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Question Answered step-by-step Benchmark – Professional Capstone and Practicum Reflective Journal… Benchmark – Professional Capstone and Practicum Reflective Journal week 10  Health Science Science Nursing NRS 493VN Share QuestionEmailCopy link Comments (0)

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Question Answered step-by-step A 58-year-old man was recently diagnosed with stage IV liver cancerand has suffered a severe occurrence of congestive heart failure The doctors determined that the patient is not a candidate for any further interventionsWhich service should be arranged given this prognosis?O Home health careO Adult day careO Skilled nursing facilityO Hospice care Health Science Science Nursing C 426 Share QuestionEmailCopy link Comments (0)
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Question Hello, Below is the discussion instructions. I need to lead the discussion so please help me do so. My partner has posted her discussion post and i pasted it below. Please help me initiate a discussion, add on her post and put in 3 concepts too that resonate to a DNP project. I will attach info regarding the possible concept you can choose from. Discussion #4 - Error Disclosure and Difficult Debriefingsaccess the IHI Modules on Improvement: www.ihi.org(Links to an external site.) (Links to an external site.) http://www.ihi.org/Under the Education tab go to the IHI Open School and register as a student if you have not used these before. It is free to students. Register for the Basic Access. Once done it will take you to a series of modules. For this assignment focus on the modules for Patient Safety especially the starred ones, 101 to 105. However, there is a lot of information contained in these modules and please feel free to review as many as you like to form your discussion. The new ones on Graduate Medical Education are interesting as well. Discuss 2-3 concepts that resonated with you and how you will consider this during your DNP project. If you choose to discuss errors you have experienced or witnessed, please do not disclose ANY identifying information of individuals, companies, or groups that were involved.POSSIBLE CONCEPTS:Reliability: Normalizing deviance is a problem because it erodes reliability. Reliability is the ability to successfully produce a product to specification repeatedly. In health care, that "product" is safe, efficient, person-centered care.Improvement and measurement: strengthening work processes and patient outcomes using improvement science, including measurement over timeTransparency: openly sharing information about the safety and quality of care with staff, partners, patients, and familiesContinuous learning: regularly identifying and learning from defects and successesReliability: applying best evidence and promoting standard practices with the goal of failure-free operation over timePARTNER'S POST: Classmates, this is us playing devil's advocate. Please answer the following questions as honestly as possible so that we may have an open discussion. If you want to discuss something that actually did happen either don't mention names or change it all to let's say a foreign country and patient a foreign name. For example, "I had a patient in Paris France name Pierre."Everyone makes mistakes. We have all made mistakes. If you feel comfortable, you may discolose an error. 1. Please discuss the feelings that you have had at making a mistake and what is behind what you felt.2. Recently (that's relative), most medical facilities have adopted an incident reporting system that has been put into place to replace the old system. The old system was pull you into the office and discuss an incident. Please discuss the pros and cons of the old system vs the new system. Which do you prefer?3. The feelings often stay with you for years influencing your conduct. Do you feel that you were "debriefed" well enough? Do you feel that just having someone(preferably not a boss- a trusted college or group) to talk with about an incident would help you get over the trauma? Do you have any suggestions about how this should be done?This is my posting to the first prompt by the leaders of the group1. Being very honest here. I feel like I am going to faint, I can feel the blood draining out of my head. It feels like I just swallowed a bomb. Later, after reviewing and correcting the mistake, I actually write a personal account of the incident and send it up my chain of command. Afterwards, I want to cry, tear my hair out. But I give myself the "talk", everyone makes mistakes. Learn from this, take what happened and make yourself a better nurse, a better human. It actually stay with you and does make me more observant, more present.My mistake, that I felt was horrific and has remained with me even now, happened while I was a medication technician in an assisted living at the beginning of nursing school. Patients would come up to the med cart outside of the cafeteria before lunch, you pull their medications, verify who they are and give the medication. My mistake was one of having been distracted. I