Case Study: An Extended Stay

This case study and the following questions pertain to Mr. Londborg, who came into the hospital with trouble breathing. Through his health history, they found out that he has a history of seizures, hypertension, and chronic obstructive pulmonary disease (COPD). His stay was extended in the hospital due to a respiratory tract infection, decreased kidney function, a blood clot in his leg, and a fall that could have been fatal. The following questions addressed throughout this paper will discuss what happened, why it happened and how it should now be prevented.

Melvin Fuller is a patient on the medical-surgical unit who was admitted during the previous evening for exacerbation of chronic obstructive pulmonary disease (COPD). He is an 83-year-old widower with two children who both live an hour away. He lives in a small house and is independent in his care. He has a housekeeper who comes in once a week to clean and fix some meals for him. He was brought to the hospital by his son who was visiting. His children visit him at least once a month. Mr. Fuller has COPD and type 2 diabetes. Alicia Brown is a 19-year-old nursing student in her first clinical rotation. She has been assigned to Mr. Fuller for morning care. Alicia enters Mr. Fuller’s room and notices that coffee has been spilled on his bed and

We then look at the errors of hazards that occurred in the Mr. B scenario.  Though we can say understaffing may have contributed to Mr. B’s demise, we cannot blame understaffing. This scenario is regrettably connected to inattentive nursing practice. It is clear that respiratory therapist was in the building and

Errors occur in health care as well as every other very complex system that involves human beings. The message in “To Err is Human”, by Archie Cochrane, was that preventing death and injury from medical errors requires dramatic, system wide changes. Health care professionals have customarily viewed errors as a sign of an individual’s incompetence or recklessness. As a result, rather than learning from such events and using information to improve safety and prevent new events, health care professionals have had difficulty admitting or even discussing adverse events often because they fear professional censure, administrative blame, lawsuits, or personal feelings of shame.

Case 2 refers to the incident of a physician known as Dr.Ben and his 74 year old patient known as Mrs.Alma Norfleet. Who complained to Dr. Ben about a pain she felt in her chest during her previous ER visit. Unfortunately, Dr. BEN ignored the symptoms and referred to it as a mere chest pain that shouldn’t be taken seriously, even though she had suffered from chronic illnesses in the past such as diabetes, heart disease, and arthritis. Later, Mrs Alma arrived to the ER, chronically ill to Dr. Ben’s surprise, he ran some tests on her, and found out that she was indeed sick and suffered from heart failure. Confronted with this issue, by one of the nurses, he denied that the patient ever reported such issues to him.

Medical errors in the United States are part of a nationwide health crisis, with hospital death amounting to the third leading cause of mortality in the USA today. The Lewis Blackman case is a tragic example of medical error; particularly one relating to decision making. Group B identified several errors, near misses, adverse events, and harm taking place in this history. Medical errors, ranging from an unaddressed low urine output, to the doctor ordering an erroneous dose to the patient, to the blindness of clinicians in seeing the indicators of Lewis’ worsening condition, all resulting in the inability to save Lewis Blackman’s life.

Throughout her life Eddy Hernandez has interacted with hospital personnel various times but many of those times were because of her kids or work. Most recently she was hospitalized herself and experienced both positive and negative interactions with healthcare professionals. Her experience began a few weeks before she entered the emergency room at Mount Graham Regional Medical Center. Eddy was intermittently experiencing chest pain, headaches and lethargy. Since the signs would come and go, she chose to ignore them but eventually they could not go unnoticed any longer. When she entered the emergency department her chest pain was unbearable; she was hypertensive and there was numbness present on one side of her face. The first individuals

