The people involved in the RCA should be the people involved in the scenario: the RN (Nurse J), the LPN, the physician (Dr. T.), the emergency room manager, and a figure from administration (Chief Nursing Officer?). These participants should conduct a RCA to determine the causative factors that lead to Mr. B’s sentinel event. The first step would be to gather data about the situation. Mr. B’s presentation, vitals, health history, lab values, pain score, medications he already takes, and medications he received (amount, dose, and times) during the conscious
Structure is measured by the staff: amount, skill-level, and education or certification. Process indicators measure the facets of nursing care, such as assessment and intervention. Outcome indicators refer to patient outcomes that are affected by nursing care and are considered nursing-sensitive if directly affected by the quantity or quality of the nursing care (ANA, 2013). Through understanding of nursing-sensitive indicators and integration into daily practice, the staff caring for Mr. J could have been more aware of potential issues that interfere with patient care. Knowledge of the increased risk for pressure ulcers and the need for frequent turning and off-loading of pressure points could have allowed the staff to prevent the one forming along Mr. J’s spine.
This score is known as the Early Warning Score (EWS) and is used in order to ensure all staff can recognise and report when a patient is becoming more poorly. All charts will have a clear monitoring plan indication what observations must be taken and how often these must be checked. The monitoring plan may be adjusted in conjunction with the patients treatment and progress throughout their hospital stay, however changing the
A Failure Modes and Effects Analysis (FMEA) will be used to project the likelihood that the suggested improvement plan would not fail. Lastly, key roles nurses would play in improving the quality of care in the Mr. B scenario will be discussed. A. Root Cause Analysis A root cause analysis (RCA) is “a process for identifying the basic or causal factors that underlie variation in performance, including the occurrence or possible occurrence of a sentinel event” (Cherry & Jacob, 2011, p. 442). The participants during the root cause analysis would be the emergency room physician (Dr. T.), the Mr. B’s LPN and RN (Nurse J) during the time of the sentinel event, the emergency room nurse manager, and the chief nursing officer (CNO) of the hospital. These members would meet in a root cause analysis meeting to discuss the causative factors that created Mr. B’s sentinel event.
In Monitor Alarm Fatigue: An Integrative Review, research evidence was broken down into themes including: effect of excessive alarms on staff, nurse’s response to alarms, alarm sounds and audibility, technology to reduce false alarms, and alarm notification systems. Non-research evidence revealed strategies to reduce alarm desensitization. Cvach concluded the article with evidence-based practice recommendations for technology manufacturers, hospitals, and caregivers. One nursing intervention recommended was to adjust alarm parameters so that they are customized to each individual’s actual needs. This intervention ensures that the alarms are valid and that they will provide and early warning to potential critical situations.
They can stop people from suffering from hallucinations and dilusions , they can help with depression and they also help people who suffer from mood swings. 4. Explain the importance of recording and reporting side effects/ adverse reactions to medication. It is very important to record any side affects to monitor the situation. If the side affects are reoccurring then staff must seek medical attention and request a medication review so that the service user stops experiencing them.
Recognizing at restraint use is a nursing specific indicator can help the staff in this situation develop an appropriate care plan. Having a set care plan makes it possible to easily identify when care is beginning to deviate from the care plan, resulting in lower quality patient care as well as risking patient safety. Quality indicators should be used to standardize all care for patients in restraints, making it less likely for the staff in this situation to experience issues. Another important indicator that can be used in this scenario is the prevention and management of pressure ulcers (Montalvo 2007). Nurses play an important role in the prevention of pressure ulcers.
Results indicators evaluate measure the quantity or quality of patient care. In applications to the hypothesized scenario, nursing sensitive organizational indicators would include nursing knowledge of the prevalence of pressure ulcers that result from patients being restrained in a bed. An understanding of procedure indicators would have guided the nurse and CNA to reposition Mr. J. with relative frequency as a preventative measure against the sores, and would have allowed them to recognize the red area on Mr. J. as the first stage of pressure ulcer development. The CNA would have then avoided placing Mr. J. on his back when placing him back in the bed. Moreover, knowledge of the appropriate use and prevalence of restraints would have given the nurse the knowledge to discern whether restraints were the proper measure to take as well as the procedures necessary for proper restraint care.
* Assess patient’s pain level and administers appropriate pain relief measures. * Maintains patient’s safety(airway, circulation, prevention of injury) * Administer medication, fluid and blood component therapy, if prescribed. * Assess patient’s readiness for transfer to in hospital unit or for discharge home based on institutional policy. 2. Identify priority nursing care to prevent potential complications following this type of surgery.
Compliance Management Tanya L. Thomas Western Governors University Abstract In this paper I will define compliance from a management perspective. I will address problems with compliance as it relates to healthcare. I will analyze specific problem with healthcare compliance. I will give scenarios of what circumstances can come from non-compliance. I will outline a prevention plan and discuss how to stay compliant.