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Patient safety in the hospital setting
The essentials of patient safety
The essentials of patient safety
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Question #1 This case involves a 67 years old man who had total right knee replacement at the hospital. His family are the plaintiffs on the case as he passed away after surgery. The defendant on the case is a now former surgical nurse that worked at the medical-surgical nursing care unit. She was reassigned to this position from the post-acute critical care unit. When the patient arrived to the care unit the nurse assessed him and considered him to be stable. Hours later, the man suffered from nausea and vomiting, making him not being able to tolerate the required respiratory therapy. The patient was checked and found to be cyanotic and unresponsive by the licensed practical nurse (LPN). A code was called and the patient was intubated …show more content…
The xiphoid and patient’s vitals needed to be properly documented and assessed constantly. This is considered a breach of duty by the nurse. It was her job to make sure this was being done. Had the patient’s vitals and status been checked more thoroughly upon his arrival, his vomiting and hypoxia could have been resolved, and possibly prevent his subsequent death. This lack of patient care is considered malpractice. In the case of a nursing malpractice situation it is defined as negligence which is “doing something or failure of doing something a reasonably prudent person would or would not do. It is the failure to use ordinary or reasonable care” (Ashley, …show more content…
Following this, the nurse should have monitored his condition constantly and intervene if necessary. The lack of proper treatment led to the patients vomiting and cyanosis. The eventual diagnosis of anoxic encephalopathy could have been prevented had he received proper care in time. I do not believe the code response team was negligent in this situation. It was the nurse’s job to check on the patient and call a code if necessary. The delay in calling a code was what made the patients’ health decline, not the time it took the code team to respond. There was also a lack of communication between medical units. I would like to believe that if the nurse would have known about the hypotension episode, that the patient would have been observed more closely. This lack of information led to the mistreatment of the patient. Negligence is clear in this case as the patient did not receive the proper care in time because of the nurse not performing her duties
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
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
I agree with you that the nurses violated provision 9 of the nursing code of ethics. Nurses have an obligation to themselves, their whole team and to the patients to express their values. Communication is key in a hospital, so everyone knows what is correct and what isn’t within the workplace. In order to have a productive, ethical, positive environment. These values that should be promoted affect everyone in the hospital, especially the patients, and can have a negative outcome if those values are not lived out. Nurses have to frequently communicate and reaffirm the values they are supposed follow frequently so when a difficult situation comes along that may challenge their beliefs they will remain strong and their values will not falter.
They were part of the healthcare team and went along with the beliefs of their team. The team should have directly included the patient and parents. I cannot help but wonder if this legal battle would never have taken place had an ethics committee been assigned to this case. Ethics committees provide structure and guidelines for potential problems, serve as an open forum for discussion, and function as a true patient advocate by placing the patient at the core of the committee discussions (Guido,
1. What is the difference between a. and a. Which K, S, and A pertain to the care you provided to the patient you have chosen? Why do you need to be a member? K- Describe the limits and boundaries of therapeutic patient-centered care. S- Assess levels of physical and emotional comfort.
4). Examples of how nurses can integrate this competency include; using current practice guidelines and researching into hospital’s policies (Jurado, 2015). According to Sherwood & Zomorodi (2014) nurses should use current evidence based standards when providing care to patients. Nurse B violated one of the rights of medication administration. South Florida State Hospital does not use ID wristbands; instead they use a picture of the patient in the medication cup. Nurse B did not ask the patient to confirm his name in order to verify this information with the picture in the computer. By omitting this step in the process of medication administration, nurse B put the patient at risk of a medication error, which could have caused a negative patient
She should have not made the assumption that there were no doctors available until 2100 hours. Instead, she should have sought clarifications on whether the Emergency Department (ED) doctor was prevailed on examining the patient. She should’ve escalated concerns to the Clinical Nurse Manager (CNM). She also should’ve not made the assumption that the administration of antibiotic would improve the patient’s condition and “recover” her from the “red zone”. Finally, she should have documented her observations and implement a care
Q.3 Nurses as part of regulated health care practitioners are responsible and accountable to abide by the standards, codes and guidelines of nursing practice (NMBA, 2016). The nurse in the case study has breached the standard 1.4 of the Registered Nurse Standards for Practice. According to standard 1.4, the registered nurse should comply with "legislation, regulation, policies, guidelines and other standards or requirements relevant to the context of practice” when making decisions because this will be the foundation of the nurse in delivering high quality services (NMBA, 2016). The nurse in the scenario did not follow the hospital policy concerning “Between the Flags” or “red zone” and a doctor should be notified of this condition. Furthermore, the nurse failed to effectively respond to a deteriorating patient.
