Core Concept in Acute Care Nursing

CORE CONCEPT IN ACUTE CARE NURSING
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TABLE OF CONTENTS
Introduction......................................................................................................................................3
1. Define adverse event....................................................................................................................3
2. Introduce the patient....................................................................................................................3
3. Brief summary of patient’s principal diagnosis, past medical history, medication and relevant
results...............................................................................................................................................4
4. Describe the patient’s adverse event. What happened? How the patient’s adverse event
managed by nursing and medical staff............................................................................................4
5. Analyze current workplace system with best practice guidelines to manage this event.............5
6. Compare current workplace systems for managing this event. What does the Australian
Commission on Safety and Quality in Health Care suggest............................................................6
7. Identify areas for improvement in the management of adverse events.......................................7
7. Conclusion and Recommendations regarding changes required in the practice.........................7
References........................................................................................................................................7
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INTRODUCTION
Adverse events depicts errors and mistakes in the process of medication which causes
injuries and problems to the person. Thus, in such respect the present research study has been
describing the impact of adverse event on the patient. The entire study has been conducted on the
basis of a case study which denotes the issue of medication error. Furthermore, in the research
study discussion has also been included regarding guidelines that are essential to be followed
especially at the time of managing adverse events. Lastly, considering this aspect
recommendations have been given to manage the impact of adverse events in health care sector.
1. DEFINE ADVERSE EVENT
Adverse events are defined as incidents wherein harm is resulted to a person who
receives health care. Adverse event usually happens because of medication errors and that also
makes the health condition more critical and severe. Adverse event include infection, falls results
in injuries and improper use of medical devices (Andersson and et. al., 2015). In the area of
clinical practice, an unfortunate medical occurrence that may present during the event with any
sort of medical error which has a causal relationship with the treatment.
Thus, in other words, adverse events is called as injury to patient that occurs due to errors
in medication. This states that hospital and medical care service providers are engaged in the
medical error that causes injuries and harm to the respective patient. The impact of adverse
events can be highly dangerous because improper emphasis on medical aspects can bring severe
challenges to the patient (D’Amour and et. al., 2014).
Apart from this, adverse event may also be called as incidents happened in the hospitals
due to errors in practices and also due to changes in the medicinal doses. Adverse events directly
generates medical burden and at the same time it also enhances liabilities of the hospital towards
the patient.
2. INTRODUCE THE PATIENT
The present study has been focusing on a 7 years old boy who was healthy admitted in
the emergency department because of swilling in his right arm. While running, he fell down on
his outstretched arm and after that he started complaining of severe pain in his wrist. The boy
does not have any sort of allergies in the body. However, when he feel down, the left wrist
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became swollen, tender and reddish and as a result, this has developed fear in the child regarding
the level of pain.
3. BRIEF SUMMARY OF PATIENT’S PRINCIPAL DIAGNOSIS, PAST MEDICAL
HISTORY, MEDICATION AND RELEVANT RESULTS
While conducting the physical examination, it is analysed that the boy’s HR is 150, RR is
28, Sat is 100% in RA, and Temperature is 37C and weight is 30 Kg. The left wrist is swollen;
hence that part has started aching. While conducting other clinical examinations, everything was
normal. X-ray was also conducted and it showed Colles fracture with displacement and
angulation of the distal end of the radius. After analysing the medical condition, the physician
decided to do close reduction by applying the cast.
Thus, to reduce the criticality of the condition, doctors decided to prescribe 2 mg of
ketamine and accordingly he wrote 60mg IV once. Prior giving any sort of medicine, the nurse
informed the other nurse (who was busy) to take 20 of ketamine. After such procedure, the
medication was given and the doctor started the process of reduction (Gaal and et. al., 2014).
While carrying out the procedure, the monitor started to show desaturation to 90% which kept on
changing. At the same time, problems were also observed in respiratory rate; hence that led the
team to prepare for intubation for the purpose of maintaining the airway. Finally, after reviewing
the entire situation, it is analysed that the child received 20 ml instead of 20 mg of Ketamine.
4. DESCRIBE THE PATIENT’S ADVERSE EVENT. WHAT HAPPENED? HOW THE
PATIENT’S ADVERSE EVENT MANAGED BY NURSING AND MEDICAL STAFF
Considering the above discussion, it is clear that there was medication error caused by the
hospital which made the boy’s condition severe. The large dose of sedative medication is highly
severe and dangerous too; hence it caused a deeper and prolonger sedation effect. As a result,
child’s respiratory rate got depressed which generated the need of respiratory system. The nurses
did not take care of the dosage and mistakenly, high dose was given to the boy. That made the
condition serious (Kalisch, Xie and Dabney, 2014). At the time of observing the critical
condition when the respiratory rate decreased, then during such time nurses gave bagging with
self- inflating bag for 1 minute. This was done for the purpose of maintaining the airway.
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