Adult Protective Services Case Study

EDI Level 5 Diploma in Leadership for Health and Social Care and Children and Young

Hello all, my name is David Jamison, MHA. I am representing Marion General Hospital as the committee chairman of the ethics committee. I am currently reviewing the case involving female patient Margie Whitson. The patient is a 95 year old patient whom wishes to have her pace maker “turned off”, due to her unwillingness to live. The death of her only remaining son was the last event that, that had forced her to contemplate the reason why she still lives. Mrs. Margie Whitson is no stranger to loss. When she was younger, she lost her youngest son to a severe motor vehicle accident that took his life at the early age of 30. She injured herself over 10 years ago, and received a hip fracture. Her most recently bout was

The general assessment findings regarding the patient ranked the general assessment as very poor regarding clothing, hygiene, nutrition and/or dehydration, and poor findings regarding skin integrity. The general assessment showed that the patients clothing were not clean; saturated with urine and food stains. In regards to nutrition this ranked very poor as well, considering the patient has lost 10 pounds since her last hospitalization only two weeks ago. This weight loss also could be because of dehydration or nutritional imbalance; further labs will need to be completed to decide if weight loss was regarding nutrition, dehydration or both. Albumin levels will be assessed for nutritional status (Bharadwaj, 2016). Skin integrity ranked a poor on the scale. The diffused red abrasions noted in sacral area could be a stage 1 ulcer. (Advanced Tissue, April 2014). Being unkempt, soiled and dirty is large warning sign of neglect especially for elderly patients (HelpingGuide.org, 2017).

The plaintiff in Ard v. East Jefferson General Hospital, stated on 20 May, she had rang the nurses station to inform the nursing staff that her husband was experiencing symptoms of nausea, pain, and shortness of breathe. After ringing the call button for several times her spouse received his medication. Mrs. Ard noticed that her husband continued to have difficulty breathing and ringing from side to side, the patient spouse rang the nursing station for approximately an hour and twenty-five minutes until the defendant (Ms. Florscheim) enter the room and initiated a code blue, which Mr. Ard didn’t recover. The expert witness testified that the defendant failed to provide the standard of care concerning the decease and should have read the physician’s progress notes stating patient is high risk upon assessment and observation. The defendant testified she checked on the patient but no documentation was noted. The defendant expert witness disagrees with breech of duty, which upon cross-examination the expert witness agrees with the breech of duty. The district judge, upon judgment, the defendant failed to provide the standard of care (Pozgar, 2012, p. 215-216) and award the plaintiff for damages from $50,000 to $150,000 (Pozgar, 2012, p. 242).

The facts of this case are that Dr. Guiles who is self-conscious of his prostate cancer diagnosis is treated horrendously when he finally decides to have surgery ( Buchbinder, Shanks & Buchbinder, 2014). Considering that Dr. Guiles is already sensitive about his condition, his unbearable symptoms are not helping matters (Buchbinder et al, 2014). Upon arrival at the hospital, he is treated subpar. The admitting clerk is rude and unbecoming to a patient who isn’t feeling well and who is embarrassed about his sickness (Buchbinder et al., 2014). To make matters worse, he has to find his own way up to the floor by walking, which causes him to be even later in checking in because of the need to stop frequently to urinate as well as having difficulty in walking (Buchbinder et al., 2014). Once he arrives on the floor, the charge nurse is not welcoming and unprofessional (Buchbinder et al., 2014). After figuring out what to do with the paperwork; and the nurse aide delivers Dr. Guiles to his room, the nurse aide does not offer to help settle him in (Buchbinder et al., 2014). Therefore, Dr. Guiles is faced with battling obnoxious family members who are on his bed and to make matters worse someone is in the bathroom which doesn’t help his need of having to frequently urinate (Buchbinder et al., 2014). When the issues are brought up to the charge nurse, the charge nurse accuses Dr. Guiles of wanting preferential treatment

Safeguarding Policy Policy Statement HIT Training Ltd is strongly committed to practices that protect children, young people and vulnerable adults from abuse, neglect or significant harm. Staffs recognise and accept their responsibility to develop the awareness of the risks and issues involved in safeguarding. The company also recognises that it has a responsibility to protect staff from unfounded allegations of abuse. The company is committed to working with existing local safeguarding or adult safeguarding Boards and other health and social care partnerships to ensure the safeguarding of its learners. The company will ensure it has one nominated person the Operations Director

D2 – evaluate the role of multi-agency working to reduce the risk of abuse of adults, with reference to legal frameworks, regulations, working strategies and procedures.

Advance Directives by the patient designates no feeding tubes, artificial ventilation, or CPR. Concerns regarding alteration of mental status consequential to his illness provoke the physician to seek consultation from the designated Power of Attorney. Nursing responsibilities compel the nurse to consider if the proposed actions of Dr. G violate the patient’s rights of self determination and confidentiality and prompt the nurse to advocate for the patient’s desires regarding medical treatment. Health care providers have a responsibility to honor the patient’s autonomy and provide quality medical care (Badger, 2009 p122). Providing artificial nutrition and ventilation transgresses the patient’s directives and is unethical. The physician appears to be asserting a paternalistic approach in deciding what is best for this patient. Should the interventions be temporary and provide resolution of the condition, the physician can defend his actions as being healing and beneficial. However, there is a chance that the interventions may be permanent and futile; avoiding passive euthanasia and terminal dehydration, serving only to prolonging the illness. Violating the patient’s directives of care by performing invasive procedures can lead to legal incriminations of assault and battery.

