Running head: SENTINEL EVENT ROOT CAUSE ANALYSIS 1 Sentinel Event Root Cause Analysis Kalleen Campbell Accreditation Audit Task 2 April 20, 2013 SENTINEL EVENT ROOT CAUSE ANALYSIS 2 SENTINEL EVENT ROOT CAUSE ANALYSIS 1. Identification of Process This report was received regarding an event that requires investigation: The pre-op nurse told the mother that once Tina went to the OR, her surgery would take about 45 minutes and then she would go to recovery and she would be there at least one hour. The mother told the nurse that once Tina went to the OR, she needed to run a quick errand involving an older sibling and would return in time to pick her up once she got out of recovery. The mother gave the pre-op nurse her cell phone number with instructions to contact her if Tina got out of surgery sooner than expected. Tina’s mother returned to pick her approximately 2 ½ hours later and found that Tina was discharged 30 minutes earlier.
Treatment planning Chart A (Medical Model) |Demographic information | | |Please describe your client’s demographic information: | |The patient is a 68 year old, caucasian female, living with her spouse in a single level home. 6weeks ago, pt. was admitted to Tampa General Hospital with weakness in her (L) leg & arm. After an MRI of the brain, | |she was diagnosed with a (R) sided CVA from a hemorrhage
Prior to seeing the nurse practitioner, he fills out a history form which elicits a family history and review of systems. His father died of a heart attack at age 72. His mother is alive and well at age 76. He has a 44-year-old sister who recently had a hysterectomy and has been treated several times in the past for depression. He has a 22-year-old son and an 18-year-old daughter who are in good health.
Dr. Jack Kevorkian, also known as "Dr. Death", believed in assisted suicide. He believed that, with the consent of the patient, he was able to relieve the patient of their long time painful suffering. A 54 year old female from Portland, Ore., by the name of Janet Adkins was Dr. Kevorkian's first patient, or as some will say, his first victim. She had been diagnosed with Alzheimers disease. After going through experimental drug treatment, which were unsuccessful, Mrs. Adkins decided to contact Dr. Kevorkian.
Patricia Wright 10-17-2009 Med. Term. Week2 Assign.4 MEDICAL REPORT Patient Name: Karen Foster Patient Number: 2009-7550-1 Birth Date: 02-14-1968 Report Date: 10-17-2009 Mrs. Foster is a 41 year old white female with a history of alcohol abuse. She is currently taking azathioprine for rheumatoid arthritis and furosemide for hypertension. She has recently been diagnosed with acute pancreatitis which is swelling (inflammation) of the pancreas.
W;t is a play written by Margaret Edson. Edson’s play depicts Vivian Bearing, a 50-year-old English college professor, who was diagnosed with stage IV metastatic ovarian cancer. Edson had a brilliant way of describing Vivian’s experience with her battle through cancer. Edson’s work took place mostly in Vivian’s hospital room with her nurse, Susie Monahan. Susie played a vital role in taking care of Vivian throughout the play.
From 1988 to 1997, he taught at the University of Virginia. He was an award-winning teacher and researcher, and worked with Adobe, Google, Electronic Arts, and Walt Disney Imagineering, and pioneered the non-profit Alice project. Randy lost his battle with pancreatic cancer on July 25th, 2008. | Jai Glasgow | The wife to Randy. Was also a literature graduate student who met Randy at a lecture.
Chronic Illness Psychosocial Implications Using the Behavioral Nursing Assessment Tool as a guide, this paper begins with a personal interview with a patient who had a right Below the Knee Amputation (BKA) related to Peripheral Vascular Disease (PVD). Mr. Gerke is a 72-year-old retired investment banker who was admitted at Manor Care Hospital on October 4, 2008 for post-op BKA rehabilitation. This assessment tool assists in developing psychosocial assessment criteria for individuals and families adapting to physical illness. Assessment Health Perception-Health Management Mr. Gerke has a history of hypertension, Diabetes and Peripheral Vascular Disease (PVD). He previously had undergone a right 5th toe amputation at Hemet Valley Hospital.
Quality of Life and Functioning Thomas Case Scenario By Vanessa Schneider Western Governors University Personal Perceptions On May 8, 1990 my mother was diagnosed with colon cancer. That day is clearly etched in my mind, because it was my birthday. Less than two years later she died. Having lived a scenario close to Mrs. Thomas’s, I personally can speak about how one’s own perceptions in regard to quality of life and health promotion might affect the care administered to a patient with a terminal illness. Often when providing care for a patient with a lingering illness the nurse must refocus to ensure the needs and wants of the patient and family are being followed and not allow her own personal beliefs to interfere.
: University of Lethbridge, Faculty of Education, c2010). George, A. J., Elliott, A., Jennings, J., Cleland, K., & Brown, M. (2009) Grief Support Group for Spouses of Deceased Iraq War Veterans. Where Reflection &Practice Meet The Changing Nature of Social Work: Towards Global Practice. Sanders, S., Ott, C. H., Kelber, S. T., & Noonan, P. (2008). The experience of high levels of grief in caregivers of persons with Alzheimer's disease and related dementia.