Capstone: NUR4922 NURSING QUESTIONS-CASE STUDY

Capstone: NUR4922 NURSING QUESTIONS-CASE STUDY

Capstone: NUR4922 NURSING QUESTIONS-CASE STUDY

Olubunmi Eunice Obasa

Rasmussen University

Capstone: NUR4922

Fairuz Manion

February 18, 2022

The scenario described in the case study incorporates a death of a 25-year-old bariatric individual who was admitted to the health center under the care of a newly graduated nurse. The patient had a history of hypertension and slept apnea with a body mass index (BMI) of 50. The 25-year-old female was installed with a nasogastric tube (NG) to gravity though she had no postoperative complications from the Roux-en-Y gastric bypass. In this regard, the physician ordered the administration of 0.45% Normal saline (NS) intravenous infusion post-op, dietary consult, and bariatric behavioral therapist consult. However, due to errors made by the newly graduated nurse practitioner, a critical concern from the nurse manager, the patient became pale, unresponsive, with no heartbeat and respiration, and distended abdomen that led to her death. This paper discusses the errors made and why they occurred, unexpected client outcomes with rationale, and the optimum approaches to minimize errors and decrease the risk of unexpected outcomes.

Descriptions of the Errors and Why They Occurred

From the evaluation report, the first error is noted from failing to examine and confirm the correct positioning of the nasogastric tube. The practitioner presumed that the nasogastric (NG) tube was in the proper position despite the assertion that the machine had come out when the 25-year-old client blew her nose. The significance for illustration of this error is defined on the nursing policy, which is not remarkable to presume particular health concerns regarding a patient. The client reported that the NG tube came out when she blew her nose in this case study. However, she pushed it back in with no pain. The presumption in this circumstance has been on the analysis of the patient’s pain level instead of the nasogastric tube setting.

The other error observed is the practitioner authorizing and enabling the patient to meet with the support group for bariatric surgery clients before the physician conducts the ward rounding. In this context, the physician could not examine the client before visiting the support group. Though the client showed no health concerns, she was left with the unattended tube despite the prior claims of NG removal. It was difficult to determine whether the patient deliberately removed the machine or it came out accidentally. The medical practitioner does not follow up to ensure that the patient gets another tube because the one she had got was misplaced after returning from the support group.

Additionally, the practitioner failed to inform the physician immediately despite noticing the nasogastric tube was missing. The medical practitioner must inform the specialists of the progress of the patients or any deviance in symptoms for the appropriate therapeutic intervention and, if necessary, introduce the care plan for the patient (Yilmaz, 2020). In this regard, the practitioner is preoccupied with a new client failing to ensure that the female patient is attended to properly despite knowing the patient’s vital signs.

The Unexpected Client Outcomes

The central objective of nursing is to give good nursing care to all patients. The primary patient outcomes in nursing care are based on the patient’s results in the nursing care. From the analysis provided, the unexpected client outcome was mortality based on the review conducted by the nurse manager on the charts and errors induced by the nurse practitioner. The effectiveness of health care factored by lower readmission and compliance with health guidelines was deterred because the nurse failed to monitor the patient and alert the physician when care guidelines required to be reviewed. In this context, the nasogastric (NG) tube removal and moving the patient to support group before the clinician conducted rounding.

The Rationales of Errors

The errors occurred because of the failure of the practitioner’s assessment of the patient. The medical practitioner should have examined the client closely and monitored any deviance on her vitals. The client might feel okay; however, the practitioner can observe any deviance by examining her appearance. The other reason the errors occurred is that the nurse based her assessment on the information obtained from the patient’s point of view, and she examined the client based on the appearance. The patient may not fully illustrate symptoms of distress; however, it does not mean the client is not experiencing it. The medical practitioner should never depend on the subjective examination of the patient. Upon the patient’s arrival from the support, she should have been examined immediately because the client is postoperative. The errors, as mentioned above, occurred because of the practitioner’s negligence. The medical practitioner failed to analyze the nasogastric tube and acquire data on the adequate cause of the tube removal or inappropriate position. Nevertheless, in this regard, the practitioner could not secure the tube despite authenticating the case and did not assess the nasogastric tube because it was already placed back by the patient.

