Using the information from the case study below, discuss the following issues from the perspective of an Advanced Practice Nurse (APN)
- Practitioner
Standards of care – what were the standards of care that were violated? Who was responsible for the violations?
In your role as an educator, administrator, or practitioner, what risk management steps needs to be taken before or after the incident to alleviate the issue?
Page length should be 3-4 pages exclusive of cover page and references.
Support your paper with a minimum of three scholarly references.
Case Study: Malpractice Action Brought by Yolanda Pinellas
Yolanda Pinellas is a 21-year-old female student studying to be a music conductor. She was admitted for chemotherapy. The medication Mitomycin was administered by intravenous infusion through an infusion pump.
During the evening shift the infusion pump began to beep. The RN found that the IV was dislodged and discontinued the infusion, notified the physician and provided care to the infusion site. The patient testified that a nurse came in and pressed some buttons and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done. The documentation in the medical record indicates that there was an infiltration to the IV.
Two weeks after the event, the patient developed necrosis of the hand and required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The patient is alleging that because of this, she is no longer able to perform as a musical conductor.
The risk manager had noted when doing chart reviews over the last 3 months prior to this incident that there were issues of short staffing and that many nurses were working double shifts, evenings, and nights then coming back and working the evening shift. The risk manager also noted a pattern of using float nurses to several units.
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MN506 Purdue Case Study: Malpractice Action Brought by Yolanda Pinellas Nursing Assignment Help
Introduction:
In this case study, a malpractice action is brought by Yolanda Pinellas, a student who experienced complications following the administration of chemotherapy. As an Advanced Practice Nurse (APN), there are several perspectives to consider when discussing the violation of standards of care and the necessary risk management steps to alleviate the issue. This discussion aims to provide insights and recommendations from the perspective of an APN.
Standards of Care:
The key standard of care that was violated in this case study is related to the proper administration of chemotherapy. The administration of Mitomycin, a medication used in chemotherapy, requires careful monitoring and adherence to established protocols to prevent complications. The patient testified that a nurse came in, pressed some buttons, and the pump stopped beeping. This implies that the nurse did not assess the IV infusion site or properly address the dislodgment issue with appropriate action.
Responsibility for the Violations:
The primary responsibility for the violations of the standards of care lies with the nurse who attended to Yolanda Pinellas. The nurse failed to adequately address the dislodged IV, which led to infiltration and subsequent necrosis of the hand. However, it is important to note that the healthcare facility also shares responsibility for the violations since risks associated with short staffing and using float nurses to cover multiple units were present and had been previously noted by the risk manager.
Risk Management Steps:
As an APN in an educator, administrator, or practitioner role, several risk management steps can be taken before and after the incident to alleviate the issue:
1. Education and Training: Ensure that all healthcare providers involved in administering chemotherapy receive thorough education and training on established protocols and guidelines for the safe administration of chemotherapy drugs. This includes education on recognizing and addressing potential complications promptly.
2. Adequate Staffing: Address the issue of short staffing to minimize the risks of errors and ensure that healthcare providers have sufficient time and resources to devote to each patient. This may involve hiring additional staff or redistributing workload to ensure safe patient care.
3. Monitoring and Quality Assurance: Establish a system for regular monitoring and quality assurance to identify and address potential risks and violations of standards of care. This may involve conducting regular chart reviews, audits, and assessments to ensure adherence to protocols and guidelines.
4. Reporting and Documentation: Encourage a culture of reporting and documentation to ensure transparency and accountability. It is important that incidents of potential violations or complications are reported promptly and accurately to enable early intervention and prevention of future incidents.
5. Continuous Professional Development: Encourage and facilitate ongoing professional development for nurses and other healthcare providers involved in administering chemotherapy. This can be achieved through participation in continuing education programs, conferences, and workshops to stay updated on the latest practices and evidence-based guidelines.
Conclusion:
As an APN, addressing violations of standards of care and implementing effective risk management strategies are essential for patient safety and quality care. By emphasizing education, adequate staffing, monitoring, reporting, and continuous professional development, APNs can play a crucial role in minimizing the occurrence of such incidents and improving patient outcomes.
