Question

Evaluate the following case study. Determine the appropriate steps that the risk manager should take. What ethical, legal and safety issues exist? Justify your answer.

Tim Hopkins is a 83 year old Alzheimer's patient with a history of falls. He was admitted to your hospital and the first night he was there he fell walking to the bathroom. A nurse found him on the floor. There was bruising in Mr. Hopkins' leg and he stated that it hurt. The nurse proceeded to complete the incident report and indicated she found the patient sitting in the chair. The incident report was submitted to the risk manager. The risk manager was discussing the injury with the nurse and the nurse said "when I found him on the found floor he was in pain and wanted to sit in a chair so I moved him to a chair."

Answer 1

While handling any incidence of fall the risk manager should take following step while handling this case.

1. root cause analysis

2. strategies to prevent incidence of fall

3. Educating and sensitizing nurse on prevent fall

4. Report and record the incidence

Legal issue that has arise after fall that the nurse have not informed the resident doctor in order to take immediate action and once initial treatment is done the patient was to be moved to a safe place, but here the nurse made the patient to sit on chair apart from that patient did not receive appropriate medical attention. This is medical negligence. Once after fall the patient should be assessed for neurological function which was not done in this case.

Ethical issue in this case was the nurse did not followed the preventive measures to prevent injuries. Since the patient is a known case of Alzheimer’s disease. Such patient falls in High risk Vulnerable patient.

Safety issues are :

Initial preventive measures like:-

1. Risk for fall assessment

2. conducting routine rounds

3. Providing calling bell and side-rails to prevent fall

4. This patient was to be kept near nurse’s station for close observation.

Risk manager should take the following steps:

1. Move the patient from chair to bed. In order to prevent further risk for injury

2.Inform resident doctor to assess the patient. Eg: GCS, physical examination and provide immediate medical attention.

3. Take steps to prevent incidence by taking explanations from nurse for not following the hospital protocol in preventing fall.

4. planing and providing awareness campaigns to all nursing staffs to prevent such incidents in future.

5. Make an action plans to prevent fall and implement.