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- QUESTION
A 67-year-old client had an epidural catheter inserted for pain management following a total knee replacement. After successful treatment of an episode of hypotension in the postanesthesia care unit (PACU), he was transferred to the medical-surgical unit. The registered nurses assessed the client and delegated direct care to an LPN, although this was denied by the LPN. Three hours later, the client experienced nausea and vomiting. The client was found cyanotic and unresponsive 10 minutes later and subsequently died of anoxic encephalopathy. Many facts were disputed among the numerous co-defendants and documentation was poor (Nurses Service Organization, 2012).
Using the scenario above, write a one-page paper using APA format, the paper should include:
Questions
Priority assessments that were missed
Steps of the nursing process that were done inappropriately or missed completely and why?What steps of the delegation were inappropriate and why?
What could have been done to prevent this outcome?
Rubic Grading Scale
> Assessment and rationale= 35.0pts
Identified all assessments that were missed with detail. Provided rationale as to importance.
> 35.0 pts
Level 4
Identified all steps that were inappropriate or missed completely. Complete rationales provide
> 20.0 pts
Level 4
Expert critical thinking identified with regards to delegation and understanding prevention methods.
> Paper does not exceed 1 page. No errors to APA format or grammar noted.For Reference
Treas, L. S., Wilkinson, J. M., Barnett, K. L., & Smith, M. H. (2018). Basic Nursing: Thinking, Doing, and Caring(2nd ed.).Russell, K. A. (2017). Nurse Practice Acts Guide and Govern: Update 2017. Journal of Nursing Regulation, 8(3), 18-25. doi:10.1016/s2155-8256(17)30156-4
| Subject | Nursing | Pages | 4 | Style | APA |
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Answer
Negligence- Ethics and Legal standard in nursing practice
This paper explores a case where negligence could have been prevented in a nursing case scenario.
Analysis
Before delegating direct care, the RN should have completed an assessment to establish if the patient can properly ambulate and feed on meals. Notably, these are factors which guide the thought process about an effective delegation to direct care (Treas, Wilkinson, Barnett & Smith, 2018). The assessment step was poorly conducted in this case. This is based on the fact that the nurse failed to explore why a direct care to an LPN was previously denied. The diagnosis stage could also have been overlooked since the nurse failed to implement clinical judgment that could have assisted in a proper process of planning and implementing the patient care. Planning was also poorly conducted because the goals of the delegated direct care did not result to a positive patient outcome (Toney-Butler & Thayer, 2019).
The second phase of the delegation was also inappropriate. Evidently, this stage is focused on improving responsibility by ensuring that the professional investigates and proposes ideas to make their decisions. This stage was considered as inappropriate as the nurse was not required to gather information and explore options before proposing what they consider as a best option because the LPN had already provided an order. The fourth phase of complete hand-off was also unsuitable since the nurse was not required to make all the necessary decisions required to work with the patient.
To prevent this outcome, I could have effectively adhered to the LPN’s guide or conducted an effective assessment process to establish why direct care was not recommended on the patient before making the decision to initiate it. Subsequently, I would focus on personally administering the care to avoid drastic outcomes as Russell (2017) advises.
References
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Russell, K. A. (2017). Nurse Practice Acts Guide and Govern: Update 2017. Journal of Nursing Regulation, 8(3), 18-25. doi: 10.1016/s2155-8256(17)30156-4 Toney-Butler, T., & Thayer, J., (2019). Nursing Process In: Stat Pearls. Treasure Island (FL): Stat Pearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499937/ Treas, L. S., Wilkinson, J. M., Barnett, K. L., & Smith, M. H. (2018). Basic Nursing: Thinking, Doing, and Caring (2nd ed.).
Appendix
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