MN506M2-2: Analyze ethical-legal principles and dilemmas related to health care.
Using the information from the case study (below), discuss the following issues from the perspective of an APN role:
- Administrator
- Practitioner
- Educator
Standards of care — Which standards of care were violated and who was responsible?
In your role as an educator, administrator, or practitioner, what risk management steps should be taken before or after the incident to alleviate the issue?
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, 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 IV infiltration.
Two weeks after the event, the patient developed necrosis of the hand, 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 alleges that she is no longer able to perform as a musical conductor because of this.
While reviewing charts, the risk manager noted that there were short-staffing issues during the 3 months prior to this incident, and many nurses were working double shifts (evenings and nights) then coming back to work the evening shift again. The risk manager also noted a pattern of using float nurses among several units.
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