Therefore, it became necessary for Security staff to go hands on. Security Officers Alonso and Ayuso using MOAB Techniques had to put the patient down on his bed controlling his arms and legs while the nurse administered the medication. The patient struggled a bit attempting to get up but did not escalate the situation to where it was necessary to use soft restraints to control him. After the medication was given the patient was released by Security and he remained calm and did not try to retaliate or fight back. Officers Johnson and Evans kept on eye on patient Montalvo while this was happening and were not forced to go hands on with the second patient. Security Staff stood by until the medication took effect with patient Atsu who was the aggressor during this…
“A moderate sedation/analgesia (“conscious sedation”) policy requires that the patient remains on continuous B/P, ECG, and pulse oximeter throughout the procedure and until the patient meets specific discharge criteria (i.e., fully awake, VSS, no N/V, and able to void).” The trained nurse had the equipment to insure that this policy was followed, however failed to perform her duties as required by this policy. The second event is that the LPN reset the alarm and made no effort to provide an intervention for the alarm. The LPN did not inform the RN of the O2 Saturation level. The LPN Was not trained properly. The third event was that there was not enough staff called in for the level of acuity that these patients had. The administration should have been made aware of the emergency coming in and called in more staff to accommodate the staffing need.…
Nightingale Community Hospital needs to repeat the steps taken to evaluate the tracer patient on a wider range of patients. They need to re-evaluate the care of at least 100 patients receiving general anesthesia and inpatient surgery within the last 60 days. This is an important step to take to make sure these mistakes were not made as an isolated incident and more as an over all hospital wide issue. Assuming these mistakes are typical to Nightingale Community Hospital, it should proceed with the following steps.…
The first step in a RCA is to form a team that will be beneficial to the analysis process. Ideally, this team should include 4-6 people as well as be interdisciplinary in nature so as to provide unique perspectives on the system operations and interventions at hand (Ogrinc & Huber, 2013). Additionally, the team members should be from all different levels of the organization so as to foster appropriate changes if necessary in the system. Based on the case study presented, it would be important to have a nurse present from the unit/department where Nurse J and the LPN work, a respiratory therapist, a doctor that works for this hospital in the same capacity as Dr. T, a risk manager and a member of the quality improvement team. After the team is formed, the first step in the process is to identify what happened. In this particular case study, Mr. B was over sedated, not correctly…
3) Moderate sedation is an area that has been identified that needs a hardwired process for not only the hospital but for the anesthesia providers. The Joint Commission standards for moderate sedation compliance will require teamwork from the hospital and anesthesia group.…
In the FMEA pre-steps the team must be identified and the team members should list the failures which can occur in the system. The team must anticipate the effect and recognize by prioritizing the interventions in the areas with the greatest concern those with the one of the most significant effect. After prioritizing the failures in the system, the team must address the failures which have the greatest concern. Prior to the quality effort improvement, the data is evaluated regarding the medication administration during the conscious sedation procedure in order to be able to compare the before and after result. The evaluated data should include both positive and negative sides of the process and also the outcome of the process before and after the quality effort improvement process.…
that should be changed is the lack of regard for the Conscious Sedation policy. In order to…
DeLamar, L.(2007) ‘ Anaesthesia’ in Rothrock J (ed) Alexander’s care of the patient in surgery. 13th edn. Missouri: Mosby. Pp.120 – 122.…
Eric Weed, a Certified Registered Nurse Anesthetist (CRNA) participates on the health care team providing all aspects of anesthesia for…
In Zora Neale Hurston’s novel, the main character’s goal is to fall in love. She goes through many difficult times to find this perfect love and happiness but never gives up and in the end she is able to find what she has been looking for all her life. Each of her marriages gives her a valuable lesson and she uses each lesson to become a strong and independent woman. In Their Eyes Were Watching God by Zora Neale Hurston, Janie Crawford, the main character, learns about self-respect when she embarks on a life long journey in search of true love.…
Williams, Robert L. (1988) Chapter Fourteen: Sleep Disturbances in Various Medical and Surgical Conditions. Sleep Disorders: Diagnosis and Treatment(Second Edition), New York: John Wiley and Sons, Inc., pp. 179-180.…
Nurse anesthetists were one of the earliest advanced practice roles in the United States (Blais & Hayes, 2011, pg. 449). Individuals in this career field have an extensive amount of classroom and laboratory instruction in the delivery of anesthesia to patients in a variety of different healthcare settings. Some of a CRNA’s tasks and duties include “performing physical assessment, participating in preoperative teaching, preparing for anesthetic management, administering anesthesia to keep the patient free of pain, maintaining anesthesia intraoperative, overseeing recovery from anesthesia, and following the patient’s postoperative course from recovery room to patient care unit” (Blais & Hayes, 2011, pg. 451). The crucial priority of the CRNA is to provide the most optimal care to ensure the health and safety of all patients undergoing…
Management of the deliriums and restlessness – The restlessness may be as a result of a number of things. It may be because of stool impaction, bladder distention or from pain. This part of the plan involves protecting the patient from injury and supporting the family. The first step would be to give a dosage of opioids to the patient in order to rule out the possibility that they may be in pain. The next step is to assess the distention of the bladder. In case there is an issue, the nurse needs to insert an indwelling catheter. If it is appropriate to do so, the next step is to assess for impaction. The patient may need to be given antipsychotics or even benzodiazepines such as haloperidol or chlorpromazine and lorazepam or midazolam respectively. It is also important to maintain an environment that is calm around the patient. One can play the favorite music of the patient and dim any bright lights. The patient should be comforted by speaking softly and saying supportive…
This essay will discuss the plan of care I developed for Mr X while he was under my care in a post anaesthetic unit. It will discuss my nursing assessments, and what diagnoses I developed from this. It will then discuss the rationale behind my nursing interventions using relevant literature. My plan of care will be analysed throughout while identifying how my nursing care meets best practice guidelines.…
In the Life of Pi, Yann Martel, through the main character in the book, Pi, makes the following statement, “I know zoos are no longer in people’s good graces. Religion faces the same problem. Certain illusions about freedom plague them both.”…