Question

There has been a car accident and the driver if the car was brought to PRU. She has been stabilized in the emergency department; however, transferring her to another facility 40 miles to ICU away would not be appropriate in her health status for her injuries would not sustain life.

The patient has to be placed in ICU in the next 1-2 hours. The night supervisory gains composure and describes the status of patients occupying the 4 ICU beds.

Patient A- A 59 year old female, comatose, stroke victim who had been in ICU for 33 days; uncertain prognosis; retired, with no family

Patient B- 2- week old premature male, has Down's syndrome and has been in ICU since birth; hospital has brought a legal action to permit surgery to repair a duodenal atresia, a procedure the parents had not permitted; family in adjacent city.

Patient C- 35 year old male who underwent emergency appendectomy, developed severe wound infection and septicemia, source of infection is unknown; because of previous anaphylactic shock in reaction to antibiotics; requires ICU care; bachelor; aged mother in city.

Patient D- 13 year old female undergoing chemotherapy for leukemia with an experimental drug; has been in remission three times in the past; close monitoring of the experimental protocol and potential reaction to drug requires ICU care; family in city.

New Patient- 24 year old patient; college honor student in physics. scholarship winner; pregnant; engaged; no family known.

The supervisor ended the brief description by asking, "What should I do?"

Randall has to make a decision.

1. What should Randall do? Why is your choice the best answer? Support your thoughts.

2. What steps should be taken in reaching a decision?

3. Describe a means to avoid a similar problem in the future and how to deal with issues as they arise. (Adding additional ICU beds is not a budgetary or space option)

Describe your facility

Describe your staff

Explain any legal or ethical issues of the situation

Explain your management style/theory

Discuss cultural issues that the situation presents

Explain budgetary plans or concerns

Explain credentialing or accreditation issues the situation present

Describe your response to the situation

Answer 1

Ans) Cultural issues:

- There are no real cultural issues due to the hospital is already approved and used in the city. If the addition is added on to the hospital it would help further the trusting relationship with the city that the hospital is looking to expand care and help.

- The budget concerns would be if it will be enough to open a new hospital wing with the needed equipment and staff. If not, does the hospital want to take this venture on? Are the costs worth the possible output?

- The accreditation and credentialing are based off state and federal laws. The hospital would not be able to function if it did not have the correct credentials. Also, legally a patient will not be treated by and healthcare provider who is not certified. These things are always checked in the background check portion of an interview and when JHACO and the state require to see certification and recertifications.

- I will graciously accept his donation. I would inform him of my understanding of his stipulations. But before I can make a commitment to the donations request I would have to run it by the Hospital director or board first. Once approval is made for the donations use, then we can proceed forward with the requests put onto the donation. The final answer shouldn’t take to long based off the amount of the donation. I would say about 2-4 weeks, since the hospital will need to crunch the numbers and weigh each possibility of what this type of new addition could bring.