please answer the following base on the video and the info underneath the question 1. Regarding the case of Charlene Murphey (separately attached
Question Answered please answer the following base on the video and the info underneath the question1. Regarding the case of Charlene Murphey (separately attached Vanderbuilt chat assignment-below), did the Vanderbuilt Nurse, RaDonda Vaught, utilize appropriate practice of the nursing process? https://qsen.org/publications/videos/chasing-zero-winning-the-war-on-healthcare-harm/When nurses graduate and begin the dynamics of caring for a group of patients, they face multiple anxieties. Will I be able to rescue a patient when complications arise? Will I know appropriate answers when physicians ask questions about patients in my care? And most importantly, will I make mistakes? Mistakes, especially medication errors, concern nurses throughout a career. In fact, it has been estimated by the FDA (and reported by AARP) that approximately 1.3 million consumers are injured by medication errors in the United States per annum, so nurses are correct to be concerned. No one wants to be responsible for potentially harming a patient.Responsible nurses learn to follow policies and procedures that are designed to minimize the risk for errors. They rigorously adhere to the Rights of Medication when dispensing patient medication. 10 rights exist in current practice; rights with * are considered unratified. (Students will practice Six Rights as indicated below for Fundy/Pharm)Right PatientRight medicationRight doseRight routeRight timeRight patient education*Right documentation*Right to refuse*Right assessment (including possible contraindications) *Right evaluation*Hospitals are legally responsible for the negligent acts of their nurses and other employees as well as the failure of their internal record and communication systems. However, no healthcare system, no matter how perfectly designed or executed, eliminates all risk, especially when utilized in an imperfect establishment: a hospital with a steady confluence of arrivals, departures, and emergencies in-between. Workarounds and shortcuts will be established, many by necessity (e.g. an Emergency patient), others by nurses who have become somewhat lax in following the rules. Awaiting trial in 2020, RaDonda Vaught (a 35-year-old float RN) had been charged with reckless homicide and elder abuse early in February of 2019. Subsequently, shock within the nursing community ensued. A felony arrest following a medication error? Wasn’t this beyond the usual response of a Just Culture that has been promoted by Nursing Leadership to improve patient safety and avoid a punitive environment, especially since the publication of the IOM’s report To Err is Human, printed in the year 2000?Although RaDonda has claimed she was “distracted” when she injected her patient Charlene Murphey with a fatal dose of a paralyzing agent, Vecuronium, prosecutors claim she made at least 10 mistakes on her way to the delivery of the drug.RaDonda was working as a float nurse in the Neuro-ICU at the time, and she was training a new nurse. In December 2017, she was called to provide a sedative for 75-year-old, Ms. Charlene Murphey, who was recovering from her subdural hematoma and had requested one prior to a PET scan due to her anxiety in small spaces. RaDonda checked in an electronic dispensing machine for Versed but did not find it, not realizing it was stored under the generic name of midazolam. Instead, she overrode the dispensing machine software by entering “VE” and obtained Vecuronium, the first drug listed. Subsequently, RaDonda injected the patient, Charlene Murphey, with the overridden drug, left her alone on a radiology table, wide awake and cognitive- but paralyzed. Ms. Murphey was unable to draw breath-let alone call for help, until she lost consciousness and her heart stopped beating.Vaught did not double-check the medication at the machine, or at the bedside, nor did she notice the warning label across the top of the vial of the drug that says “WARNING PARALYZING AGENT” as she mixed the powder with a liquid before injecting it into the patient. It seems she missed many opportunities to stop and check herself, such as calling another provider to question why the medication needed so many steps to be completed before delivery or recalling if these steps were normal practice when giving Versed, nor did she stay and monitor the patient after injecting the medication, even though she was expecting the medication to be in a premixed syringe and not admixture. If she had, she might have noticed the patient’s inability to breathe, then turning cyanotic before suffering a cardiopulmonary arrest in the scanner.Issues did exist on both sides of this case with the nurse and the facility. Vanderbilt University Medical Center had “system and management deficiencies recognized by the Centers for Medicare and Medicaid Services (CMS)”, which placed the hospital at risk for losing funding until they filed a plan for corrective action. Some issues listed were · no system in place for requiring a second check of medication when attempting to override a drug from the medication dispensing system, · no requirement to barcode scan medication given at the PET scanner, and · no requirement for vital sign checks for patients entering scanning labs. Many of these deficiencies allowed the death of Ms. Murphey to initially be reported as one of the natural causes. Two Vanderbilt neurologists report Murphey’s death to the Medical Examiner without mentioning the medication error or vecuronium. Murphey’s death is attributed to bleeding in her brain and deemed “natural” in course. Thusly, the medical examiner does not independently investigate the death. The error is not reported to state or federal officials, which is required by law, or the Joint Commission, an accrediting agency that recommends but does not require reporting. Vaught is fired by Vanderbilt University Medical Center in January 2018. An anonymous tip in October 2018 to federal and state health officials indicated an ‘unreported medication error’ as the cause of death for Murphey instead of natural causes.Parties have discussed when nurses as practitioners, new hires, and hospitals need to be concerned about the drift in nursing between a shortcut here and a workaround there, and ultimately the possibility of total collapse of patient safety systems. Question posed in court have wondered: “If RaDonda Vaught was taking liberties with nursing process practice all while training a new nurse, what then would her practice look like on a usual day sans trainee?” Health Science Science Nursing NURSING 330 Share QuestionEmailCopy link Comments (0)
