|Perfect Number of Pages to Order||5-10 Pages|
Discussion of Delegation to Assistive Personnel
Scenario for the First Meeting:
Case Study of a Nurse:
The CNA was visiting a mutual patient and informed her that her gastrointestinal (GI) tube had come out during the night. The RN informed the CNA that the patient would need to go to the emergency room to have the tube re-inserted because she would not be able to see the patient for many hours. The patient’s family preferred not to take him to the emergency room, preferring instead to wait for the RN to see him. The CNA told the RN that she had re-inserted multiple GI tubes while working at a nursing home and that she felt confident doing so with this patient’s tube. The RN consented to allow the CNA put the tube in, but urged her not to resume feedings. The CNA contacted the RN 45 minutes later to confirm that the tube had been re-inserted without difficulty and that proper placement had been confirmed. The nurse noted that the patient was receiving tube feeding when she arrived at the patient’s home several hours later. When questioned, the daughter stated that she commenced tube feedings shortly after the CNA had departed and that she had not been advised to wait. The patient was complaining of abdominal pain and feeling sick, according to the RN. During physical examination, the patient’s abdomen was swollen and palpation revealed pain. The nurse called 911 once the feeding was stopped, and the patient was taken to the nearest hospital, where she was diagnosed with peritonitis as a result of the GI tube being mistakenly put in the peritoneal cavity. The RN and the home nursing agency were both sued by the family. The following were among the claims leveled against the RN:
Patient care is improperly delegated to unlicensed assistive employees (e.g., a CNA);
Failure to adhere to the agency’s policies and procedures regarding delegation, GI tube placement, and supervision of unlicensed assistance workers;
Failure to call the referring provider and acquire an order to reinsert the GI tube; and Failure to contact the referring provider and receive an order to reinsert the GI tube.
Failure to ensure that the patient and family were informed about the re-insertion of the GI tube and the holding of GI feedings.
Prior to a lawsuit coming to trial, a settlement was struck. The nurse was also reported to the National Practitioner Data Bank, as required by state law (NPDB). The overall cost of defending and settling this litigation on our insured nurse’s behalf surpassed $255,000.
1. What should the nurse have done to properly regulate the situation and reduce the risk of erroneous delegation? Provide a detailed response as well as a reference. There are two resources that are based on evidence.
2. Identify 3 to 4 risk control recommendations that may have been used in this scenario based on what you learned from the necessary video.