Fluent Essays

Week 8 Quality and Safe 1. Assignment:   The LPN and the patient requiring tube feedings.  Go over the case study on Chapter 5 and submit APA Paper due by Sunday at 2359. Instructions:  In Chapter 5, a patient was transferred to a nursing facility under the care of a licensed practical nurse. The nurse failed to follow tube feeding directions on a timely basis and this eventually led to the patient dying. Answer the following questions in the form of an APA paper: a.      What were the physician’s orders during the transfer from the hospital to the nursing care facility? b.      In your opinion, what should the care team done differently to avoid such a dire outcome? c.      What was the nurse’s responsibility when assessing the patient and realizing she would not have the feeding tube available in a timely manner? d.      Should the care team have discharged this patient to this level of care or not and why?   Paper must be at least 1 page, excluding title page and reference page. (at least 1 reference no more than 5 years old), make sure to reference the article. Week 9 2. Assignment: Read Case Study and submit APA Paper due by Sunday at 2359. Instructions: Read HISTORICAL CASE STUDY #1: Misplaced Affection, Professional Responsibility   Submit APA Paper addressing the following: a.      What are some of the ethical issues involved in this case? b.      What are some of the nursing responsibilities which were overlooked and what recommendations would you make for nurses confronted with this situation?   Paper must be at least 1 page, excluding title page and reference page. (at least 1 reference no more than 5 years old), make sure to reference the article. 3. Discussion Forum: Read Safety culture assessment: a tool for improving patient safety in healthcare organizations.  https://qualitysafety.bmj.com/content/12/suppl_2/ii17   - due Friday by 2359.  Instructions : Discuss the culture changes that must take place in order for a healthcare organization to foster culture safety? What are some steps management can take to promote safety?   Provide  1 reference  to support your point of view related to Improving quality & safety in healthcare. Case Study HISTORICAL CASE STUDY #1: Misplaced Affection, Professional Responsibility HISTORY A state mental health facility suspended Ms. Priscilla Rothschild, a registered nurse, pending an investigation into allegations that she had a romantic relationship with a patient. A county recorder indicated that a marriage license named a patient, Mr. Benjamin Huntington, as the groom and Nurse Rothschild as the bride. Nurse Rothschild was permitted to resign from employment, and the situation was reported to the board of nursing. Nurse Rothschild had worked in general adult psychiatric units throughout her career. She was licensed initially as a licensed practical nurse, then progressed to complete an associate degree in nursing. She obtained her license as a registered nurse in 1995. She had no preCase Study for assignment #1Historical Case Study #1: When Nursing Care and More Complex and Adequate Training and Supervision Are Absent ENVIRONMENT AND HISTORY This case took place in a small rural community of 8000 people. Mr. Kenny Salamino was a developmentally and physically disabled 32-year-old man. He had lived most of his life in a group home with seven other residents and was cared for by a staff of two unlicensed assistive personnel (UAP) 24 hours a day. Ms. Marsha Mitchell, a licensed practical nurse whose title was “Medical Director,” had worked at the group home Monday through Friday, 8 AM to 5 PM, for 7 years. Ms. Rose Sinclair, a registered nurse, served as “Consultant.” Nurse Sinclair was employed to “be a resource” and provide a course entitled “Assistance With Medications Course for Unlicensed Assistive Personnel.” The owner of the facility, Mr. Brian Adams, did not live at or maintain an office at the facility. He hired the staff and expected the registered nurse and the licensed practical nurse to manage the resident care. The state board of nursing in which the facility was located received a complaint from the Department of Health and Welfare. Mr. Salamino had died after admission to the hospital, and the states surveyors from the Bureau of Facility Standards had investigated the circumstances of his death. Over a period of 6 months, Mr. Salamino had lost 40 pounds during which time the nurses had not assessed his health care needs or provided for adequate medical or nursing interventions. The bureaus investigation determined that the events that led to Mr. Salaminos death were due to lack of fiduciary responsibility of Practical Nurse Mitchell and Nurse Sinclair who, the report asserted, should be held accountable for Mr. Salaminos death. THE NURSES STORY I have been a registered nurse for 10 years. I worked full time in a small hospital in a nearby town for 9 years as the supervising registered nurse. When I decided to work part-time, I chose to drop back and work in a less restricted environment than the hospital. The administrator of the group home hired me as the “Registered Nurse Consultant,” and my responsibilities included teaching to new unlicensed assistive personnel a course entitled “Assistance With Medications Course” and providing to the licensed practical nurse 24/7 support face to face or by cellular phone. My contract specified that I was to be paid for 24 hours of work every 3 months. I did not receive an orientation to residential care/group home, federal, and/or state regulations. The first indication I had that Mr. Salamino was having a problem was when Practical Nurse Mitchell called me and said that Mr. Salamino had just returned from the hospital with a new jejunostomy tube (J-tube). She said that she thought Mr. Salamino should have been discharged to a skilled nursing facility, but his physician, Dr. Fred Stark, sent him back to the group home because he thought Mr. Salamino would receive be