University Hospital is a well known hospital with a level 1 trauma treatment center for the tri-county area of a northwestern state, the hospital enjoys the fact they are known for their promising reputation among healthcare professionals and the public they serve. Jan Adams is an OR supervisor that has been working there for ten years, as a professional she makes surgeons follow protocol as required and enjoys working with trauma patients. One Friday night, which is the busiest day of the week for the trauma department; the unit was notified that a helicopter was on its way with a 42 year old man who had been in a car accident. Shortly after the patient arrived to the trauma center, the resident and other medical staff noted that he was in very bad physical conditions, needed immediate surgery or otherwise he was going to die. The issue was that the on call surgeon had to be present during the surgery and had not yet arrived, but regardless of the matter and protocol they proceeded with medically treating the patient immediately. The concern is that in doing so they violated medical procedures and put the patients safety at risk, this lead to a long list of ethical issues for example, patient well-being, impaired healthcare professional, adherence to professional codes of ethical conduct, adherence to the organization’s mission statement, ethical standards, and values statements, management’s role and responsibility, failure

The Department of Human Resources received a report on Ms. Sue Salter on 9/17/14 alleging Ms. Salter a paraplegic who is paralyzed on her left side was living in a home with no water, power, and had an inadequate caregiver. During investigation, utilities were reconnected and Hospice service provided. Hospice stated Ms. Salter was losing notable weight and found lying in urine during visits. Due to this, several bedsores increased and the doctor ordered a catheter and low air mattress. Ms. Harville, the caregiver was educated on wound care numerous times and demonstrated a working knowledge but choose not to administer wound care.

MICU 15A was dispatched to 30 West Ave, @ Genesis Healthcare, Wayne Center in the Wayne Business District in Radnor Township, for an ALS Emergency, Assault Victim. The weather conditions were cloudy, cool and dry. MICU 15A responded with care per protocol to the stated location with EMT Straub driving. On arrival, the EMS Crew proceeded to the nurse's station, and the individuals there did not know anything about an incident, there was a female standing in one of the hallways who advised that there was a person sitting over where she was. The EMS crew proceeded to that area and found a 43-year old female who was a registered nurse and was conscious and alert x4 and was sitting on a chair, the EMS crew asked her what was happening, "she replied that she was in a patient room and stated that the patient had an IV in her arm and became disturbed and picked up a pocketbook and then assaulted her by the swing it and striking her in the right frontal region of the head", the nurse then exited the room and went and sat down in the hallway, where the EMS crew found her.

CNA Code of Ethics for Registered Nurses (2008) provides guidance in dealing with cases like this by explaining the core nursing values and responsibilities involved which are: a) providing safe, compassionate, competent and ethical care; b) promoting health and well-being; c) promoting and respecting informed decision-making, and d) Preserving dignity; e) maintaining confidentiality, f) promoting justice and g) being accountable. The first nursing value is always expected to be upheld in any case because it is their duty to provide care using appropriate safety precautions and preventing/minimizing all forms of violence (CNA, 2008). The collaboration of the nurses between the physician and Mr. C’s family has been evident since then. This therefore calls Mr. C’s nurses to be more compassionate about his situation and try to recognize where he is coming from as they build a trust-worthy relationship before judging him or jumping into conclusions like he does not want to live anymore. Even if he decides to withdraw from these potentially life-sustaining treatments, health care providers are still obliged to give him the care he need the best way they can up until the end of his life. The second nursing value, just like the first one, still calls nurses to still aim to promote or at least maintain Mr. C’s health and well-being to the highest possible level regardless of the path he had chosen for his life. This can be achieved by continuing to collaborate well with other

Case Study: An older woman was partially paralysed as she had a stroke. Her carers came into her home two times a day, her husband cared for her the rest of the day. Her husband became increasingly aggressive behaviour. One day at night, she asked him to help her to the toilet, he pushed her and she fell on the floor and hitting and slapping in her face. one day she called Social Services, they saw bruise on his face, injury in his knee and he was depressed. Social services also noticed that she could not move properly and due to her back pain and lot of unexplained marks. She is seeking help and was crying. Social service sent her to GP for treatment.

Anna is a fifty five year old homeless, unemployed woman who was admitted to the Emergency Room (ER) at Victoria Hospital in London, Ontario for pelvic pain and postmenopausal bleeding. During the nurse’s head-to-toe assessment it was found that the patient also had presenting abdominal distention, prompting her physician to order an X-Ray to determine if a gastrointestinal issue caused this distention. Once this was ruled out, Anna’s physicians continued to search for the underlying cause of her abdominal distention, in addition to her other admitting symptoms. As a result, Anna was admitted to the hospital as an inpatient on the Acute Medicine Unit. The day following admission, Anna went for further testing to hopefully discover the cause of her symptoms. The first test completed was an

During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to