Application of Techniques to Avoid Errors and Reduced Risk of Unexpected Outcomes

Risks and errors are vital issues in health infrastructure and can result in unexpected outcomes such as death or ineffective health care. It is challenging to uncover a direct cause of errors and, even if obtained, to offer a steady, reliable solution that reduces the chances of a recurrent incident. By learning from the errors and risks and preventing them, patient outcomes can be enhanced. Several strategies could be used to ascertain that a similar case does not occur with the provided scenario. One technique could be a follow-up activity for the patients. It is necessary to adopt the use of a checklist. Generating the checklist and proper documentation would aid in minimizing the risks linked with negligence of essential responsibilities and procedures, which each practitioner should partake. This approach would facilitate that the practitioner embarks on the appropriate guidelines and activities to implement in case an incident occurs. Workload reduction may facilitate nurses’ proficiency in work (Mohsenpour, 2017). In this case study, the nurse practitioner was overwhelmed with newly graduated work and performed analysis on two patients. Following the provided case, other strategies that may be applied to avoid errors and minimize the risk of unexpected outcomes include; double-checking on the client’s vital signs, use of evidence-based performance guidelines, teamwork with clinicians and informing the specialist about the patient, and carefully reviewing of the work performed.

Techniques with Rationales, Nursing Theory and Evidence from Literature

Learning is a continual process and does not end at graduation. Nurses should obtain nursing skills generated from numerous practices inside the patient’s room. Evidence-based practice is the appropriate rationale based on the nursing theory in the techniques mentioned above to minimize risks and errors. Evidence-based practice involves nursing practice through phases such as forming a therapeutic evaluation to identify a health concern issue, collecting preferred evidence, examining the evidence, applying the evidence to clinical practice, and assessing the outcome. Benefits to nurses and patients on the evidence-based practice include a scientific survey to enhance a well-founded decision and validation of methods for patient care to improve recovery.

Regarding the nursing theory, evidence-based practice enhances the practitioners to analyze the study so that they apprehend the risks or effectiveness of a diagnostic test or treatment. Based on the provided literature, the nurse practitioner would not neglect the aspect of tube removal and documenting the inappropriate information of the patient profile concerning tube if she had an evidence-based practice that outlines approaches that can assist the patient. The vital advantages of evidence-based practice are good patient outcomes and reduction of health care resources (Mohsenpour, 2017). The unexpected patient outcome from the literature was mortality; this could be avoided with evidence-based practice.

Analyzing the root cause can aid in the elimination of undesirable consequences. Some of the common root causes of medical error are communication issues, deficiencies in experience and training, incomplete assessment and failure to offer education to patients, and inadequate policies to guide the health staff. The nurse practitioner lacks experience because she is a new graduate nurse with no training and experience capacity. There is a communication issue; the nurse does not provide information to the physician concerning the tube removal. There is an incomplete assessment to observe whether the tube was fitted properly despite removal. The correction of these causes would result in better patient outcomes (Charles, 2017)

In conclusion, the description of the errors and the unexpected death outcome was due to negligence and incompetence as of health infrastructure. The support choices are well outlined, and strategies such as evidence-based practices and evaluation of root causes would assist in error identification and minimize the risk of unexpected outcomes.

References

Charles, R., Hood, B., DeRosier, J. M., Gosbee, J. W., Bagian, J. P., Li, Y., … & Hake, M. E. (2017). Root cause analysis and actions for preventing medical errors: quality improvement and resident education. Orthopedics, 40(4), e628-e635.

Mohsenpour, M., Hosseini, M., Abbaszadeh, A., Shahboulaghi, F. M., & Khankeh, H. (2017). Nursing error: an integrated review of the literature. Indian J Med Ethics, 2(2), 75-81.

Yilmaz, Ş., & Yalim, N. Y. (2020). The effect of medical error education on the knowledge and attitudes of nursing students. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi, 11(2), 170-177.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – Capstone: NUR4922 NURSING QUESTIONS-CASE STUDY

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Capstone: NUR4922 NURSING QUESTIONS-CASE STUDY

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

• Guarantee

  

• Zero Plagiarism
• On-time delivery
• A-Grade Papers
• Free Revision
• 24/7 Support
• 100% Confidentiality
• Professional Writers

• Services Offered

• Custom paper writing
• Question and answers
• Essay paper writing
• Editing and proofreading
• Plagiarism removal services
• Multiple answer questions

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper