Scholarly Discussion Forum: Risk Management and Patient Safety (graded)

Order Instructions
Scholarly Discussion Forum: Risk Management and Patient Safety (graded)
Discussion
Please review the case scenario and answer the questions below.
Diane was an 80-year-old resident who was returning to the nursing home from the hospital following a left hip fracture on Friday evening. She has a history of congestive heart failure with frequent exacerbations. Her hospital discharge medication list was different than the prior medication list at the nursing home, specifically relating to her Lasix prescription. Diane was already taking Lasix at the nursing home before her hip fracture. All of her medication orders were transcribed by hand onto a new medication administration record (MAR). The old MAR, prior to the hospital stay, was not removed. The nurse checked Diane’s new orders and wrote “repeat” next to the new Lasix order and yellowed out the line. She was interrupted and was not able to finish reviewing the orders so she asked another nurse to review it for her. The second nurse reviewed the order and saw that the old MAR was still there. She removed the old MAR and finished reviewing the new MAR.
On Sunday, the medication nurse passed meds for Diane, as she had done for the past three days. She saw the yellowed line through the Lasix order and thought that the medication had been discontinued. She sent the medication back to pharmacy. Pharmacy picked up the medication on Monday. On Monday, it was noted that Diane weighed three pounds more since being discharged from the hospital. The nurse recorded the weight and placed a call to the physician, who failed to respond. At 2:00 a.m. Tuesday morning, Diane began to have difficulty breathing. Assessment findings included +4 pitting edema, a BP of 190/110, a HR of 120, and respirations at 28. Crackles were heard through her lungs. The on-call physician was consulted and an order was placed to transfer Diane back to the hospital. She went into cardiac arrest while waiting for the ambulance and was not able to be resuscitated.
Provide your risk analysis for this event. Develop an action plan for the prevention of events like this one in the future. Which theory or model would you apply in developing your action plan?

The initial posting must meet the following expectations:
• Address the TD question in a thorough, substantive manner.
o Demonstrate application of scholarly resources.
 Provide relevant evidence of two scholarly resources in the initial post, clearly stating how the evidence informed or changed professional or academic decisions.
 One scholarly resource must be from a nursing peer-reviewed journal.
o Demonstrate application of course knowledge.
 Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life, professional situations.
 Compare concepts and principles from the weekly lesson with personal experience as it applies to the practice setting.
• Include correct spelling, grammar, punctuation, syntax, and sentence and paragraph structure.
• Include a minimum of two scholarly sources, current within five years, to support information presented.
o Scholarly sources required for the TD must be sources that are separate from course-related sources and/or reading assignments.
o If course-related sources or readings are used as a source in the TD, they must be in addition to the required scholarly sources for the discussion and must be cited following the current APA guidelines.
o If used as a source in the assignment, course-related readings must meet the criteria for scholarly work: current within five years.
o Sources older than five years may not be used without the permission of the course professor.
o Correct APA format for citing and referencing sources is applied.

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