Compare two leadership theories. Provide an overview of each and discuss the strengths and weakness in relation to nursing practice.

 

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Read the case study presented at the end of Chapter 17 (Guido, p. 362)

Judy, age 20, was admitted to an inpatient psychiatric facility for acute depression and suicidal ideation. She had gone to the local police station the previous afternoon, stating that she was suicidal. The police transported her to the emergency center, and Judy was admitted on a 24-hour emergency mental health hold. O n admission, Judy was obviously depressed and stated that she was still tormented with thoughts about killing herself. Later that evening, the nurses heard a crash from Judy’s room and, upon investigation, found her sitting on the bed with an overturned chair next to the bed. She had torn her robe, tied the pieces together as a rope, and fell from the chair as she was attempting to tie the homemade rope to the ceiling. Judy was immediately placed on a 15-minute observation protocol. The following morning, the patient was still on observation every 15 minutes. The nurse at that point determined that Judy was more coherent and noted that Judy was disturbed by her appearance as she had not bathed in some days. The nurse unlocked the bathroom door so that Judy could shower. S oon after the bathroom door was unlocked, Judy’s psychiatrist came to speak with her. She remained with Judy for about 45 minutes, left the room, and entered a charting area next 

to the nurses’ station. The nurse caring for Judy did not see the psychiatrist leave Judy’s room, nor did the psychiatrist inform the nurse that Judy was now alone in her room. The nurse checked on Judy approximately 15 minutes later. She found Judy hanging by the belt of her bathrobe from the shower rod. Judy was in full cardiac and respiratory arrest, a code was called, and Judy now has severe and permanent anoxic brain injury. Her parents have brought this lawsuit alleging breach of the standard of nursing care.

Was the nurse negligent for unlocking the bath-room door and allowing Judy to shower by herself?

Was it below the standard of care for the nurse to leave the bathroom door unlocked when the psychiatrist came to see Judy?

How significant are the hospital policy and procedures in this instance?

How would you decide this case?

Read the case study presented at the end of Chapter 18 (Guido, p. 393)

Gonzales was admitted to a surgical center for a routine colonoscopy during which three polyps were removed. The procedure began at 11:00 a.m. and he was released at 12:30 p.m. The patient began experiencing abdominal pain the following day. He tried to phone the attending physician at 2:00 p.m. and later called the physician’s nurse at 5:00 p.m. Mr. Gonzales told the nurse he was experiencing severe abdominal pain and that he was flushed and felt he had a fever. The nurse told Mr. Gonzales that everyone had gone home for the day, and she advised him to take aspirin for the fever and call back in the morning. Mrs. Gonzales drove her husband to the hospital the following morning at 10:00 a.m. He was placed on antibiotics, which did not resolve the problem, and he had surgery on the fifth day following the original colonoscopy. At that time, it was determined that the patient’s intestine was perforated at the time of the 

polyp removal, and Mr. Gonzales now has a permanent colostomy. The patient has now filed a lawsuit against the nurse and physician for malpractice.

Was the nurse negligent in the advice she gave Mr. Gonzales concerning his condition?

Did the nurse exceed her scope of practice in the advice she gave the patient?

Should the nurse have instructed Mr. Gonzales to go immediately to the local emergency center?

How would you decide this case? Who, if anyone, is liable in this case?

Read the case study presented at the end of Chapter 20 (Guido, p. 439)

Aburu, 81, with a history of cerebral vascular accidents, was hospitalized as an outpatient for a surgical procedure to incise and drain a skin lesion on his chest. After the procedure, he returned to the long-term care facility with sterile packing in the partially sutured incision site. The packing was to remain for 3 days, then be removed, and the wound covered with a dry dressing. The risk of complications for this type of surgery was considered quite low, and both the nursing home administrator and the attending surgeon saw no reason why the patient could not be adequately cared for in the nursing home immediately after surgery. A pproximately 5 hours after Mr. Aburu returned to the nursing home, blood was observed at the incision site. He was transferred back to the acute care hospital, where he died the following day. E vidence at trial showed that for the 5 hours that Mr. Aburu was at the nursing home, several licensed and unlicensed personnel attended to him. At lunchtime, two aides escorted Mr. Aburu to the dining room; lunch was about 3 hours after his return to the 

nursing home. None of the personnel examined his dressing until an aide noticed that he was bleeding though his bed sheets. Shortly after discovering the bleeding, the patient was transferred by ambulance to the hospital. His family has filed a lawsuit for the wrongful death of their father, alleging that the care given to the patient after surgery fell below the acceptable standards of care.

What should the standards of care be for such a patient?

Even though the nursing care plan did not specify that the wound should be checked hourly, how should the prudent nurse have acted?

