Advance Leadership question 5

Scenario For Module 4

Put yourself in the role of an advanced practice nurse leader working in an urban emergency department (ED) in your state. You just received a report of a patient death. The patient was recently discharged to home from the ED after being diagnosed with a complicated urinary tract infection. The patient died two days later in presumed septic shock. As the advanced practice nurse leader, you examine the case and find that multiple issues contributed to this event.

· The patient presented during peak hours in the ED. The ED is currently under pressure from administration to keep wait times down. Patient discharge is sometimes hurried to allow for additional patients to be seen.

· Two nurses and a nurse practitioner called in sick during the shift, which likely contributed to staffing issues that day.

· A serum lactic acid level was drawn, but the results did not return until after the patient was discharged home. The elevated level was likely never seen by a nurse or medical provider.

· The patient was discharged with a 10-day course of ciprofloxacin and advised to follow up with their primary care provider (PCP) in 2 days. The patient was uninsured and did not follow up with their PCP as recommended. 

RUBRIC:

Application of Course Knowledge

20 pts

Exceptional

The initial post thoughtfully considers and responds to the discussion questions using well documented, sound logic, and is clearly and succinctly written. The post fosters ongoing dialog in a professional and scholarly manner.

Scholarly Synthesis and Referencing

20 pts

Exceptional

Initial post is supported by evidence from scholarly sources. The initial post is approximately 200-300 words in length and includes relevant citations from the course readings and/or professional literature. In-text citations and full references are utilized.

Clarity, Relevance, and Organization

20 pts

Exceptional

All discussion posts are relevant to the topic and are presented logically and clearly. This includes initial posts and posts to peers. Direct course applications and synthesis of scholarly information is easily discernable.

Scenario

In Module 4, we discussed the nurse leader's experience evaluating a poor patient outcome related to ED care and unmet discharge needs. Continuing that discussion, as the nurse leader in the ED, you must now gather additional information regarding the patient’s ED stay. To facilitate this, you will need to discuss the scenario with the individuals from the interdisciplinary team who played a role in this patient's care. The team includes the bedside registered nurse (RN), the charge RN, the emergency medical technician, the nurse practitioner, and the physician. With this in mind, address the following discussion questions:  

Discussion Questions

1. Examine communication techniques that may be appropriately utilized by nurse leaders in obtaining information in sensitive situations and/or providing constructive feedback when an error must be addressed. Apply your findings and suggest an approach for addressing the team in the scenario.

2. Analyze the concepts of expecting perfection versus honoring excellence in addressing errors. 

3. Describe 3 different preventable errors that occurred or may have occurred in this scenario. Examine the literature and explore possible methodologies for prevention of these errors. Synthesize your findings.