applied clinical judgement and decision making skill to prioritise the patient’ need to be urgently medical reviewed by the ED doctor even though she may receive some verbal abuse. Once she is confident with her clinical reasoning and judgement, she would take action on arranging urgent medical review, documenting her assessment for further examination and
My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to protect her safety and dignity, whilst also trying to ascertain what was going on. During the unresponsive episodes we returned the patient to the stretcher where she spontaneously recovered and refused hospital treatment. I completed my patient report form to reflect the patient's decision and highlighted my concerns. The patient’s intoxicated husband then carried his wife back into the house.
...ort her actions, then Jack must do so as he is too responsible for making this situation known to the appropriate people. However, one must acknowledge how difficult this may be for Jack due to the long-standing relationship he has with Linda. It should also be apparent now that Linda’s actions are unjustifiable. She is not only acting unprofessionally and unethically by not delivering the medication but she is committing an illegal offence by falsifying records and stealing from the ward. To conclude, it is important to remember that the Department of Health and Children (2008) acknowledge that healthcare has originated in a world which is not flawless and that as humans, errors are possible. However, members of the healthcare system must try and prevent these errors from occurring where possible to ensure a high standard of care which is owed to the service users.
Every day there is a constant trust adhered to many different people in the profession of Nursing—the decision of what will help patients in terms of medicine, and the confidence to make these decisions. One false act or one slight misdiagnoses of medication to a patient could be the prime factor in whether the patient lives or dies. Nurses in hospitals across the country are spread thin, and thus makes the probability of mistakes higher. If a medicinal dose is off by even one decimal a patient could die, so the only real answer is for nurses to not be afraid to ask for assistance, always follow procedure and voice opinion is they feel something is wrong.
After review of the timeline of the events surrounding Mr. B, there are several causative factors that led to this sentinel event. These are inappropriate staffing, inability to identify trends of deterioration, policy for conscious sedation was not followed, inadequate observation and monitoring, failure to respond to alarms, inadequate home medication evaluation, medication dosing, appropriate medication administration times, and failure to start cardiopulmonary resuscitation in a timely manner.
In this essay the author will rationalize the relevance of professional, ethical and legal regulations in the practice of nursing. The author will discuss and analyze the chosen scenario and critically review the action taken in the expense of the patient and the care workers. In addition, the author will also evaluates the strength and limitations of the scenario in a broader issue with reasonable judgement supported by theories and principles of ethical and legal standards.
A confused man presents into the Emergency Department in a dishevelled and unkempt state, the nurse assigned to this patient recognises the following; the man is in his mid-sixties, confused and disorientate, anxious, has an acetone breath odour, also at examination locates a haematoma on the right side of his forehead while the patient also states repeatedly that he wants to pass urine. As acknowledged previously the nurse responded in an inappropriate manner therefore making a significant impact on the care of this patient for the upcoming shift, the nurse presented signs of neglect thus actions need to be taken to keep the patient safe with the best suitable care possible.
One important fact in this case is medication that the physician administered to the patient is not listed in the case study. All information must be documented, this helps to keep track in the event the patient gets a reaction this is significant information that must be recorded. Although this may be unimportant to the case this should still be listed. As this patient condition worsened he was diagnosed with osteomyelitis. As mentioned above knowing all medications being administered are important, when treatment first began the pharmacist in this case did exceptionally well keeping track of the medications being administered. Another important factor is that the pharmacist kept track of the care being provided to the patient because the pharmacist reviewed patient results he was able to make suggestions to the physician to check the patients creatinine levels. However the pharmacist in the case is the defendant. Although the pharmacist did well in reviewing the patient’s information during most of the treatment, he did fail to do a follow up check. The
Christopher death could have been avoided if the Doctor had been able to identify the cause of his desaturation on time. Due to lack of nursing care and many human errors from both the medical team and nurses, it leads to his death as per the inquest. Patient safety was compromised. It was found that Dr. Wooller the anesthetist and Dr. Young the surgeon who operated on Mr. Hammett didn’t investigate on the significant oxygen desaturation event that occurred in PACU while he was transferred from Operation Theater. DR. young assumed it was due to obstructed airway. As Mr. Hammett had Guedels inserted. The inquest stated that the anesthetist was supposed to review the arterial blood gas and transferred Mr. Hammett to High dependency unit due to his desaturation event for more than 20min. The nurses looking after MR. Hammett in PACU was RN Turrell and RN Proud. RN Proud notified Dr. Woller about the desaturation event for which doctor paid the visit but didn’t physically examine Mr. Hammett and left with short conversation. If Dr. Woller had investigated the cause of desaturation event at that time probably they could have prevented the rest desaturation event but unfortunately, none of them were implemented, which lead to additional complication Following the event the deceased was administered bolus morphine for his pain, which was scored 4/10. The nurses working in PACU RN Proud notified the anesthetist about the oxygen stat
She reports pain in her left thigh which she describes as constant burning, shooting pain that radiates down her leg. The pain is 10/10 in severity. She states that her pain is so bad she has not slept in 4 days; the pain is preventing her from sleeping, eating and standing to perform her ADLS. “When I am in this much pain, I cannot eat” she has a poor appetite, has been taking small sips of boost nutrition supplement. The patient appointment with Dr Delo is schedule for Thursday 2:30 pm. I call Dr Delo’s office to request a sooner appointment for the patient. I spoke with Donna who informed me that, they did not have an earlier appointment available. The patient is getting lymphedema therapy and massage at home from home health agency, but it is not effective. I called Dr Conidi office with intent to discuss the patient’s unrelieved pain, I was informed by the office staff, to call back office and leave a message. The patient has tried different classed of pain reliever (Opiates, NSAID, Neuropathic pain agent) with not relive or reduction in her pain. After collaborating with the Palliative medical director and discussing the patient unrelieved pain, the different medication that has been tried with no palliation of her pain,