Scenario Discussion

Health Care Law

Scenario 2: Delegation

Registered nurses (RN) owe a duty of care to patients in a wide range of healthcare settings, including nursing care effectiveness, among other elements. This team includes the patient and licensed professionals and paraprofessionals who are there to assist the patient in their daily activities. As an R.N. working on a busy women’s unit with an experienced UAP and LPN, I will keep patient 3 as my assignment. This is because patient 3 involves clinical reasoning, nursing judgment, critical decision making, and patient education regarding breastfeeding and birth control methods, which neither LPN nor UAP can detailly give (Reiner, 2020).

Delegation is the practice of entrusting the performance of patient care activities and duties to unlicensed assistants while yet maintaining responsibility for the results. Making nursing decisions cannot be delegated by a qualified nurse. The essential principles of protecting the public’s health, safety, and well-being guide all decisions about delegation and assignment (Barrow & Sharma, 2018). Nursing and healthcare decisions should represent the nurse’s primary dedication to the patient, an individual, a family, a group, or a community.

To help registered nurses practice in situations when they delegate responsibilities to unlicensed helpers, the American Nurses Association has published Principles for Delegation to Unlicensed Assistive Personnel (UAP) (Bakr, 2021). R.N.s should verify with their state board of nursing to see any discrepancies in delegation policies between their state and the federal government. The registered nurse is ultimately responsible for deciding whether or not to delegate to unlicensed helpers. As such, I will give patient 2 to the UAP based on the above factors. Simple, basic activities like making vacant beds, assisting patients with cleanliness, and feeding meals fall under their purview. Because patient 2 is stable, there is no current bleeding, and the incision is open to the air, I will work closely with UAP to ensure that the patient receives the best possible care.

Finally, under the direction of an R.N. or another healthcare professional, LPNs offer primary nursing care such as feeding, dressing, or bathing patients and monitoring patients’ vital signs, such as their blood pressure and body temperature. Therefore, these make them ideal for patient 1, which involves new admission in which the patient has Bartholin Gland cyst and Abscess with an elevated temperature, abnormal labs, alert, and oriented. I will task the LPN to supervise the patient’s vital signs and monitor any complications such as cyst enlargement that will make one side of the labia majora hang lower than the other and manage fever and chills.

Scenario 3: Competencies of AHRQ

Healthcare Research and Quality (AHRQ) is the primary federal agency responsible for enhancing the quality and safety of the United States’ healthcare infrastructure. AHRQ aims to assist healthcare providers and systems in providing high-quality, safe, and cost-effective care (AHRQ, n.d.). The three primary competencies, including health systems research, practice improvement, and data and analytics, help AHRQ achieve its purpose.

It is possible to make healthcare more economical, safe, effective, and patient-centered by utilizing findings from health systems research. Health care systems and professionals’ benefit from AHRQ’s research investments by gaining access to fresh evidence (AHRQ, n.d.). It is possible to develop healthcare benefits and drive policy using findings from health systems research, for example. This research helps frontline clinicians and patients make better decisions and supports health care delivery systems.

Concerning improving practice, AHRQ aims to enable health systems and frontline clinicians to provide safe, high-quality treatment at a reasonable cost (AHRQ, n.d.). People in the healthcare industry want to use tried-and-true ways to better the lives of the patients they serve, so they research, develop, test, and disseminate tools and tactics to make this happen. AHRQ statistics and analysis enable healthcare decision-makers to comprehend how the operation of the American healthcare system and available chances for improvement.

Scenario 1: Case Study

The case study that interested me was Ashcraft Jill, whose profession was put on probation. According to the case study, Jill committed two accounts of violation. First, Jill did not attain the required standards of satisfactory and prevailing nursing practice by giving Ativan to K.S. within an hour apart when the order was for every 4 hours as needed; administering 5mg Ativan to K.S. over 7 hours above the ‘prescribed amount—of 1mg every 4 hours; administering Precedex to K.S. in a 0.7 mcg/kg drip per hour when the order was for a 0.3mcg/kg drip per hour; and administering Precedex two additional times with bolus within one hour when there was no physician order. On the second account, Jill committed unprofessional conduct due to inaccurate recording by failing to record any administration of Precedex or Precedex with bolus to patient K.S on or about May 17, 2015. In layman, I can sum up these accounts in one word: Medication error. Errors in the patient’s treatment can result in a new condition, such as itching, rashes, or scarring of the skin. Medication errors can cause severe harm or even death to patients, despite how rare they are.

A sentinel event is a patient safety incident that results in death, long-term harm, or severe temporary harm (Lippincott NursingCenter, 2004). Patients and medical professionals alike suffer when a sentinel event occurs. Based on this case, the two accounts of violation graduate it to sentinel event due to medication error that harmed the patient.

For the most part, suspensions are only for a few months. However, if your license is revoked, it will be permanently removed from your hands. If you have had your license revoked, you cannot apply for a new one for at least one year and, in some cases, more than a year, depending on the severity of the infraction. If someone is put on probation, they may continue working as a registered nurse under the BRN’s supervision and guidance. The following are only required for a set period of time; nevertheless, their license might be suspended or revoked if they do not adhere to them within that timeframe.

Licensing and monitoring licensed nurses in Florida are the responsibility of the Florida Board of Nursing (FBON), which also provides education, discipline, and rehabilitative services when necessary. This would apply to the case chosen since it is responsible for issuing licenses to healthcare personnel.

References

AHRQ. (n.d.). AHRQ’s core competencies. Agency for Healthcare Research and Quality. Retrieved May 23, 2022, from https://www.ahrq.gov/cpi/corecompetencies/index.html

Bakr, M. M. (2021). An Exploration of the Relationship between Unlicensed Assistive Personnel Role and Patient Safety. Journal of Nursing and Health, 2(4), 105-112.

Barrow, J. M., & Sharma, S. (2018). Five rights of nursing delegation.

Lippincott NursingCenter. (2004, November). Clinical rounds: 10 most common Sentinel events. Lippincott NursingCenter | Professional Development for Nurses. https://www.nursingcenter.com/journalarticle?Article_ID=531210&Journal_ID=54016&Issue_ID=531132

Reiner, G. (2020). Nurse Legal Case Study: Wrongful delegation of patient care. Tennessee Nurse, 83(2), 13-14.