Should the lawsuit center primarily on the surgeon for allowing this patient to be sent back to the nursing home for post- operative care rather than insisting he be kept for 24 hours in an acute care facility post-operatively?

How would you decide this case?

Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Create an APA essay with 1200-1500words, complete the following questions using 4 scholarly sources to support your perspective. please an introduction and conclusion needed.

 

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Assignment #1: Management Tools for Health Care Organizations to Comply with Patient’s Legal Rights (12.5 points)

Hide Assignment Information Instructions

From the list below, choose one topic and identify two specific legal obligations that a specific health service organization has to its patients and then write a paper discussing all the areas listed in the outline following this subject list.  Include a cover page and a list of references at the end of the paper.  Paper will be double spaced and be approximately 4-5 pages in 12 point New Times Roman font.

• The Genetic Information Nondiscrimination Act (GINA)
• Elder abuse Mandatory Reporting
• Child abuse Mandatory Reporting
• HIV Mandatory Reporting
• The False Claims Act- the civil penalties
• TB Mandatory Reporting
• Proper treatment of environmental hazards.
• Medical error-Critical Incident
• False credentials of health care personnel
• Medical Charting violations
• Violation of HIPAA – confidentiality
• Failure to treat patients in a timely manner
• Failure to maintain required Staffing ratios
• Patient Choice and treatment consent

Note: Outline:  Must use the headings from the outline below in your paper and the paper must be in narrative form not outline or bullet format. A penalty will be deducted from paper if underlined headings not used in your paper. 

1. Official Title of the Law or Laws:  

State the official title of the federal and/or state law, the statute and section number.  Must be either a federal statute or state statute and you must cite both if applicable. Thus if there is both a federal and state law that covers your subject picked then you must cite both. Do not assume that there is just a federal and or state law. In most cases there is both a federal and state law. You must use the laws cited in this section throughout the rest of the paper.

1. Health Care Organization’s Obligations to meet Patients’ Legal Rights: 

Describe in detail two specific legal obligations, required by the federal and or state law, that a health care organization owes to its patients.  Include the specific law citation that describes the patient’s rights.  Use in-text citations for all statistical references. 

1. Consequences for Non-Compliance: 

First, discuss in general the civil and criminal consequences from either the federal and or state law. List the two legal obligations from the previous section, then discuss two (2) specific consequences from the federal and or state law, one consequence for each legal obligation, for the organizations’ non-compliance. Then for each consequence you must research and discuss one relevant real life case. In other words, you must discuss one (1) consequence for each legal obligation and have one real life researched case for each consequence. See outline below. Cases must be found via the internet or print media or from personal real life experiences.  In other words, what would happen if the organization neglected to meet its obligations to its patients? Be specific. Provide the specific Federal and or state law citations to back up your claim of the consequences.   Provide link to source of information. 

1)     Legal obligation 1 

• One specific consequence  
• One real life case

2)     Legal obligation 2 

• One specific consequence  
• One real life case

1. Health Service Organization Management Actions to meet Legal Obligations for Patients’ Rights:

Describe in detail three (3) specific management actions, within your control as a health care manager that you would institute, to ensure the health care organization complies with its obligations to protect the patients’ rights. Be specific as to each management action you would personally institute and why. No general comments.  These actions may include specific uses of technology, procedures, human resource training, and other management tools. 

1. Conclusion: Summary of your findings above.
2. Reference List [APA Format] 

 

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Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Assignment:

Professional Development Exercises :