There was inappropriate staffing in the Emergency Room which was a factor in the event. There was one registered nurse (RN) and one licensed practical nurse (LPN) on duty at the time of the incident. Additional staff was available and not called in. The Emergency Nurses Association holds the position there should be two registered nurses whose responsibility is to prov...
In accordance with the Nursing and Midwifery Council (NMC), (2008) all identifiable details have been changed in accordance with (NMC, 2010). The author, a healthcare assistant working in the nursing home, will present a scenario of Mrs. Keller (not her real name) who is confined in the dementia unit of the care home.... ... middle of paper ... ... Cox (2010) reports, “shifting boundaries in healthcare roles have led to anxiety among some nurses about their legal responsibilities and accountabilities due to lack of education in the principles of legal standards underpinning healthcare delivery” (p. 18).
Nurses come in direct contact with the patients and their families. Therefore nurses are held liable for their work. Negligence is when nurses fail to perform according to the standard of care that results it any kind of harm, damage or death of a patient. If the patient suffers any of the problems they have a full right to bring legal action against the nurse for negligence. Negligence can be civil or criminal. In this case we can look at RN Manton he has shown negligence with his duty of care towards Mr. Hammett therefore he is liable for his death. We have observed that Manton didn’t follow the hospitals protocol during the desaturation event and treated Mr. Hammett on bases of his own experience. Manton admitted that he had ignored the prescription from Dr Woller in relation to oxygen that indications negligence. This shows he has failed to apply his skill and knowledge in this case He also relied on EN valentine to do all the observation and look after the patient on that shift which shows Manton being irresponsible towards his duty of care. He should have check on Hammett himself and monitored
This may happen due to the nurse thinking it is the patients fault, and therefore thinking they do not deserve the same quality of care as the next person. This is not fair to the patient, as one never knows what the underlying cause is, that has led to the situation. It is really important to form a good patient nurse relationship, and to get all the facts, in order to assure this does not happen.
The patient in question was admitted with suspected pancreatitis. This piece of reflection will pay particular attention to the care I gave the patient in the form of instigating admission documentation, assessing their condition, instigating care plans and administration of any medications required. The patient in question had complex needs and as a staff nurse and according to the NMC (2009) I should be able to provide the care he/she required.
Several ethical principles that are incorporated in the nursing care of patients on a daily basis are nonmalificence, autonomy, beneficence, justice, fidelity and paternalism. Nurses should strive to comply to as many of the principles as possible. In this case there are principles which support and conflict with the wishes of the patient. The first principle that supports the wish of the patient is autonomy. Autonomy means that competent patients have the right to make decisions for themselves and the delivery of the healthcare that they receive. Another factor that would support the patient’s wish to not be resuscitated is nonmalificence. Non maleficence means that nurses should not cause harm or injury to their patients. In this case the likelihood of injury after resuscitation was greater than if the patient were allowed to expire. A principle that could have negatively affected the outcome of the provision of ethical care was paternalism. Paternalism is when a healthcare provider feels that they know what is best for a patient, regardless of the patient’s desire for their own care. I demonstrated the principle of paternalism because I thought that I knew what was best for the patient without first consulting with the patient or family. This situation might have had some very negative consequences had the patient not have been competent. Practicing a paternalistic mindset might have caused a practitioner in the same instance to force their ideas about not resuscitating the loved one onto the family. This could have caused a sense of remorse and loss of control of care amongst the
...ve heard, it may not be possible to prosecute the nurse as she was just following the home’s policy. In the same manner, it may also not be possible to prosecute the nursing home because such conditions (i.e. not administering CPR) are clearly stated in their policy, and all of their clients understand and are amenable with it. However, in cases like this, I don’t think that the law should be the be-all and end-all of things, that is, I think that mere compliance with the law does not necessarily equate to good management or administration; rather, I believe that good administration should also be guided by moral and ethical guidelines.