Please answer the questions below in response to the scenario, include two EBP references overall and note the citations and references in APA format.
An 82-year-old woman in fairly goodhealth had been experiencing several bouts of bronchitis and had borderlineCOPD (chronic obstructive pulmonary disease) due to a 20 pack year history ofcigarette smoking. After an appointment with her local physician, she wasadmitted to the critical access hospital (CAH) acute care unit for treatment ofacute bronchitis. When the patient had completed her course of therapy, she wasnot well enough to go home and needed short-term care or swing-bed assistanceuntil she could be independent at home. She was a widow and lived alone in a one-level condominium and had two grown children in the area. She was concernedabout the cost of a swing bed stay, but the physician told her that since shewould be getting intravenous steroids (Solumedrol 40 mg IV every 8 hours), thecost of swing bed would be covered by her insurer. The patient agreed to theswing bed admission. The patients home medication was identified and newtreatments ordered. Since there is no pharmacist on-site at the CAH, the nursewill need to reconcile all meds and pull medication from central supply until alocal pharmacist fills all orders at the end of the day when the retailpharmacy store closes.
After two weeks in swing bed thepatient was found obtunded with the following vital signs: BP 96/47, T 100.5,HR 67, R 10, and SaO2 62%. The patient was stabilized and transferred to alevel IV trauma facility. She was admitted to the intensive care unit fortreatment of respiratory failure due to steroid masking of exacerbatedpneumonia. After the patient was weaned off of CPAP and high-flow oxygen fortwo days in ICU, she was transferred to the medical floor. Her white count wasover 30,000 and blood gases were normalizing. The patient received treatmentfor the pneumonia and steroids were tapered off. After meeting dischargecriteria, the patient was transferred back to the original facility for swingbed placement. The patient had extensive muscle wasting due to long termsteroid use and needed rehabilitation from physical therapy and occupationaltherapy. The patient became anxious and disinterested in most of her cares andtreatments. She was lethargic much of the time and refused activity. Ten daysafter readmission to the CAH, the nurse found the patient unresponsive. Thepatient was again transferred to the level IV trauma center. She had a CT scanand general workup that supported an ischemic stroke diagnosis. The patient wasdetermined to be terminal and had a living will designating supportive caresonly. After the patient was deceased, it was determined that due to multiplehospital transfers, the clients medication was not reconciled and thereforeher anticoagulant (from her home medication list) was not administered for aperiod of time. Because of the severe muscle wasting, inactivity, and lack ofanticoagulation, the patient ultimately suffered stroke leading to hersubsequent death.
1. Whattypes of errors occurred in this patients scenario? Explain. (50-150 wordresponse)
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2. Whatcould have been done to prevent the medical errors that this patientexperienced? (50-150 word response)
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3. In yourprofessional experience, have you had a similar situation occur? If not, wasthere any instance where lack of collaboration or communication affected apatients outcome? What happened? (50-150 word response)
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4. Howdoes this case reflect the need for interdisciplinary teamwork? Now that youknow more about teamwork, safety, and quality, what is your perspective of theexperience? (150-300 word response)
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5. TheRHIhub (Rural Health Information Hub) lists the following as barriers tocare coordination in rural areas: Shortages ofhealthcare providers and other workers, Difficulty working with small,independent healthcare providers, Limited access to specialty services andproviders, Legal, policy, and regulatory barriers, Financing to support programdevelopment and implementation, especially health information technology, andPatient non-compliance and missed appointments. Please select one of thesebarriers to apply to the case study and elaborate on its impact on thesituation. (150-300 word response)
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