Introduction
The principles of leadership nursing constructs the model for understanding the challenges of health care practice within health care organization. The dimensions that analyze the problem in the case below is effectively built in root cause analysis establishing the cause of the problem in a bid to map out the solutions within the management and execution of health care principles. Once the cause is identified and a plan of action established it is useful to conduct a failure mode and effects analysis (FMEA) to reduce the likelihood that a process would fail. As a member of the healthcare team in the hospital described in this scenario you have been selected as a member of the team investigating the incident.
Root Cause Analysis
From the case it is evident that the nurses in the hospital were few and overwhelmed leading to ineffective approach to treating Mr. B. Nurse J is now fully engaged with the emergency care of the respiratory distress patient which includes assessments evaluation and the ordering respiratory treatments CXR labs. According to Braaksma Klingenberg & Veldman (2013) the fundamental challenge of understanding the problems is to underscore the extent to which the problem in Mr Bs case was formalized. In light of this it is imperative to note that the problem of ineffective health care evidenced in the hospital is caused by inadequate staffing in the emergency wing in the hospital. Lack of adequate staffing is synonymous to inefficiencies in addressing the vast challenges and demands evident in the emergency room (Chen 2003). This is informed by Respiratory therapy is in-house and available as needed. At the time of Mr. Bs arrival the ED staff is caring for two other patients. One patient is a 43-year-old female complaining of a throbbing headache. The patient rates current pain at four out of ten on numerical verbal pain scale.
With the evident workforce issues as well as patient safety at stake it is evident that the culture of nursing care in the hospital does not map out the ethical tenets of responsive health care administration hence producing reduced and undesired outcomes of health care delivery (Fibuch and Ahmed 2014). Evident from the case it is plausible to note that the patient states that she has a history of migraines. She received treatment remains stable and discharge is pending. The second patient is an eight-year-old boy being evaluated for possible appendicitis. Laboratory results are pending for this patient. Both of these patients were examined evaluated and cared for by the ED physician and are awaiting further treatment or orders.
The question of inadequate staffing comes with inadequate training. The process that Mr. B went through details a shortcoming in the staff training and mentoring. In view of this it is plausible to note that the inability of nurse attending to Mr. B to determine the dangers in the evidenced from the health history marks serious indicators in referring the patient to other facilities that are recognized with brain injuries. However the nurse decided to address the situation without any knowledge about the case (Guerrero & Bradley 2013). This is revealed by the revelation that all practitioners who perform moderate sedation must first successfully complete the hospitals moderate sedation training module. The training module includes drug selection as well as acceptable dose ranges. Additional (backup) staff was available on the day of the incident. Nurse J had completed the moderate sedation module. Nurse J had current ACLS certification and was an experienced critical care nurse. Nurse Js prior annual clinical evaluations by the manager demonstrated that the nurse was meeting requirements. Nurse J did not have a history of negligent patient care. Sufficient equipment was available and in working order in the ED on this day. This is a clear breach of the codes of practice enshrined in the guidelines fir effective nursing care. Supposing the nurses staff were trained the patients death would have been avoided.
Process Improvement Plan
The efficiencies in health care process must be implemented within the model of systematic examination. The foundational aim is to improve the response of the nurses to the patient positively affecting the quality of the health care service provided as well as the general process involved in treating the patient. According to Gaur and Bhardwaj (2004) it is plausible to note that the process must be improved by prioritizing the involved processes from admission of the patient tracking the history of the problem providing immediate response and in the case of cases beyond their level refer the patient to other facilities with capacities and abilities. Such prioritization approach will extensively address the workforce issues as well as patient safety in the health care organization. As a result the hospital mist establish the current state of patients safety evaluate the experiences of relationship between nurses and patients in terms of capacity address supervisory and leadership dimensions of the hospital routines to emphasis of the education and knowledge levels among the health care specialists. This will extensively update procedural uses suggesting the patient safety improvement within the setting of emergency response.
Application of three steps of the FMEA
In the case of Mr B it is evident that a number of steps must be followed within specific and standardized response to the problem.
The hospital must assemble cross functional staff and experts with diverse knowledge about health care provisions the process and the needs of the patient. () notes that functional basis of the process will be composite of designing the quality measures to address the efficiencies of the health care process.
Similarly the hospital must identify the FMEA scope to establish the systemic basis of the health care process and design. At this step it is imperative that the boundaries of the FMEA scope must be detailed with the use of flow charts s that every health care stakeholders understanding the subject in the FMEA.
Identifying information in the FMEA form is critical because it maps out the seriousness and frequency of the occurrence of the problem hence establishing the periodic approaches to improve the control mechanisms of health care provision.
There is need to identify the function of the scope Predict the ways failure could occur within mechanisms of potential failure mode.
Establish consequences in the system within the dimension of process relation determine the potential root causes and the occurrence rating (Braaksma et al 2012).
Conclusion
The principles of leadership nursing constructs the model for understanding the challenges of health care practice within health care organization. There is also a relationship between the occurrence of the adverse events and the organizational aspects of the health care services they are supposed to receive. Such events have a negative effect on patient health outcome.
References
Braaksma A. Klingenberg W. & Veldman J. (2013). Failure mode and effect analysis in asset maintenance: a multiple case study in the process industry.International Journal Of Production Research51(4) 1055-1071.
Braaksma A. Meesters A. Klingenberg W. & Hicks C. (2012). A quantitative method for Failure Mode and Effects Analysis.International Journal Of Production Research50(23) 6904-6917
Chen C. (2013). A developed autonomous preventive maintenance programme using RCA and FMEA.International Journal Of Production Research51(18) 5404-5412
Fibuch E. & Ahmed A. (2014). The Role of Failure Mode and Effects Analysis in Health Care.Physician Executive40(4) 28-32.
Gaur S. & Bhardwaj A. (2014). Criticality analysis of human resource functions using failure mode effect analysis: a case study.International Journal Of Human Resources Development & Management14(4) 205-218.
Guerrero H. H. & Bradley J. R. (2013). Failure Modes and Effects Analysis: An Evaluation of Group versus Individual Performance.Production & Operations Management22(6) 1524-1539