You walk into the intensive care unit. There are no patients or family members sitting in the chairs; the patients in bed are on ventilators, attached to all kinds of tubes. The nurses are dressed in various colors of scrub suits. You notice two sedated patients on ventilators who have at least one side rail down on the bed. One of these beds is also elevated. Tubes are visibly seen attached to machines for monitoring and maintaining physiologic functions such as blood pressure, oxygen levels, and nutritional support. No labels are noted on the tubing. Patient armbands are taped to the side rails instead of to the patient. In a rush to take care of multiple patient needs, nurses go from one room to another with gloves on.The noise level consists of alarms going off intermittently, the whir and hum of machines, and the spoken technical jargon of staff.The physicians and nurses are talking in a language that is specialized in their area. “Mr. Smith has multifocal PVCs (premature ventricular contractions) and PCWPs (pulmonary capillary wedge pressures) are high. Mr. Smith is hypotensive, tachycardiac, and is receiving titrating IV medications to increase urine output and blood pressure.”There are observable clusters of care in the intensive care unit. As the physicians round with the nurses and ancillary staff, the language of each specialty is heard. There is an urgency and quickness of pace. Emergent care interrupts the rounds, and the attending physician, residents, and nurses rush to the bedside of a patient who has “coded.”
Case Study Reference:Patient Safety and Hospital Accreditation: A Model for Ensuring Success Sharon Ann Myers Copyright 2011, Reproduced with the permission of Springer Publishing Company, LLCISBN: 978–0–8261–0639–1
After reading the scenario, you will choose a specificissue which is identifiedas a patient safety concern.You will target your analysis based on the issue you choose below. Remember that your analysis of the regulation(s) should just be the regulations and standards associated with the specific issue you have chosen.
Issue One:Potential for falls for patients
Issue Two: Potential for harm to the patient due to tubing not being labeled
Issue Three: Potential for harm to the patient due to disorganization of care and miscommunication
Issue Four: Potential for harm to the patient or medicine errors due to patient identifier policy not being followed
Specifically,the following critical elements must be addressed:
I.Analysis of Regulations: In this section, you will analyze the regulation and accreditation standards that impact the given scenario. Be sure to:
A.Identify appropriate healthcare regulations or accreditation standards that would apply to the department or institutional system from the given scenario.
B.Analyze the impact your identified healthcare regulations or accreditation standards could have on the daily operation and clinical practice of the department or system.
C.Explain the influence of key laws on the development of healthcare regulations or accreditation standards you have researched or reviewed. Key laws could include but not be limited to: HIPAA, EMTALA, ACA, etc. Be sure to provide examples to support your response. D.Determine key similarities and differences between federal and state healthcare regulations or accrediting standards that would apply to the department or system. For example, how might HIPPA be similar to an applicable state regulation? Different?
E.Analyze federal and state healthcare regulations or accrediting standards for how they inform deemed status of healthcare organizations. In other words, what regulations and standards must be met?
F.Explain the implications of deemed status as it relates to healthcare regulations or accreditation standards that would apply to the institution or system. In other words, what is the importance of deemed status? How would it apply to and affect your department or system (or the institution)?
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