Question

a) Give one example of a sentinel event that could potentially occur in a clinical setting

b) What type of errors/ sentinel events could potentially occur to a patient, what interventions could you implement to prevent these errors

Answer 1

Sentinel events are unexpected events that result in patient death or serious physical injury or psychological .

a) common sentinel events occuring clinical settings are,

* Performing procedure to a wrong patient ,wrong site

* Unintended retention of a foreign objects

* falls related events etc.

b) The sentinel events is the unanticipated occurence of death or major loss of patient organs or limb that is unrelated to the patient condition or underlying illness. This occure by performing wrong procedure to the wrong patient or wrong site etc.

Sentinel events are prevented and managed by their policies.

* The sentinel events policy , to maintain a positive impact on patient , and improve the patient care , treatments and prevent sentinel events.

* To focus the attention of a disease specific Care program that has experienced in sentinel events .

*Understanding contributed factors in sentinel events such as causes, action failure , future problems etc.

*Disease specific Care program system, culture and process reduces the future complications.

* To improve the knowledge in sentinel events and their prevention.

These are the sentinel event policies to follow up

If any sentinel event occure ,

* First report the root cause analysis , that is identify the causes that occure in sentinel event.

* Then Action plan this is plan to identify the strategies to implement to reduce the risk of sentinel event.

* Finally survey process evaluate the facilities compliance to manage sentinel event.