pulled one patient's medications got pulled into the office by one of the bosses to answer a question, came back and passed the medication. Problem was during the time that I had gone into the office. The little old lady had gone into the cafeteria and a very similar looking old lady came and stood in front of my cart. I felt devastated. I realized what had happened as the patient was walking away. I immediately went to the DON at the facility, we discussed the occurance. Notified the MD, the patient, and the family. I was lucky the patient did not have any allergies to any of the medications. The doctor was very understanding. The patient was very understanding. Understandably, the family of the patient was the most upset. I had to do the best that I could to explain how it happened and what steps wer being taken to monitor & correct the situation.2. Old vs new? Old system made me feel as if I were being persecuted, almost as if I had done it because I was a bad nurse. New system of incident reporting and correction, is open and helps us to be able to admit mistakes. My most recent experience has been the most positive in all of my years. Mistake were openly discussed at huddle, beginning of shift, for the whole staff. How it possibly could happen, what should have happened, open discussion about what else is happening and suggestions asked for. Loved this method. It allows everyone to feel that system breakdowns have an ability to be corrected.3. My debriefing of the mentioned incident was done very well. The DON of the facility told me that everyone makes mistakes. Always admit to them, follow up as quickly as possible, don't beat yourself up too badly but keep it in mind to be sure that you don't make similar mistakes again. She also told me to find a friend and just talk about what happened, don't hold it inside.It is true that this was not a "deadly" incident. BUT the understanding, non-accusitory, fact like manner that the DON and the MD took reassuring me made my recovery much easier. I did complete nursing school. I believe that it is much more difficult dealing with mistakes made in the hospital. Dealing with deaths of patients, even just patients coding or needing to change to a higher level of care. This makes debriefing even more important. If you are comfortable write out what happened. Going to your manager and discussing it can be helpful. Sometimes, we don't feel comfortable with that person. Facilities usually offer counseling, but for the debriefing the occurance needs to be discussed.As DNP NPs we will probably have a greater burden of stress behind mistakes. I truly believe in transparancy. As a patient, a parent, a child of a patient, I want and need the staff to be open and honest with me. I don't want things sugarcoated, don't want to be treated with kid gloves. I need all information to make informed decisions. If there has been a mistake made, I don't want it ignored. I have personal experience with a family member who had to get a second opinion after a hospital made a mistake. Luckily, surgery corrected the original mistake, amputation was not needed. It angers me that the original hospital did not disclose the true condition. So when I see the videos about people who have had errors made and have lost something I understand how they feel about transparancey. Just tell me, I will be upset but I would rather move forward being informed. I am human, medical personel are humans, no one is perfect. Mistakes are made.Part 2The concepts that resonate the most with me are psychological safety, transparency, and negotiation.Psychological safety involves making yourself approachable, valuing everyone's opinion, and making co-workers feel safe speaking openly, asking for help and asking for input.Transparency involves being openly sharing information in all "relationships", whether it be between healthcare workers/staff, or patients and staff.Negotiation is coming to agreement on important matters, allowing listening and some Q&A time between coworkers, interdisciplinary team members and patients.To me these are the three concepts that resonates the most, all of the concepts are important. In my DNP project I hope that my making myself approachable to the patients they will learn new ways of communication with their PCP and learn how to ask questions. The same can be said of the relationship between the preceptor and myself. I believe that transparency with the participants of the study will assist them with moving toward becoming more responsible participants in their health issues. Negotiation will be valuable in the project as some of the participants may need encouragement to complete the "assigned work."Creating a culture of openness and safety during my DNP project should allow for clearer and more accurate outcomes. Image transcription textCulture Psychological U Accountability Safety Leadership Teamwork & Communication Engagement ofPatients & Family Transparency Negotiation Reliability Continuous Improvement Learning & LearningSystem Measurement... Show more Health Science Science Nursing NURSING N701 Share QuestionEmailCopy link Comments (0)