Recommendations for Change: Analysis of Nursing Negligence Case Study

This case study analyzes a case of nursing negligence involving an 85-year-old patient, Daisy Mayes, admitted for pneumonia. The analysis highlights failures in patient monitoring, medication management, and adherence to clinical governance standards, leading to a fall, fractured femur, and subsequent wound infection. The assignment identifies breaches in patient care and provides recommendations for improvement, including enhanced patient monitoring, addressing family concerns, and staying updated with best practices to prevent similar incidents. The study emphasizes the importance of clinical governance, effective communication, and compassion in nursing practice to ensure patient safety and quality healthcare outcomes. The case underscores the need for healthcare professionals to prioritize patient safety, adhere to job requirements, and foster a compassionate approach to care to mitigate the risk of negligence and improve overall patient well-being.

Clinical governance standard
Introduction
Daisy Mayes is an 85 year old lady who was admitted in the hospital because of infection in the chest and bilateral
lower lobe pneumonia. However, after being admitted in the hospital, she broke her right neck femur and had a
laceration in her forehead due to a sustained fall. Despite her daughter’s efforts to explain to the nurse in charge that
Daisy’s was confused so that the nurse could closely monitor her, she was neglected the whole night and was only
attended to when a patient in Daisy’s room rang the nurse in charge. Also, the ward that Daisy was transferred to was
far from the nurse’s station which left her unattended to despite her efforts to contact the nurse severally.
Basically, Daisy did not receive a safe and high-quality healthcare hence the clinical governance standard breach. This
standard requires a healthcare facility to maintain and improve reliability, safety and quality of healthcare (Australian
Commission on Safety and Quality in Healthcare, 2017), all of which were not offered to Daisy. This standard also
recognizes the essence of patient care environment in providing quality healthcare, but the environment in which Daisy
was transferred to was not conducive for such care.
Clinical issue
The clinical issue in this situation is negligence of an 85 year old patient who was admitted
due to pneumonia and chest infection. However, while admitted, she was left unattended to
and sustained a fall which resulted into fractured neck femur and later had a surgery for the
same. Also, no nurse monitored her wound even after complaining that it hurt too much to
walk. It was only 4 days after her surgery that the nurses realized she had a wound infection.
Moreover, the nurses failed to include Daisy’s usual medication in her medication chart until
her daughter inquired about it.
Best Practice for the Clinical Issue
Negligence in nursing is a situation of malpractice where a healthcare professional fails to do
something which a reasonably prudent individual would do. According to Clifford, and Gough
(2014), negligence is the failure to use ordinary or reasonable care to attend to a patient. Healthcare
professionals can be sued for being negligent if it results into injury of the patient. Chinn, and
Kramer (2017) argue that disregarding or failing to take appropriate history of the patient, post
surgical infections and failing to properly monitor a patient are considered negligence. Usually, it is
the duty of the nurse to monitor the patient and keep track of the condition of the patient so as to
enhance the quality of care.
Recommendations for change
Patient monitoring is very critical in every healthcare organization. According to Wattjes et al. (2015),
continuous monitoring of in-patients is very critical in ensuring the physiological stability of the patient. The
healthcare practitioners in charge use the vital signs to determine if a patient is stabilizing or destabilizing and
respond immediately. Continuous monitoring of patients even if they are far from the nurse’s station reduces the
rates of complication or injury (Hawe, 2015).
Nurses should also take into consideration the concerns of family members and relatives of the patients
(Coleman, & Roman, 2015). Addressing the concerns of the family members is critical in identify the gaps in
patient care so as to improve the quality of care. Coleman and Roman (2015) argue that feedback from family
members help nurses to identify the signs and symptoms that may have not been handled before. Family
members know the patients better than the nurses and their input should be equally important.
According to Coleman and Roman (2015), feedback from patients should also be addressed so as to enhance
engagement of the patient. Boosting patient engagement enhances health outcomes and reduces chances of
negligence as the patient communicates freely with honesty their thoughts and feelings.
Staying up-to-date with the standards of practice is also a way of preventing negligence (Hawe, 2015). For
nurses to abide by the law, they must first understand them. Regulations differ and they are often revised within
each jurisdiction. It is thus essential for nurses to be aware of current standards which they are expected to
comply with and the updates to those standards during their practice.
References
Australian Commission on Safety and Quality in Healthcare (2017). Clinical governance. Retrieved from https://www.safetyandquality.gov.au/sites/default/files/migrated/Clinical-Governance.pdf
Coleman, E. A., & Roman, S. P. (2015). Family caregivers' experiences during transitions out of hospital. Journal for Healthcare Quality, 37(1), 12-21.
Clifford, C., & Gough, S. (2014). Nursing and health care research. Routledge.
Chinn, P. L., & Kramer, M. K. (2017). Knowledge Development in Nursing-E-Book: Theory and Process. Elsevier Health Sciences.
Fotaki, M. (2015). Why and how is compassion necessary to provide good quality healthcare?. International journal of health policy and management, 4(4), 199.
Hawe, P. (2015). Minimal, negligible and negligent interventions. Social Science & Medicine, 138, 265-268.
Specchia, M. L., Poscia, A., Volpe, M., Parente, P., Capizzi, S., Cambieri, A., ... & De Belvis, A. G. (2015). Does clinical governance influence the appropriateness of hospital stay?. BMC health services research, 15(1),
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Wattjes, M. P., Rovira, À., Miller, D., Yousry, T. A., Sormani, M. P., De Stefano, N., ... & Rocca, M. A. (2015). Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—
establishing disease prognosis and monitoring patients. Nature Reviews Neurology, 11(10), 597.
Best Practice for the Clinical Issue
The clinical governance standard requires all healthcare organizations to come up with strategies which
include actions of the stakeholders involved to ensure improved clinical outcomes of a patient (Specchia et
al. 2015). Healthcare practitioners should therefore operate with the framework of clinical governance so
as to enhance the safety and the quality of healthcare offered to the patients. Breaching this standard has
the ability to result into substandard care which may in turn worsen a patient’s situation or even cause
injury.
To prevent negligence in nursing, healthcare practitioners must ensure they positively impact the safety of
the patient (Hawe, 2015). Following the job requirements as well as being an effective communicator
reduces the chances of being negligent. Fotaki (2015) argues that compassion also helps in reducing the
chances of negligence when caring for the patient because it provides emotional support, ensures the nurse
exercises empathy, sensitivity and kindness. Moreover, compassion motivates the actions of a nurse hence
thoughtful and decent care.