Question

Mary is a 32-year-old G2 P2 who delivered a baby boy by repeat cesarean section at 1200. She received epidural morphine for pain management. Mary returned to the mother-baby unit at 1530. She had an IV of LR infusing, but the nurse discontinued it at 2000 after Mary tolerated sips of clear liquids and then a regular diet at dinner. It is now 0800. When the nurse enters the room, she finds Mary unresponsive with a respiratory rate of 8 breaths/min.

1. Who sets the nursing standards of practice for perinatal and women’s health nursing?

2. How are these standards reflected in the hospital setting?

3. How is negligence determined?

4. The risk management department reviews the nurse chart and finds that vital signs were taken q 8 hours. The unit policy on epidural morphine states that vital signs are assessed q 4 hours x 24 hours, and the respiratory rate is assessed q 2 hours. The policy also states that an IV must be in place for 24 hours. Which of the standards of professional performance that delineate roles and behaviors for the professional nurse apply in this situation?

5. Did the nurse fulfill her legal responsibilities as a nurse?

6. A code blue is called, but Mary does not regain consciousness. She is intubated and transferred to the intensive care unit and placed on a ventilator. In a court of law, could the nurse’s care be considered negligent?

Answer 1

PERINATAL CARE IS VERY IMPORTANT ,A PERINATAL NURSE CARES FOR WOMEN THROUGH PRECONCEPTION,PREGNANCY AND THE WEEKS FOLLOWING THE BIRTH OF THEIR BABY

1.....NURSING STANDARDS OF PRACTICE IN PERINATAL AND WOMENS HEALTH NURSING HAVE BEEN DESCRIBED BY SEVERAL ORGANIZATIONS

THAT ARE- ANA

AWHONN

ACNM

NANN

STANDARDS OF CARE IN NURSING ARE GENERAL GUIDELINES THAT PROVIDE A FOUNDATION AS TO HOW A NURSE SHOULD ACT AND WHAT HE OR SHE SHOULD AND SHOULD NOT DO IN HIS OR HER PROFESSIONAL CAPACITY.

DEVIATING FROM THIS STANDARD CAN RESULT IN CERTAIN LEGAL COMPLICATION.

2....... THESE STANDARDS REFLECT CURRENT KNOWLEDGE,REPRESENT LEVELS OF PRACTICE AGREED ON BY LEADERS IN THE SPECIALITY,AND CAN BE USED FOR CLINICAL BENCHMARKING

=THE NURSE SHOULD PROVIDE FOUR PHASES OF HEALTH CARE

1.HEALTH PROMOTION

EDUCATING THE CLIENT TO BE AWARE ABOUT THE GOOD HEALTH

2.HEALTH MAINTANANCE

INTERVENING TO MAINTAIN HEALTH WHEN RISK OF ILLNESS IS PRESENT

3.HEALTH RESTORATION

RETURN CLIENT TO WELLNESS RAPIDLY

4.HEALTH REHABILITATION

PREVENTING FURTHER COMPLICATIONS FROM AN ILLNESS,BRINGING ILL CLIENT BACK TO OPTIMAL STATE OF WELLNESS

3.....NEGLIGENCE DETERMINED BY THE MAL PRACTICE ,THAT ARE;

FAILURE TO COMMUNICATE ADEQUATE INFORMATION TO THE PHYSICIAN.

INADEQUATE PATIENT ASSESSMENT ,NURSING INTERVENTIONS OR NURSING CARE

MEDICATION ERRORS

INADEQUATE INFECTION CONTROL

UNSAFE OR IMPROPER USE OF EQUIPMENT

NEGLIGENCE AS A FAILURE TO USE SUCH CARE AS A REASONABLY PRUDENT AND CAREFUL PERSON WOULD USE UNDER SIMILAR CIRCUMSTANCES.

IF THE NURSE FAILURE TO DEAL WITH OCCUPATIONAL EXPOSURE AND EXPERIENCE OF DEATH IS NOT AN OPTION BECAUSE ITS IMPACT ON NURSES AND THE PATIENTS THEY CARE FOR IN FUTURE IS SIGNIFICANT

NEGLIGENCE IS DETERMINED AS DOING SOMETHING OR FAILING TO DO SOMETHING THAT APRUDENT,CAREFUL,AND REASONABLE NURSE WOULD DO OR NOT DO IN THE SAME SITUATION .IT IS THE FAILURE TO MEET ACCEPTED STANDARDS OF NURSING COMPETENCE AND NURSING SCOPE OF PRACTICE.