A majority of the burden is on them, due to the fact that Alex could possibly lose his life if something went wrong. There is also a big burden on Dr. Kim, because he is liable if something goes wrong with Alex’s treatment. Also, he would have to deal with the emotional trauma of not being able to help his patient. The third party involved, the pharmaceutical company, does not face any of the burden of this situation. The worst-case scenario for them is that they do not profit from the drug. If something went horribly wrong for Alex or Dr. Kim, they would not have to deal with it. Knowing that they do not have to keep all of these factors in mind, because there is only one way that their goal could not be met, it is unfair to assume that the reps at the pharmaceutical company can objectively consider all of the possibilities for prescribing the drug. Knowing this, it is only right for Dr. Kim to keep the pharmaceutical company’s needs and wants completely out of the equation when he makes his decision. According to the Ethics Unwrapped video about choice, there are factors that make it easier for us to make ethical

Pharmacists’ main focus is to ensure patients have the best medication outcomes. However, Jessica Thompson never experienced this. Due to the laziest of the pharmacist and others, Jessica did not receive the help she was entitled to. First, the technician used the wrong percentage of sodium chloride solution and did properly check with the pharmacist to ensure it was the right dose. Second, the pharmacist did not follow up with the tech to ensure the correct medication and dosage was right even after seeing a spent bag, Third, the nurses and doctors should have noticed changes in Jessica’s vital signs and after her complaining about headaches. Clearly, interest was not in the patient.

Nurses encounter ethical issues with chronically ill patients suffering from a predominance of medical regimens. One ethical issue nurses

The scenarios discussed in the textbook indicates that errors were made by health professions risked the patient. During the first medical recording, the nurse forgot to record physician-patient oral

I had a clinical experience where I felt unprepared during my clinical placement in the Respiratory ward. I had a female elderly patient with aspiration pneumonia, she also has a history of hypertension, and there were no other cardiac illnesses in the handover. She was stable when care was taken over. I assisted her with mobilising to the bathroom and I noticed that her labour of breathing increased although she was on oxygen. When she went back to bed, she started to present short of breath, also she kept rubbing her chest and she was too unwell to stand so she sat down but she could not sit stably by herself. In this situation, I should have realised that she might be experiencing chest pain and pressed the staff assist button for help.

An inpatient admitted June 10 and discharged June 14 would have a 4 day length of stay or LOS. Medicare has defined an inpatient stay as “ a person who has been admitted to a hospital for bed occupancy for purposes of receiving inpatient hospital services” (Keough, 2006, p. 112). In essence, for the purpose of accurately billing Medicare the inpatient stay starts once the patient is admitted. The length of stay is important data needed for sending clean claims for reimbursement and for administration to manage the hospital operation. This is especially true as payment for patient stays move towards value based reimbursement.

As an advanced practice nurse (APN), a primary function is facilitating pharmaceutical interventions. The APN is legally responsible for providing safe, appropriate, and cost-effective drug interventions. Before writing prescriptions, the practitioner must take a thorough history and perform a physical examination of the patient, followed by a diagnosis, disease review, selection of the most appropriate first line therapy available, and lastly, evaluation of the patient?s response to the treatment. Some questions that come to mind are, is this the best drug for the presenting problem? What drugs does the person currently utilize? Does the patient have allergies to any medications? Can the patient take the medication? What is the cost of the drug? (Arcangelo & Peterson, 2013, pp. 6-10). The scenario I chose for this week?s discussion is number four. The APN is questioning whether the expensive drug therapies given to some of her patients are the most efficient in managing the patient?s health condition and improving their quality of life. The purpose of this discussion is to explore the ethical and legal implications of the above scenario, and strategies to ensure that the APN is providing the most legally and ethically competent care for your patients.

As of April 2017, the Australia Government abolished the Temporary Work (skilled) visa (subclass 457) and replaced it with the Temporary Skill Shortage (TSS) to be effected on March 2018 (Australian Government, 2017). The TSS visa is deemed to cause an overhaul on temporary employment of overseas workers who fill jobs requiring critical skills. This is because a more stringent criteria that is not in use under the 457 visa will be employed to assess incoming overseas temporary workers. This change will not only affect businesses, but the human resource planning and recruitment practices as well. The HR will be forced to revise its forecast practices so as to align their organisation’s strategic direction with proper planning, while