Planning, Policy and Healthcare Economics-Unfolding Case Study
Read the following scenario and answer Discussion Question 4.1. Use your Nursing Today textbook and the nursing article you were instructed to find at the beginning of each Learning Plan from the Ovid Database, as references. Cite the references in the discussion postings and responses using APA format.
After two weeks you still sense there is a great deal of resistance to medication barcode scanning. You have formulated your plan for change, provided the nursing staff with evidenced based literature on the benefits of medication barcode scanning, presented it to the nursing staff, and worked to defuse conflict on the nursing unit. Despite the communication of the message, you have been informed that a medication error occurred that resulted in a sentinel event for a patient on the unit.
You review the details of the incident report and it indicates a registered nurse who has worked on the unit for over twenty years delegated the initiation of an intravenous chemotherapy medication to an English as a second language (ESL) LPN/LVN who was newly licensed 3 months ago. The registered nurse said she delegated the administration of an oral anti-emetic medication to the LPN/LVN and the LPN/LVN misunderstood her. The LPN/LVN said she misunderstood what the registered nurse wanted her to administer and just followed her directions because the registered nurse was impatient with her and wanted to hurry and administer the medication. The registered nurse removed the chemotherapy medication from the medication cart and did not verify the medication or the dosage. Because the patient was vomiting the registered nurse handed the medication to the LPN/LVN and instructed the nurse to give the medication immediately. She also informed her that there was “no need to check it with the barcode scanner-I already checked it so silence the warning tone and just give it.” The LPN/LVN administered the medication without verifying the dosage or the medication and because it was three times the previous dose and the dose was so close to the time the patient had received the medication earlier, the patient went into kidney failure, was transferred to the Intensive Care Unit. The patient spent four weeks in the Intensive Care Unit and the final result was the patient had to have a kidney transplant. The family sued the hospital, a large settlement was paid out and the hospital had to absorb the cost of the entire hospital bill for this patient.
Based on the information presented in the scenario post responses to the following in the D2L discussion area:
1.A breakdown in delegation between the two nurses resulted in a catastrophic outcome. Discuss what inference you can make that if proper delegation principles were followed within this transcultural work team that the outcome may have been different for the patient?
2.The outcome for this patient resulted in a very large economic loss to the hospital. Explain why health care is an important segment of the US economy and why issues such as these affect healthcare economics.
3.As a result of the negative outcome for the patient – the patient’s health insurance refused to pay for the entire hospital stay. Determine strategies to control health insurance costs.
4.Use the article you chose for the LP4 – Learning Activity # 1 to respond to other students in support what you have learned from this discussion and to discuss what you have learned from their postings of the assigned discussion questions.
Please site only OVID nursing database peer-reviewed nursing articles only no older than 5 years. Nursing Today 8th edition for sources, please.