• Read the case study presented at the end of Chapter 11 (Guido, p. 222) 
•  A nurse had been working in a critical care unit for more than 25 years, gaining respect for her competence and dedication before suspicions began to gather that she was diverting narcotics for her 
• own use. The acute care hospital had recently installed a “computerized medicine cabinet” for enhanced distribution and better monitoring of narcotics. The cabinet recorded the nurse’s per
• 222 Part 4 • Impact of the Law on the Professional Practice of Nursing
• nurses testified that they often deviated from the physician’s order for an IM injection, electing to give the medication by an IV route. Finally, there was testimony that the hospital had no formal policy for which nurse was to document narcotics in the paper record when two nurses, such as a preceptor and a mentee, both had responsibility for the patient. The nurse who was suspended testified that she, too, frequently entered data into the paper record long after she had administered the medication and, in some rare instances, entered the data on the following day. 
•   QUESTIONS    1. D   id the facility have sufficient evidence to suspend the nurse from their employee?      2.    How should the testimony of the other nurses in the unit affect the outcome of this case?      3.    What additional questions should the institution address before the court rules in this case?      4.    How would you have ruled in this case?     
• sonal keypad code and the patient’s data before it could be unlocked and narcotics dispensed. The nurses were also required to document the narcotic usage by handwriting the patient’s name, medication, time, route, and dosage on a more traditional paper medication administration record (MAR). D iscrepancies were noted between this nurse’s patients’ electronic data for narcotic administration and the handwritten notations made on the paper record. The nurse was first questioned by her supervisors and then she was suspended, as they did not find her explanations credible. Her grievance was upheld by the arbitrator assigned to the case and the hospital appealed. A t trial, other nurses from the same unit testified that they frequently completed their paper record documentation during their breaks or at the end of the shift, often when they could not remember exactly what medications or dosages they had administered to patients. There was additional information that the nurses would electronically sign for narcotics, prepare IV drip bags in advance of when they were needed, and then discard these same IV bags when they were no longer required or the physicians had changed the medication orders. Additionally, these 
  • Did the facility have sufficient evidence to suspend the nurse?
  • How should the testimony of the other nurses in the unit affect the outcome of this case?
  • What additional questions should the institution address before the court rules in this case?
  • How would you have ruled in this case?
• Read the case study presented at the end of Chapter 12 (Guido, p. 238) 
•   preschool teacher called child protective services about a child who appeared to have a vaginal infection and the child protective services worker instructed the mother to take her child to the emergency center at the local acute care facility. In the emergency center, the child was examined by an ANP who found a vaginal tear, which the ANP felt could have been caused by digital penetration. The child would not talk about the injury with the ANP. T he ANP then discussed the child’s case with the child protective services worker, and the child was admitted to the facility. The parents were subsequently questioned regarding potential abuse of the child. Charges of child abuse were filed against the father, who is now a registered sex offender in the state. The parents filed suit against the preschool teacher, the case worker and the ANP. A t trial, evidence was presented that the ANP did not share her findings or impressions of possible child abuse with the mother, the child’s primary pediatrician, or other emergency center physicians. She also did not recommend that the mother contact the 
• child’s pediatrician for an evaluation and a second opinion. The ANP also admitted that it was possible that the child had scratched herself as a result of the infection and that the child herself had caused the vaginal tear. 
•   
  • Did the ANP have a duty to consult with the child’s physician or another emergency center physician regarding the possibility of child abuse before she reported her findings to the case worker?
  • What questions would you anticipate might be asked regarding the injury itself and the possibility that the child had caused her own injury?
  • Did the ANP have a duty to report the injury, even though the diagnosis was not absolutely conclusive at the point that the child was initially examined?
  • How would you determine liability in this case, assuming that the trial court found liability against any of the three defendants?
• Read the case study presented at the end of Chapter 16 (Guido, p. 329) 
•   licensed practical nurse (LPN) employed by a nursing personnel agency worked one evening shift at the Veterans Administration Hospital in a major city. She cared for a patient who had recently undergone hip replacement surgery. Since his surgery, the patient had consistently spiked significant temperatures, and his temperature generally responded well to oral Tylenol, 500 mg, 2 tablets, every 4 hours as needed. The change nurse explained to the LPN that the patient was to continue on vital signs every 4 hours, including temperatures, and that he was to be medicated if his fever increased, even if only at low-grade levels.  During the evening that she worked, the LPN obtained the patient’s temperature at 4 p.m. and again at 8 p.m. He had a lowgrade fever at the 4 p.m. hour and his temperature had risen to 102 degrees orally at 8 p.m. At both intervals, the LPN administered Tylenol as ordered. The charge nurse did not assess the patient during the evening, nor did she inquire about the patient’s condition. The nurse caring for the patient at midnight noted that his temperature was still elevated (102.4 orally). When notified, the attending physician ordered blood cultures, additional treatment for his ever-increasing fever, and a change in antibiotic therapy. 
• D espite this aggressive therapy, the patient developed a fatal septicemia and the patient’s family sued for wrongful death. At trial, the court determined that the charge nurse had been derelict in her duty to supervise this patient and assessed partial liability against the LPN and the charge nurse
  • Did the nurse manager have a responsibility to supervise the care of the patient?
  • Was the care of this patient appropriately assigned to the LPN by the charge nurse, or could the charge nurse have delegated this patient’s care more appropriately?
  • If the charge nurse assigned the care of the patient to the LPN, did she retain any supervisory responsibility that would result in her liability in this case?
  • How do the principles associated with delegation and supervision figure into this case?
  • How would you decide this case?
  • You are not required to adhere to the 500-1000 word count for each of the responses, but please be thorough in your responses so that you adequately address all aspects of each question.

Please combine all of these responses into a single Microsoft Word document for submission

Please submit only complete assignments (not partial or “draft” assignments). Submit only the assignments corresponding to the module in this section.

 

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