Prof. Nursing Leadership week 6 peer responses

In your response to your peers respond to the following:

· Consider how healthcare systems may have helped or hindered the peer’s situation as described.

· Provide at least one recommendation for your peer in the situation described.

Respond to your peer in one paragraph. These posts should be thoughtful, respectful, and add value to the discussion. This response could include relating your experience to whatever they initially posted. Use a different scholarly source, reference it using APA format, and include in-text citations when using the referenced material in your post.

1st peer post

McKenna Davis

Apr 8, 2024 at 7:19 PM

An example I found of  a nurse manager or leader who was held legally responsible for a patient outcome, was that of a male patient in his 90s who was admitted to a rehabilitation/skilled nursing facility for physical therapy following a hip fracture. When the patient was admitted he had a deep tissue injury on his sacrum and blanchable redness on both heels. The facility had a treatment nurse (wound care RN) who was responsible for wound care. While this particular resident was at the facility, the wound care nurse was on leave, and the DON (who is responsible for staff assignments) assigned an LPN to be the wound care nurses replacement who was not properly or adequately trained for wound care. As a result, the resident’s wounds were not treated properly, and their pressure injuries on their heels and sacrum worsened during their time at the facility. The resident was admitted at the facility for 27 days in which time he developed stage III bilateral pressure injuries to his heels and hyponatremia resulting in hospitalization.  Allegations against the facility included failure to ensure proper treatment/services to prevent pressure injuries, failure to ensure proper nutritional status and sufficient fluid intake contributing to tissue breakdown, failure to maintain proper clinical records on each resident, and failure to maintain accurate pressure documentation. While these were issued to the facility allegations specifically against the DON included: failure to perform nursing duties in a competent manner (incompetence), and unprofessional conduct (Nursing Service Organization, 2023). 

I think that the professional standard that was not met was: 
assignment, delegation, supervision as well as 
failure to warn. 

The role of the nurse leader/manager: The DON was responsible for staff assignments, facility policies and procedures, and overall operation of the nursing team. She should have noted that the LPN was not properly trained on wound care, ensured that changes to the patients status/condition were noted in the healthcare information record, reported to the charge nurse, as well as the residents physician and family. 

The burden of responsibility and liability that nurse leaders assume in their role is significant. They are responsible for making sure that all of the nursing staff under their leadership adheres to policies, evidence based practice, and regulations ensuring safe patient care. In addition, they can be held responsible legally for actions (or omissions) made by their staff that results in poor outcomes. 

Resources, strategies, or support that can be used to help mitigate liability, and could have improved this patients outcome include maintaining open communication with staff and creating and promoting a culture of safety and accountability. This DON should have held her staff to a higher standard and been very clear about the expectations for doing full assessments on patients, charting abnormal findings, and reporting these findings to necessary healthcare professionals/members of the interdisciplinary team (Hofmeyer et al., 2021). In addition, this DON should have done a better and more thorough job of staffing a replacement for the wound care nurse. 

References

Hofmeyer, A., & Taylor, R. (2021). Strategies and resources for nurse leaders to use to lead with empathy and prudence so they understand and address sources of anxiety among nurses practicing in the era of COVID-19. 
Journal of clinical nursing. https://doi.org/10.1111/jocn.15520

Nursing Service Organization. (2023). Nurse leader case study: failure to perform director of nursing duties in a competent manner. https://www.nso.com/Learning/Artifacts/Legal-Cases/Failure-to-perform-Director-of-Nursing-duties

2nd peer post

Kala Neopaney

Apr 10, 2024 at 12:14 AM

I choose discharge planning or transfers between units or healthcare organizations. Imagine a scenario where a nurse manager oversees the discharge planning process for a patient who requires specialized care upon leaving the hospital. When a patient moves between healthcare places for special care, the nurse manager in charge of the transfer must ensure all the patient’s medical records and care instructions are sent to the new place. If this isn’t done correctly, the patient might have to wait longer for treatment or may not get the proper care, which could make their condition worse or cause other problems. If harm comes to the patient because of this, the nurse manager could be legally responsible.

The professional standard wasn’t met because there was inadequate communication and coordination of care. Nurse leaders must ensure patients move smoothly between places, with all their medical info and care continuing as needed. In this situation, the nurse leader supervises the discharge process, ensuring everything is done to help the patient, like sending medical records, communicating clearly between nurses, and following up on abnormal test results. Nurse leaders have a big responsibility for patient safety and care continuation. They must meet professional standards, follow rules, and ensure their staff gives good care. Not doing this can lead to legal trouble for negligence or malpractice. To handle this situation, the nurse leader can use standardized processes and checklists for discharge planning, electronic health records for secure info transfer, and train staff on discharge planning, communication, and patient safety. Evidence shows that medication reconciliation boosts patient satisfaction and treatment outcomes during transitions from hospitals to other care settings or home. Clear communication between providers and patients, through methods like post-discharge calls and telehealth, is vital for successful care transitions (Mansukhani et al., 2015). Effective transitional care, which includes accurate medication reconciliation, is crucial for improving patient outcomes, lowering hospital readmissions, and cutting healthcare costs.

Reference

Mansukhani, R. P., Bridgeman, M. B., Candelario, D., & Eckert, L. J. (2015a, October). 
Exploring transitional care: Evidence-based strategies for improving provider Communication and Reducing Readmissions. P & T : a peer-reviewed journal for formulary management. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606859/