Nursing admin
Possible Causes a. In order to Improve the process In dealing with this specific Incident changes must be made to implement a new process in order to better deal with these situations in the future. The first step would be to develop a team that is specifically trained to handle these emergent situations. Each member should have a specific role designated to them to know their specific tasks that should be handled during the emergency response.
Once the team is developed, special training should be given to better educate the team members In dealing with these patients. Once each member Is confident In their training and knowing their role, the team will be ready and prepared to handle any future situations. B. To organize a team that would be the first responders for all emergent situations, the team would include a leader, facilitator, recorder, time keeper, and team members. The leaders would be the primary URN and primary physician on the given case.
The facilitator of this team would be the ICC nurse. The recorder and time keeper would be the same person being one of the unit staff members, not necessarily a URN but could be the charge nurse or resource nurse. The team member included could be the respiratory therapist who could help assists with necessary task if not preoccupied with a respiratory distress patient. In addition to these team members, I would include a security officer to be present and on standby for these patients that are combative and a possible threat to themselves or others.
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In this specific case the security team could have helped assist with the patient leaving the scene. C. Unfortunately, the staff Is currently uneducated on how to deal with these types of patients and incidences. This is causing them to have negative attitudes towards the patient's only rather accelerating the behavior of the patients. The staff does not know the correct steps to take in order to diffuse the situation. By not knowing what to do, there is too much lag time creating too much time for the situation to further escalate.
Another problem that added to the situation escalating was having no security guards present at the time of Incident, causing opportunity for the patient to escape the hospital and disappear. D. Patient arrived at DE due to possible stroke Admitted with lack of knowledge of cause of symptoms Rapid response due to patient outburst Staff responds with negative attitude and lack of knowledge on how to address Mr... X Mr... X flees the hospital County police find Mr... X at home Mr... X admitted to same acute unit Staff avoids Mr... X e.
As stated previously in "letter a", to improve the process and decrease the risk of this situation happening again a team should be implemented who is specifically trained in dealing with these situations. The emphasis should be placed on training and education for the staff and team members so this situation of staff not knowing how to respond or deal with this patient, will not happen again. A unit protocol should also be set in place, so that the staff does not have questions regarding how to deal with these patients in the future when this situation reoccurs. AAA.
Improvement Plan In order to best be prepared in case this situation should happen again, a plan should be developed and in place so there is no questions as to whom should respond and what tasked should be taken. First there should be a team established and trained to be prepared for these situations. At the first sign of an emergent situation arising, the primary nurse should notify the charge nurse of events are age overhead so the entire team is alerted immediately. All of the members of the team should rapidly respond to the page and report to the location of the incident.
Once all assemble the team members should assume their roles, the leaders would be the primary URN and primary physician on the given case. The facilitator of this team would be the ICC nurse. The recorder and time keeper would be the same person being one of the unit staff members, not necessarily a URN but could be the charge nurse or resource nurse. The team member included could be the respiratory expiratory distress patient. And the security team should be present and close in proximity.
The team leaders should be taking control of the situation by giving verbal orders of steps necessary to diffuse the situation. The respiratory therapist should be taking care of oxygen and breathing treatments if necessary and assisting the team with any other necessary tasks. The unit staff member who is designated as the recorder and time keeper should be taking detailed notes of each task and order that is being carried out. Each team member should be all hands in throughout the entire mime until the situation is diffused or the primary MD orders for the team to discontinue treatment.
Since the team has been thoroughly trained, their attitude will be more accepting of the patient and they will be proactive with approaching the patient due to the fact that they know which steps to take and skills in handling these patients. Once the situation in diffused and handled, the recorder should chart all the details that occurred during the response and the team should debrief regarding how things were dealt with and improvements that could be made. AAA. Implementation In order to implement this plan, a team must be developed that is specifically trained to handle these emergent situations.
Each member should have a specific role better educate the team members in dealing with these patients. The members should be educated in detail regarding the plan and how to carry it out. It should be clear to all individuals on what their specific role is and each task they are responsible to implement. AAA & AS. Plan Measurement & Evaluation of In order to measure and evaluate if the plan would be effective a "mock" emergency could be staged in order to gage and evaluate how the team members react and successfully carry out the process.
To be measurable, the response time could be recorded in order to evaluate how long the team takes to respond to the emergency and how long it takes to secure and safely treat the patient. Evaluations on each team member could be done and reviewed in order to make further corrections if necessary. After each emergent situation a debriefing could be held to discuss the outcomes and areas that need to be improved in order to better the process each time. B. Unit Protocol 1). No staff member should approach the patient by themselves, always have second staff member present at all times. ). At first sign of behavioral outburst, call security team in for backup. 3). Call team overhead to alert all members at first signs of emergency, in order to initiate first steps of the developed process. 4). Never attempt to restrain the patient before or during behavioral episode without consulting MD first. 5). Do not risk putting yourself in way of harm of physical danger if patient in combative, allow security team or police office to handle extreme cases of behavioral episodes.
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