Failure to adequately assess and monitor the patient post operativel.docx

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A 67-year-old man underwent a knee replacement surgery and was discharged to a medical-surgical unit with an epidural catheter for pain management. The assigned nurse assessed the patient but oversight of his care was delegated to an LPN. Several hours later, the patient vomited and became unresponsive. Experts determined the nurse breached the standard of care by failing to adequately monitor and notice changes in the patient's condition, which likely contributed to his death.

Education

Failure to adequately assess and monitor the patient post
operatively resulting in the patient’s death
NOTE:
There were multiple co-defendants in this claim who are
discussed in this scenario.
While there may have been errors/negligent acts on the part of
other defendants, the case, comments, and recommendations are
limited to the actions of the defendant; the nurse.
The decedent/plaintiff was a 67 year old male who underwent a
right total knee replacement.
Following the procedure, the plaintiff was treated in the post-
anesthesia care unit where an epidural catheter was inserted for
postoperative pain management.
Following one episode of hypotension which was treated
successfully with ephedrine, the plaintiff was discharged to an
inpatient medical-surgical care nursing unit with the epidural in
place.
Although the defendant nurse customarily worked on the post-
acute critical care unit, she had been re-assigned to the medical-
surgical nursing care unit.
The defendant nurse stated that she understood her assignment
at the time of the plaintiff’s admission to this unit was to
provide oversight of the patient care on the entire floor for that
shift.
The defendant nurse assessed the plaintiff upon his admission to
the unit and found him to be stable.
The defendant nurse understood that the direct care of the
plaintiff was assigned to a c-defendant licensed practical nurse
(LPN).

Approximately three hours after arriving on the unit, the
plaintiff was unable to tolerate ordered respiratory therapy due
to nausea and vomited shortly thereafter.
According to the defendant nurse, approximately ten minutes
after the episode of vomiting, the LPN found the plaintiff
cyanotic and unresponsive and immediately called a code.
The defendant nurse responded, as did the code team, and the
plaintiff was intubated and transferred to ICU.
This account of events was disputed by the LPN and two other
staff on the unit who understood that the defendant nurse was
responsible for the direct care of the plaintiff.
The LPN stated that it was the defendant nurse who found the
plaintiff to be unresponsive at some point after the episode of
vomiting and called the code herself.
The elapsed time between the episode of vomiting and the code
is also disputed.
The eventual diagnosis was anoxic encephalopathy due to the
time that elapsed before CPR was initiated.
The prognosis was poor and life support was withdrawn.
The plaintiff breathed independently and was transferred to
hospice care where he subsequently expired.
Ordered vital signs and checks of the xyphoid process were not
documented.
The fact that the plaintiff had experienced hypotension in the
recovery room should have warranted even closer observation.
The episode of nausea and vomiting should have resulted in
additional observation and notice to the physician.

Resolution
Experts determined that the defendant nurse had breached the
standard of care.
Discussion
1.
Summarize the case and the verdict.
2.
Based on your review, do you agree with the court’s decision?
Defend/discuss your answer.
3.
What [if any] practice-related standard of care issues were
breached.
4.
Identify a risk management action plan to prevent this type of
issue(s) from reoccurring.
The case must be written in APA format with a minimum of
four (4) current scholarly references (textbook does NOT
apply), with in-text citations and no more than 4 pages. Your
paper will have 4 headings - 1 for each question.

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Final Project The Final Project should demonstrate an understanding of the reading assignments, class discussions, your own research and the application of new knowledge. It should utilize previous skills developed in foundational health care courses and apply them within the context and viewpoint of a health care administrator and their role in managing health and human services. For the Final Project, select one of the following topics and conduct scholarly and professional research while integrating the course’s learning outcomes to address a selected topic: Research specific leadership and management traits and theories necessary for managing a multidisciplinary and multicultural health care organization to promote organizational effectiveness. Present how strategic planning, performance improvement, and information systems are interrelated and fundamental to the delivery of quality health care. Examine the financial characteristics of health care delivery along with managing costs, revenues, and human resources. Analyze ethical and legal concepts, including specific federal regulations, required of health care organizations to ensure the delivery of high quality health care that protects patient safety. Research Requirements Academic research and papers must meet certain standards of quality that are recognized by the academic community. What constitutes quality academic research? The use of primary (original), credible sources written by experts in the field of study. Ensuring secondary sources are supported by research in primary sources. Making sure all research is relevant and that material used is pertinent to the area of study. In graduate work, the use of peer-reviewed journal articles (journal articles reviewed by recognized experts in the relevant field of study) is required. Keep in mind that educational websites may be appropriate, in some cases, but should be evaluated carefully. The Ashford University Library offers many excellent databases and other resources to assist you in conducting scholarly research. What sources are not acceptable for academic research and referencing? Encyclopedias Dictionaries Wikipedia, other wikis, or blogs Websites and other sources that do not provide quality researched materials (e.g., they do not use credible sources to support the information in the document). All research must reflect professional academic protocol and must be documented according to APA standards as outlined in the Ashford Writing Center. Creating the Final Project You may choose to present your research is the form of an eight- to ten-page research paper (excluding title and reference pages) or a comprehensive 10- to 15-slide PowerPoint presentation (excluding title and reference slides) with detailed speaker notes. In either case, the content of the assignment must include each of the elements listed below: Introduction Describe the issue. Include why it was selected, the perspective of your appr.

Final ProjectThe Final Project should demonstrate an understanding.docx

MalikPinckney86

Final Project Imagine that you work for a health department and have been asked to make a presentation to a group of health care professionals on the role and responsibilities of community and public health. After reviewing the materials throughout the course and based on what you have learned, create a PowerPoint presentation of at least six slides that covers the following topics: Describe the role of community and public health in the well-being of populations. Describe the public health organizational structure. Examine the legal and ethical dimensions of public and community health services. Analyze funding of public and community health services. Discuss the role of communication in community and public health programs. Creating the Final Project The Final Project: Must be created using a screencast program such as Jing, Screencast-O-Matic, Screenr, or other audio/video program. Must be a minimum of six PowerPoint slides in length (excluding title and reference slide), and formatted according to APA style as outlined in the Ashford Writing Center. Must include a title slide with the following: Title of presentation Student’s name Course name and number Instructor’s name Date submitted Must include a succinct thesis that is presented on the opening slide. Must address the topics with critical thought. Must use at least four scholarly sources (not including the course text), including a minimum of two from academic journals found in the Ashford University Library. Other sources should be obtained from appropriate epidemiological information. Must document all sources in APA style, as outlined in the Ashford Writing Center. Must include a separate reference slide, formatted according to APA style as outlined in the Ashford Writing Center. .

Final ProjectImagine that you work for a health department and hav.docx

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