Who Is Sorrel King Josie's Story Summary

Giving myself time to read up on nursing experiences, attending more clinical practice labs, participating and watching these duties in the health care setting will allow me to develop a secure level of confidence the next time that this type of situation may occur. Staying in the room allowed me to experience the feeling of support while looking past social norms and how they are challenged. I met my personal values, and I believe that one should respect another person`s privacy. This understanding allowed me to be there to support the resident during her time of need. In the article `starting out` by Jane Schulz, a nursing student shares her experience of helping her colleague assist an elderly patient with daily care. Observing the compassion and care between nurse and patient from fundamental tasks, she took away a valued lesson of how our support and caring methods affect an individual. My relation to this story allowed me to reflect on the effects my care and supporting actions had on our patient.

When people think about nurses, many ideas come to mind. They think of the hideous old starched, white uniforms, a doctor’s handmaiden, the sexy or naughty nurse, or a torturer. The media and society have manipulated the identity and role of nurses. None of these ideas truly portray nurses and what they do. Nurses are with the patients more than the doctors. People do not realize how little they will encounter the doctor in the hospital until they are actually in the hospital. People quickly realize how important nurses are. Because nurses interact with their patients constantly, nurses are the ones who know the patients best.

Root cause analysis process will utilize a systematic step-by-step approach to help identify all causative factors leading to this sentinel event. The main purpose of the Root Cause Analysis is to understand how the event happened, why did it happen, and what can be done to prevent an event from happening again. The first step, collect all necessary data associated with this event such as: current policy and procedures, incident report, Mr. B’s health history, environmental flowcharts, dispensed medications, equipment and staffing factors relevant to the event. The process of identifying causative factors can begin once all the data is collected. The goal, of a Root Cause Analysis, is to identify interventions to prevent an event from reoccurring.

First of all, I recognized that I was dealing with humans, and not just dealing with a disease process and application of the nursing process in the aspect of restoring patient health. I was dealing with emotions, and families, and cultural beliefs that influenced individual’s aspects of care. I started to see that health did not just incorporate healing the disease, but also recognized the importance of making sure patient’s felt that their

Never events are serious medical errors that are often preventable. When such events transpire, it is necessary to fully assess the situation so that these errors can be prevented in the future. Root cause analysis (RCA) is a tool employed by healthcare facilities to analyze adverse events and the systems that lead to them.

The television screen showed the image of a nurse, murdering the people he was supposed to be saving, by injecting them with his own concoctions of drugs. The disgust was beyond imaginable, as he was expected to be the one that saves people, yet he broke that expectation as the unprotected patients’ lives faded away. Charles Cullen was a New Jersey nurse who broke the bond of trust between nurses and patients. I knew that I had to do this project on him because he changed United States history by creating more laws for hospitals and nurses, so that they patients’ rights were not violated.

A root cause analysis (RCA) is a “systematic approach to understanding the causes of an adverse event and identifying system flaws that can be corrected to prevent the error from happening again” (Huber & Ogrinc, 2010). The root cause analysis is used to determine why the problem occurred in the first place and to identify the cause of a problem using a specific set of steps (Mind Tools, n.d.). The RCA team which consists of interprofessionals who are knowledgeable of the issues and processes related to the incident and the people who are involved in the incident should be formed first before the RCA meeting takes place (Huber & Ogrinc, 2010). In the given scenario, the team includes the emergency department (ED)

Chapter 13: Here, King records a video of Josie’s story and receives requests from all over the United States for it, as it underscores patient care and safety. She creates the Josie King Foundation,

The provided scenario gives an account of a busy emergency department with competent staff, and the multiple errors that led up to the most severe error possible in healthcare, unnecessary death of a patient. A root cause analysis (RCA) can be utilized to help understand the systems at fault within the facility so that improvements can be determined and implemented to prevent any future occurrences (Cherry, 456). RCAs focus on systems rather than blaming individuals involved, therefore they are only appropriate in cases where there has been no willful negligence or criminal acts (Huber & Ogrinc, 2014). The overall purpose of RCAs is to find out the causes of the adverse event and determine how to keep similar errors from

A root cause analysis is defined as, “a process for identifying the basic or causal factors that underlies variation in performance, including the occurrence or possible occurrence of a sentinel event” (Cherry & Jacob, 2011, p. 442). Involved participants, in the case, the emergency room physician, registered nurse, and licensed practical nurse present during the sentinel event, as well as the emergency room nurse manager, and Chief Nursing Officer, should meet to discuss the events leading up to the patient’s (Mr. B’s) death and establish a root cause analysis. They should explore all hazards and errors in Mr. B’s care. Data should be gathered, facts surrounding the death analyzed, and causative factors should be explored to establish

After careful analysis of what had happened and what should have happened takes place, the RCA team should ideally focus on why the adverse events happened. In this step, the goal is pinpoint the direct causes and contributory factors (Ogrinc & Huber, 2013). By doing this, the root cause of an event can be identified. One suggestion made by the Institute of Healthcare Improvement in the root cause analysis process is to ask “Why?” five times (Ogrinc & Huber, 2013).

In the root cause analysis, the root cause analysis team investigates the role of multiple factors that could have contributed to the event, such as communication, equipment failures, staffing levels and/or fatigue, training, policies/procedures, and organizational culture. Following the analysis, the facility must implement a corrective action plan to implement the findings of the analysis or at least report to the appropriate state department any reasons for not taking a corrective action plan. The findings of the root cause analysis and a copy of the corrective action plan must be filed with the commissioner within 60 days of the event for the State of Minnesota. The team of clinical and quality improvement experts review the root cause analysis and corrective plan meet all criteria and that the facility is able to take steps to reduce this risk of any future adverse events. The review team will provide feedback to the facility and allow modifications to be applied until all criteria have been met. Each event can go through up to three reviews (Minnesota Department of Health,

Although working as a team to reach goals seems straight forward and logical, King’s theory is based on several assumptions. King believed that the nurse-patient working relationship is affected by how each sees the situation as well as how the goals, needs, and values. She believed in patient rights to personal information and to make decisions effecting their lives including the receipt of care. King knew that

The writer believes Jesus is her leader, and the patient is the primary center for attention. She believes it is her duty to handle each patient with dignity and render the appropriate care. Health is a universal term that is more than the absence of illness. As a future nurse practitioner, she believes that she the responsibility to her Lord, the creator and His people to provide the best available care with the supervision of a physician.

King’s theory encompasses all facets of the patient’s being. Focusing on nurse patient communication and goal attainment created the backbone for King’s theory. The three essential components of her theory that will be discussed are “the need for health information, the need for care that seeks to prevent illness, and the need for care when the patient is unable to help themselves” (Nursing Theory, 2011).