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Asked by Dejahingle

You are the nurse manager on the ICU floor. A 20-month-old boy was admitted to the unit following a Fontan surgical procedure for hypoplastic left heart syndrome. The child initially made good progress. He was weaned from inotropic support and tolerated enteral liquids on the first postoperative day. That evening, the child developed respiratory distress with acidosis and fever. The child’s nurse notified the on-call ICU attending , who came in from home to manage the child’s respiratory status. The surgeon called from home to check on the child at midnight and spoke with the patient’s nurse, who indicated that the child had suffered respiratory deterioration and that the ICU attending was at the bedside managing the patient . The surgeon requested an echocardiogram, but did not speak directly to the ICU attending, and the cardiology fellow who performed the echocardiogram communicated results to the surgeon, the child’s attending of record for this admission. After stabilizing and monitoring the child’s respiratory status, the ICU attending returned home . The nurse communicated with the ICU attending by phone and pager through the rest of the night, as the child’s status was not improving as expected. The nurse assumed that the ICU attending was communicating with the surgeon, and thus did not contact the surgeon or cardiologist. The child suffered a cardiac arrest at 7:00 AM from low cardiac output. Despite aggressive resuscitation efforts, the child suffered massive brain injury and subsequently died. 

Related question #1

Using the fairness algorithm to analyze this error determine who (if anyone) should be held accountable for the error. If the information was not provided just state not applicable.
Did the individuals intend to cause harm?
Did they come to work drunk or impaired?
Did they do something they knew was unsafe?
Could two or three peers have made the same mistake in similar circumstances?
Do these individuals have a history of
involvement in similar events?

Related question #2
As the Nurse Leader identify at least three structural, process, and outcome measures for which you might collect data that contributed to this error. Select at least one of these measures and specifically identify how you would collect the data. Then describe how you would use your findings to increase the likelihood that future practice on the unit will be evidence based.

SCIENCE
HEALTH SCIENCE
NURSING
NURS 4200

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