Nursing Quality, Scenario #1
If you have ever looked at a Gallup poll for honesty and ethics, nursing is always near the top. In the December 2016 poll (GALLUP, 2016), nurses ranked at the top of the list. While we review our first scenario we run into some ethical questions. We also run into questions regarding patient advocacy as it applies to nursing-sensitive indicators. We will identify these points as we progress through the scenario with concerns and possible improvement projects.
Our first concern is for fall risk and restraints. If we use a fall risk assessment tool, such as the John Hopkins Fall Assessment Tool (John Hopkins Fall Risk Assessment Tool, 2007), even though we don’t have enough information to complete the entire …show more content…
This has multiple facets to it. The patient received an incorrect dinner tray. Luckily it was not a food allergy which could have had immediate health risks. However the tray the patient received is contrary to his religious beliefs. The nurse brings the issue up to the supervisor who down plays the event by saying to “keep quiet.” This is not an ethical response. The patient should be informed at a minimum. This is an issue from a quality stand point. A more appropriate response to the nurse could have been that the supervisor would let the kitchen know so this would not happen again and for the nurse to inform the patient and family (since the patient has dementia) when they next visit or call for an update. This would give transparency and follow through to the incident. The supervisor does notify the kitchen supervisor of the error and the kitchen supervisor alerts the staff. If it was a chronic problem an assessment of the system may be in order to find out why the error is occurring. Having a quality reporting system in place would improve the supervision of these types of …show more content…
The physician supplies the information that shows this a recurring problem and not an isolated incident. At this point an investigation should be initiated. We are not talking about an inquisition but a review of dietary tray process and staff knowledge regarding diet and complex psycho social issues such as religious preference. All other revisions would need to wait until those results were obtained. Seeing as there is a Jewish hospital within 20 miles it may behoove them to request assistance on Jewish cultural education. On that same note, including the patient’s daughter on the process if she would consent would possibly go a long way to provide comfort that the situation was a mistake and that the facility is making the attempt to improve.
This scenario is riddled with nursing-sensitive indicators and other factors that impact the quality care of patient. As stated above a process review would be helpful to check if there is a failure in the process. Follow up with the floor director would be useful to find out why a nurse would be told to keep quiet regarding something concerning patient care. There should be safety in reporting errors. If the system can be fixed before there is a major problem it should be and it will be all the better for
If you have ever looked at a Gallup poll for honesty and ethics, nursing is always near the top. In the December 2016 poll (GALLUP, 2016), nurses ranked at the top of the list. While we review our first scenario we run into some ethical questions. We also run into questions regarding patient advocacy as it applies to nursing-sensitive indicators. We will identify these points as we progress through the scenario with concerns and possible improvement projects.
Our first concern is for fall risk and restraints. If we use a fall risk assessment tool, such as the John Hopkins Fall Assessment Tool (John Hopkins Fall Risk Assessment Tool, 2007), even though we don’t have enough information to complete the entire …show more content…
This has multiple facets to it. The patient received an incorrect dinner tray. Luckily it was not a food allergy which could have had immediate health risks. However the tray the patient received is contrary to his religious beliefs. The nurse brings the issue up to the supervisor who down plays the event by saying to “keep quiet.” This is not an ethical response. The patient should be informed at a minimum. This is an issue from a quality stand point. A more appropriate response to the nurse could have been that the supervisor would let the kitchen know so this would not happen again and for the nurse to inform the patient and family (since the patient has dementia) when they next visit or call for an update. This would give transparency and follow through to the incident. The supervisor does notify the kitchen supervisor of the error and the kitchen supervisor alerts the staff. If it was a chronic problem an assessment of the system may be in order to find out why the error is occurring. Having a quality reporting system in place would improve the supervision of these types of …show more content…
The physician supplies the information that shows this a recurring problem and not an isolated incident. At this point an investigation should be initiated. We are not talking about an inquisition but a review of dietary tray process and staff knowledge regarding diet and complex psycho social issues such as religious preference. All other revisions would need to wait until those results were obtained. Seeing as there is a Jewish hospital within 20 miles it may behoove them to request assistance on Jewish cultural education. On that same note, including the patient’s daughter on the process if she would consent would possibly go a long way to provide comfort that the situation was a mistake and that the facility is making the attempt to improve.
This scenario is riddled with nursing-sensitive indicators and other factors that impact the quality care of patient. As stated above a process review would be helpful to check if there is a failure in the process. Follow up with the floor director would be useful to find out why a nurse would be told to keep quiet regarding something concerning patient care. There should be safety in reporting errors. If the system can be fixed before there is a major problem it should be and it will be all the better for