see details below PART A AND B

Description

A) One Small Cut that Killed

Dr. Contadina is a primary care physician in a Metropolitan area at a large, not-for-profit, integrated health care system. On average, she sees several patients a day from a variety of backgrounds who come in with an assortment of conditions, injuries, and ailments.

One day, a patient comes to see her complaining of ankle pain on his right leg. The patient is a farmer and says that he fell while he was taking care of his chickens in the chicken coup. He has some cuts and bruises on either leg, complains of a swollen right ankle, but appears to be fine otherwise. Dr. Contadina instructs him to purchase an air cast at a pharmacy along with some ibuprofen and to take it easy. Dr. Contadina returns to seeing other patients and Joe goes home.

Three days later Joe is admitted to the emergency room. He has low blood pressure, a fever, extreme shaking, an irregular heartbeat, and is very agitated. After removal of the air cast, the nurses notice a cut that has become infected on his left leg (the other leg with the swollen ankle). Joe’s condition continues to worsen, and he eventually goes into septic shock. After two days in the ICU, Joe dies of complete organ failure.

The family wants answers, and so far all they know is that he came in with one small cut and suddenly died. The hospital is pressuring Dr. Contadina to apologize in hopes of mitigating some legal trouble. Dr. Contadina is afraid that if she admits that there was any chance she made a mistake, that she’ll be in bigger trouble- both legally and professionally. She is very afraid of what her colleagues and patients will think if she admits that she made an error.

Discussion Question:

  1. Does this scenario deal with moral, ethical, and/ or legal conduct?
    1. Why?
  2. What is the nurse’s ethical role in this case?
  3. Describe an unsafe, illegal, and/or unethical practice you have witnessed in your personal life, nursing or student practice.
  4. What made it unsafe, illegal, and/ or unethical compared to the expected professional standards for practice?
  5. What resources are/were available to resolve the issue?

Please be sure to use citations to support your point of view. Then reference them at the end. For more grading specifics, please refer to the rubric.

B)

1. What theory best describes your organization’s approach to external influences on care delivery, Systems (with open or closed) or Chaos or another?

1b. why?

2. State what your workplace’s mission, vision, & philosophy (values) are.

3. What themes or unity do you see between these statements? (i.e. What do they have in common?)

3b Does your workplace culture reflect these concepts? Why or why not? How do you see them being enacted (or not)?

3c. Does your health care setting (the unit where you work) interpret these statements differently than other settings within the organization? (i.e. Are the statements broad enough to fit all circumstances?) Elaborate.

4. Find an organizational chart from your facility.

4a. What type of operational structure exists at your organization? (For example, is it Functional? a Service line? a Matrix? Flat? etc…)

4b. Describe it to defend your interpretation of the structure.

5. Do you feel your organization could benefit from a different operational strategy?

5b. why or why not?

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References:

Nursing Standards

Nursing and Midwifery Board of Australia. (2018). Code of conduct for midwives. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Clinical Guidelines

Guideline Adaption Committee. (2016). Clinical practice guidelines and principles of care for people with dementia. NHMRC Partnership Centre for Dealing with Cognitive and Related Function Decline in Older People. https://cdpc.sydney.edu.au/wp-content/uploads/2019/06/CDPC-Dementia-Guidelines_WEB.pdf

Living Guideline

Stroke Foundation. (2022). Australian and New Zealand living clinical guidelines for stroke management – chapter 1 of 8: Pre-hospital care. https://app.magicapp.org/#/guideline/NnV76E

Evidence-based practice

BMJ Best Practice

Goldfarb, S., & Josephson, M. (2020). Cystic fibrosis. BMJ Best Practice. https://bestpractice.bmj.com/

Schub, T., & Cabrera, G. (2018). Bites: Head lice [Evidence-based care sheet]. Cinahl Information Systems. https://www.ebscohost.com

Beyea, S. C., & Slattery, M. J. (2006). Evidence-based practice in nursing: A guide to successful implementation. http://www.hcmarketplace.com/supplemental/3737_browse.pdf

JBI: Evidence summary

Swe, K. K. (2022). Blood glucose levels: Self-monitoring [Evidence summary]. JBI EBP Database. https://jbi.global

JBI: Best practice information sheet

Bellman, S. (2022). Experiences of living with juvenile idiopathic arthritis [Best practice information sheet]. JBI EBP Database, 24(1), 1-4.

Cochrane Database of Systematic Reviews

Srijithesh, P. R., Aghoram, R., Goel, A., & Dhanya, J. (2019). Positional therapy for obstructive sleep apnoea. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD010990.pub2

Drug Information

Codeine. (2023, January). In Australian medicines handbook. Retrieved February 2, 2023, from https://amhonline.amh.net.au

Colorado State University. (2011). Why assign WID tasks? http://wac.colostate.edu/intro/com6a1.cfm

 

Dartmouth Writing Program. (2005). Writing in the social sciences. http://www.dartmouth.edu/~writing/materials/student/soc_sciences/write.shtml

Rutherford, M. (2008). Standardized nursing language: What does it mean for nursing practice? [Abstract]. Online Journal of Issues in Nursing, 13(1). http://ojin.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Health-IT/StandardizedNursingLanguage.html

Wagner, D. (n.d.). Why writing matters in nursing. https://www.svsu.edu/nursing/programs/bsn/programrequirements/whywritingmatters/

Writing in nursing: Examples. (n.d.). http://www.technorhetoric.net/7.2/sectionone/inman/examples.html

Perth Children’s Hospital. (2022, April). Appendicitis [Emergency Department Guidelines]. Child and Adolescent Health Service. https://www.pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Appendicitis

Department of Health. (n.d.). Who is being active in Western Australia? https://ww2.health.wa.gov.au/Articles/U_Z/Who-is-being-active-in-Western-Australia

Donaldson, L. (Ed.). (2017, May 1). Healthier, fairer, safer: The global health journey 2007-2017. World Health Organisation. https://www.who.int/publications/i/item/9789241512367

NCBI Bookshelf

Rodriguez Ziccardi, M., Goyal, G., & Maani, C. V. (2020, August 10). Atrial flutter. In Statpearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK540985/

Royal Perth Hospital. (2016). Procedural management: Pre and post (24-48 hours) NPS. Canvas. https://courses.ecu.edu.au

 

 

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