HCS/449 Version 5 / 1
University of Phoenix Material
Case Studies
Select one of the following case studies to analyze in your Week Five Learning Team assignment.
Case Study 1: Night Supervisor
At 1:45 a.m., Jimmy, the night supervisor at a local nursing home,is informed by police that the nursing home needs to evacuate due to a cresting river nearby. The river is scheduled to crest by 5:00a.m. Jimmy has 60 patients in need of relocation.He only needs beds and furniture for a short period of time. The weather service has estimated that the evacuation will need to last for 24 to 36 hours.
There is a regional hospital nearby, but it is undergoing remodeling. Jimmy calls the head RN at that hospital and finds that they have 54 beds open, but many are in a wing that was just repainted.
Jimmy needs to make a decision quickly. What should the night supervisor do in this situation? What procedures are in place?
Case Study 2: Risk Management
Tracy is the risk manager at ABC Medical Center, a 300-bed urban teaching facility. One morning, she receives a call from Jerry, the medical director of surgery, asking her to come immediately to one of the operating rooms where a patient had been scheduled for an amputation of the right foot.
As Tracy approaches the OR, she reviews the preoperative care required for all patients having surgery. The identification of the patient, the verification of the involved limb, and the time out procedure are all in place.
Tracy enters the OR and immediately notes the concern on the faces of the medical and nursing staff present. The Medical Director proceeds to explain the reason for the call:the wrong limb has been surgically removed from the patient.
Tracy now has a series of notifications to complete as this is a sentinel event. Who needs to be notified, and what follow-up process must be completed to remain in compliance with state and the Joint Commission requirements?
Case Study 3: Emergency Room Visit
Betty is a 64-year-old woman who reported to the emergency room of her local hospital on a Friday evening after falling down 10 stairs. It was determined that she had a distal fracture of the right wrist, and an orthopedic resident responded within 2 hours.
Betty was instructed to call the orthopedic surgeon on call on Monday morning to be seen as soon as possible. In addition, the resident indicated surgery would be done by Thursday at the latest. She was given a soft cast at the time and provided with instructions for care and a prescription for pain.On Monday morning she called the orthopedic surgeon’s office and was told the earliest appointment was Wednesday, as the doctor is never in until Wednesday.
Bettywent back to the ER on Mondaybecause of increased pain and swelling. She was seen by a physician assistant who loosened the dressing and prescribed additional pain medication to cover until the visit on Wednesday. Betty questioned the appointment and availability of another physician, but she received no response.
On Wednesday, during a snow emergency,Betty’s brother drove her to the office of the orthopedic surgeon. It was decided that surgery would be her best option. The surgeon, however, told Betty that he did not operate on hands, and she was referred to another specialist.
When Betty returned home, she called the new nurse manager at the emergency room, Linda, to discuss the quality of care and the referral process. The main question was why a physician would be on call when he was not available as the resident indicated. In addition, the PA was abrupt, did not answer questions, and appeared bothered by the entire process. Betty also indicated extreme dissatisfaction at expecting to have surgery as instructed by Thursday. What should Linda, as the new nurse manager, do to provide quality care to all patients?
Case Study 4: Records Management
Sam is the records manager for an urgent care clinic in a midsize city. His clinic is merging with another nearby to form a large urgent carethat can meet the needs of the growing suburban area. Sam knows that his clinic uses a number code system for records management. The other clinic uses an alphabetical system to code their records. He also knows that the new urgent care will have an electronic records management (ERM) system that is new to all records employees. The merger and transition to a new facility will be happening in four months. What does Sam need to consider in this move? How can he combine the two methods of record management? Which method should the new clinic use? What challenges does the new ERM system pose and how can Sam overcome these challenges?
Case Study 5: Technology
Caitlin is the office manager in a large private pediatric practice in the city. The physicians met and decided to switch all records to a laptop-based system where nurses and doctors will log all records in a laptop. All patient interactions, data, and records will be entered primarily into the laptop, and no hand-written records will be taken. Caitlin is asked to come up with a plan for the conversion. This office has 13 doctors, 10 nurses, and 2 physician’s assistants that will all be using the laptops when evaluating patients. What should Caitlin consider in her conversion plan? How should patient questions be dealt with? What other concerns should Caitlin take into consideration when formulating her plan?
Case Study 6: Security
Janice is the head nurse in a 24-room Alzheimer wing of an assisted-living center. All 24 patients in this wing have various stages of Alzheimer’s disease. Due to the nature of the disease, the unit is permanently locked so that patients are not permitted to leave the area. Flo, one of the residents, is frequently found to be waiting at the door and attempts to leave when the door is opened. Janice has informed the entire center about security issues in her wing and all staff members are required to ensure that no one enters or leaves when the doors are opened. One evening, Janice receives an emergency call from Flo’s family saying that when they arrived to visit her, she was not on the ward. Janice now has a series of notifications to make. Who does she need to notify? What follow-up procedures should be put into place to ensure this does not happen again?