OHS in Child Care Center - Coursework Example

It is a sad incident where a young patient lost her life due to poor OHS practice at the Seattle’s Children hospital. Investigations and post mortem reports showed that the baby had died from an overdose of calcium chloride given to her by Nurse Kimberly Hiatt The nurse was on duty on the night of the incident and gave the routine drug with the dosage given to adults with the same problem. The nurse did not however know was that children with advanced cardiac problems are not supposed to receive such a high dosage. A qualified pediatrics doctor would have been able to know this but unfortunately they were out on duty caring of another child that was critically ill. The nurse only did what she had to do to the best of her ability with disastrous consequences. By using the Systems Approach to Occurrence Causation (SAOC), we can conclude that the cause of the occurrence can be traced to several factors that combined to bring about the event. We can start of by pointing out that the nurse was on duty unsupervised. This was of course what led to the patient sustaining the overdose which led to the brain hemorrhage that killed her. The second cause can be attributed to the nurse not having proper knowledge concerning the dosage required for the child and as such ended up giving ten times more than was required and the child’s system could not handle this. Third we can attribute the occurrence to a failure by the hospital to implement proper guidelines that would have prevented the nurse from administering the medicine without a doctor’s supervision. Lastly the medicine was administered at a time off the usual routine which made it hard for the doctor to be available as per schedule which could have negated the need for the Nurse to do the administration of the medicine alone without supervision. The other cause can be put down to understaffing at the hospital which meant there was no qualified pediatrician when the Nurse was doing her rounds administering the medicine. In this incident, the energy in this scenario is the medicine being administered and we can identify the administration of the medicine as the source of risk especially without proper supervision. A hazard is a source of potential harm in terms of human injury, ill-health and damage to property, the environment, or a combination of these. In this case, we can pinpoint the hazard as being the drug administered by the nurse. This case can also be used to express an example of psychosocial hazard. The work conditions were liable to cause the accident and lead to psychosocial stress for the nurse who ended up unemployable and even took her own life after. Proper scheduling and supervision is the barrier that was to prevent the occurrence from happening. The energy could have been controlled to prevent harm by using the following four steps. Firstly by reducing the energy; this could have been achieved by reducing the dosage given to the child. Secondly, by placing a barrier around the energy; this could be achieved by restricting the unsupervised access of the medicine by the untrained nurses and other staff without proper knowledge of medicine. Thirdly preventing transfer of energy; this was possible to achieve by ensuring proper training of the relevant handlers who are entrusted with caring for the patients. The energy if it can be stopped by preventing energy transfer also helps in raising the threshold for injury or other disruptions. In this case, if the nurses could be trained properly or specialist nurses hired for the wards, it would help. Lastly, by protecting the endangered patient from misdiagnosis and improper administration of medicine; this could be done by allocating specialized staff to deal with children cases only or adult cases only solely as a specialty and then having treatment charts with well spelt out dosages clipped onto the beds of the patients. The method of transfer for the energy in this case was through the wrong dosage administered by the nurse who did her job but without proper guidelines or knowledge. In this transfer of the energy, we find the nurse as the week link which led to catastrophe in conjunction with the other factors. The protective shield was supposed to be the supervisory role to be played by the pediatricians and other policies the hospital should have had in place to prevent the occurrence from transpiring. If they had a supervisor around and if proper scheduling for the administration of the medicine had been followed, then the barrier would have been effective in stopping the energy flow that ended up causing loss of control. Possible interventions to prevent such an occurrence could include better scheduling, better staffing, better training, better chart and other instructional delivery/placement and better supervision of staff. We need to ask ourselves if we can eliminate the hazard from the wards to prevent such occurrences and as such make the place safer. The answer could be in having the medicine to be administered stored only in relevant dosage quantities. This can be in ampoules or tablets pre counted and stored ready for administration to prevent errors. Then we have to ask if we can improve on the reliability of the monitoring supervisors to ensure no mistakes are committed. This can be done by establishing protocols that reduce on the need for constant supervision. For instance, the nurses can be given pre-packed medication for each patient and have on it written the time for administration this lessens cases of accidents. Can we prevent the transfer of energy? Can we separate the recipient and the energy source? This question can be answered by ensuring the medication of the patients is done only by the trained pediatricians or by specialized nurses. This can be a good way to prevent cases of people without proper knowledge ending up committing mistakes that can be deadly. Can we protect the person, increase the threshold for injury? If we can intervene as early as possible to prevent the occurrence from happening closer to the energy source, we can reduce the chances of such accidents from happening. This would mean we intervene right from the way the medicine is dispensed to the nurses. If a way to do the administration of the medicine without involving the non specialized nurses can be found, then the threshold for such occurrences is greatly increased. The hospital to prevent such cases in future can use OHS processes to avoid such events in the hospital and avoid loss of control which led to loss of life. The hospital can achieve this by managing establishing proper controls and doctor schedules to make sure that there is always a doctor on duty rather than just a nurse. This will minimize the risks with the aim of achieving an ALARP (As Low as Reasonably Practicable) scenario. The hospital should be willing and able to put up proper and tight controls to make sure that their work system is error free. This would entail taking some serious steps to ensure that they use proper OHS procedure which will in turn help the staff to work more efficiently and in a safer environment both for them and the patients. Works cited Prof Dennis, “Occupational Health and Safety.” The SafetyLine Institute. January 2009. S. Chrissie., “Occupational Health and Safety.” The SafetyLine Institute. January 2009. V. Derek, “School of Science and Engineering”, University of Ballarat. 2009. Occupational Health and Safety Practitioner. “Learning Guide” The SafetyLine Institute. January 2009. Read More