4.......THE ANA STANDARDS OF PROFESSIONAL PERFORMANCE DESCRIBES A COMPETENT LEVEL OF BEHAVIOUR IN THE PROFESSIONAL ROLE INCLUDING ACTIVITIES RELATED TO QUALITY OF CARE.THAT IS STANDARD 10.QUALITY OF PRACTICE ALSO AFFECTED. THE REGISTERED NURSE SYSTEMATICALLY ENHANCES THE QUALITY AND EFFECTIVENESS OF NURSING PRACTICE.

ANA STANDARDS OF PROFESSIONAL PERFORMANCE;

STANDARD 1.ASSESSMENT

STANDARD 2.DIAGNOSIS

STANDARD 3.OUTCOME IDENTIFICATION

STANDARD 4.PLANNING

STANDARD 5.IMPLEMENTATION

standard 5A-CO ORDINATION OF CARE

STANDARD 6.EVALUATION

STANDARD 7.ETHICS

IN THIS CASE ALL THESE STANDARDS ARE AFFECTED .ALL STANDARDS PROVIDE QUALITY CARE.

STANDARDS GIVE NURSES THE NECESSARY INFORMATION THAT THEY NEED TO KNOW THE QUALITY OF CARE THAT THEY MUST PROVIDE TO PATIENTS AND ESTABLISH MEASURES IN WHICH TO EVALUATE THE CARE PROVIDED.

HERE THE NURSE DIIDNOT PROVIDE GOOD QUALITY OF CARE.WE DENOTE THE NEGLIGENT OR UNSKILLFUL PERFORMANCE OF DUTIES WHEN PROFESSIONAL SKILLS ARE OBLIGATORY.

THE NURSE DO NOT FOLLOW THE POLICY ,SHE/HE NEGLECT THE POLICY AND THE QUALITY OF CARE ALSO.THE CATEGORIES OF NEGLIGENCE HERE ARE ;FAILURE TO FOLLOW STANDARD OF CARE,FAILURE TO ASSESS AND MONITOR

=HERE THE NURSE FAILURE TO FOLLOW STANDARDS OF CARE, HOSPITAL POLICIES HAVE EVOLVED TO PROTECT CONSUMERS FROM STANDARD CARE.HERE THE NURSE DO NOT FOLLOW STANDARD OF CARE AND HOSPITAL POLICIES.

5..........IF A NURSE DOES NOT MEET THE ACCEPTED STANDARDS OF PRACTICE ,HE OR SHE MAY BE FOUND NEGLIGENT IF NEGLIGENT CAUSED A PATIENT HARM.IN MOST LIITIGATION,A NURSE IS ACCUSED OF VIOLATING A STANDARD OF CARE IN A NEGLIGENCE LAWSUIT.IN THE MEDICAL PROFESSION ,THIS IS OFTEN REFERRED TO AS MALPRACTICE.

THE NURSE DID NOT FULFILL HER LEGAL RESPONSIBILITIES,THE NURSE DID NOT MONITOR THE PATIENT CONDITION OR NOT  BE ALERTED TO CHANGES IN THE PATIENT CONDITION.HERE THE NURSE DID NOT FOLLOW THE STANDARDS OF CARE THAT AFFECT THE PATIENT.

THE NURSE SHOULD FOLLOW THE STANDARDS AND NURSES ARE REQUIRED TO COMPLETELY AND ACCURATELY REPORT THE ASSESSMENT AND OBSERVATIONS THAT THEY MAKE REGARDING EACH PATIENT IN A TIMELY MANNER

6..YES,THE NURSE CARE BE CONSIDER NEGLIGENT. A CHARGE OF NEGLIGENCE AGAINST A NURSE CAN ARISE FROM ALMOST ANY ACTION OR FAILURE TO ACT THAT RESULTS IN PATIENT INJURY -MOST OFTEN,AN UNINTENTIONAL FAILURE TO ADHERE TO A STANDARD OF CLINICAL PRACTICE AND MAY LEAD TO A MALPRACTICE LAWUIT.

THERE ARE FOUR PRINCIPLES OF NEGLIGENCE ARE

DUTY OF CARE-towards the client in the given situation

BREACH OF DUTY

DAMAGE

CAUSATION-damage or loss was caused by the breach of duty

HERE THE NURSE DID NOT FOLLOW THE QUALITY CARE AND NURSING STNDARDS .SO THE LAW CONSIDERED IT IS NEGLIGENCE.THE NURSE PROVIDE INADEQUATE CARE AFTER A PROCEDURE AND NOT GIVE PROPER CARE THE EXACT TIMINGS.