Class 6 Unit 3 Topic 1 Comment 3 (M)

Thing to Remember:

Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

1 References, find resources that are 5 years or less

No errors with APA format 6 Edition

To Comment:

Case Study #2: Wrongful Death by Howard Carpenter on Behalf of Wilma Carpenter, Deceased. 

                Postoperative patients must be monitored and assessed closely to identify any deterioration in their health care (Liddle, 2013). The case study involves a 55-year-old female that goes in for a routine hip surgery and during postop experiences a hypotensive episode. She was treated for the hypotensive episode post-operatively, then transferred to the medical-surgical unit. Apparently, somewhere along the way the communication was lost between the two floors and the med-surg nurse was never told about the patient’s recent hypotensive episode after surgery. Which later lead to a nurse finding the patient unresponsive and blue. The events that preceded this “code blue” was the patient’s status, which decreased the ability to tolerate her respiratory treatments. The patient was then intubated and sent to the intensive care unit (ICU), where she also later expired from hypoxic encephalopathy. Although studies have shown that the respiratory rate is among the first to be affected if there is a change in the patient’s state, it is often poorly assessed (National Patient Safety Agency, 2007). The biggest error noted was the inconsistency of documentation. It has been said that if it is not documented in the chart then it was not done, which is what happened in this case specifically. 

References:

Liddle, C. (2013). Postoperative care: Principles of monitoring postoperative patients. Nursing Times, 109(22), 24-26. 

National Patient Safety Agency [NPSA] (2007). Safer caring for the acutely ill patient: Learning from serious incidents. London: NPSA.