The Administration of Short Burst, Sustained, and Emergency Oxygen to Patients in Hospitals - Essay Example

? Legal aspects of nursing Legal aspects of nursing come into play in cases of patient negligence. In the case study, Mrs. M succumbs to aspiration pneumonia due to faulty handling of the humidifier attached to the oxygen mask. The nurse assigned to care for her abdicated her duties when she left the patient under the sole care of a driver. Consequently, Mrs. M sued the hospital due to neglect by personnel. The paper reviews the legal aspects of the case with recommendations for appropriate policy changes in nursing care and amendments of the procedures manual. In addition, the disciplinary action of the nurse and untrained personnel is discussed. Legal aspects of nursing The nurse caring for the patient has exhibited professional negligence. Mrs. M successfully underwent surgery to remove a brain lesion. She had problem with swallowing, and the medical team promptly carried out further investigations to ensure patient comfort and a quick recovery. The X-ray revealed that her lungs showed no signs of infiltration or congestion. However mismanagement and negligence emerged during her transportation. A driver was charged with the care of Mrs. M. The patient was in a critical state after undergoing an intensive surgical procedure. In addition, her recovery was difficult as she had a swallowing problem. It is inappropriate for the hospital management to entrust patient care of critical patients to untrained personnel. All personnel handling patients need to be professional nurses or doctors. Untrained personnel should be closely supervised by nurses. Lack of supervision is tantamount to patient neglect and this is act of gross misconduct. This is evident in the case of Mrs. M during her transport from the hospital room to the X-ray room for a repeat chest film. The untrained patient transporter who was the sole care giver in the course of the transportation allowed the humidifier attached to the oxygen line to lay on its side. This allowed water to accumulate and enter the patient’s lungs. Clearly, the untrained personnel did not understand the ramifications of his/her actions. The hospital management is to blame for the unprofessional care at the hands of the untrained transporter. The transporter is equally at fault as s/he should have consulted a professional nurse/doctor in the handling of the humidifier. Moreover, the untrained transporter needs to understand his/her responsibilities as stipulated in this/her job description. Clearly, it is not his/her responsibility to make decisions on the placement of medical devices. The nurse charged with the care of Mrs. M should have supervised the untrained transporter. Due to patient mismanagement, water accumulated in Mrs. M’s lungs and she developed a bout of aspiration pneumonia. This led to her subsequent readmission in the intensive care unit. It was a major inconvenience for the patient as recovery time was prolonged. Aspiration pneumonia is a serious medical condition as it may lead to lung inflammation, lung abscess (accumulation of pus in the lungs) and chronic pneumonia. Fortunately, Mrs. M recovered well without encountering any complications. The unfortunate incident would have been prevented via proper supervision. The nurse charged with the care of Mrs. M should have fulfilled her responsibility. She should have overseen the transport and handling of Mrs. M. The uptake of oxygen via the oxygen mask should have been checked to avoid any mishaps. The humidifier attached to the oxygen line would have been maintained in the right position and not allowed to lie on the side. All supplemental oxygen that is routinely administered to patients needs to be humidified. According to BTS emergency oxygen guidelines, humidification is necessary for patients who need high flow oxygen for a period exceeding 24 hours especially if they report discomfort of the upper airway as a result of dryness. In the administration of an oxygen mask, the oxygen flow meter is attached to the wall outlet. Secondly, the humidifier is filled with the right volume of sterile water. The humidifier is attached to the flow meter and the pop valve should be checked by occluding the outlet and initiating oxygen flow. The mask tubing is attached to the humidifier, and the mask is fitted over the patient’s mouth and nose without extending to the eyes. The nurse should regularly check functioning of the entire system by looking for any bubbling in the humidifier as well as listening for gas flow in the device (RUH. 2012). The current policies on patient care are ineffective as evidenced in the current case of patient neglect. Patient neglect and mismanagement is a violation of human rights. Hospitals must endeavor to provide good quality health services to all patients. This will notably cut on the transmission of nosocomial infections, and it will enhance the speedy recovery and comfort of patients. Policies will address the mandatory supervision of patients by qualified nurses and doctors. Moreover, protocols on the administration of all medical devices should be made and disseminated to all hospital departments. The medical devices should be administered by qualified nurses and doctors. For accountability, the name of the doctor/nurse should be indicated and he/she must be responsible for the proper functioning of the medical device. All untrained personnel dealing with patients must be supervised by qualified nurses/doctors. These details must be addressed in the hospital policies. The nurse-in charge must dutifully enforce these policies. Nursing leaders in the hospital and doctors in charge of departments should be involved in policy making and making changes on the procedures manual. Hospital supervisors should sign on the list of policies as this is a sign of approval. The new policies and changes on the procedures manual can be enforced in the hospital. A statement that explains the application of policies and new changes should be included. It is inherent that all nurses engage appropriate department heads for interpretation of new policies as well as the clarification of changes on the procedures manual. The patient’s nurse should face disciplinary action by the hospital as she abdicated her duties. S/he entrusted her patient in the care of an untrained transporter. The nurse is familiar with the sensitivity of handling medical devices and the repercussions of poor handling of medical devices. The ignorant transporter also deserves disciplinary action as s/he is not allowed to handle medical devices. In addition, s/he should act on instructions received from a nurse/doctor to avoid accidents. The actions of the nurse and transporter made the hospital vulnerable to a lawsuit. The transporter should be suspended and, must undergo training to understand the duties and responsibilities of a hospital transporter. The nurse should also be suspended until the legal proceedings are complete. S/he should also face disciplinary action from the board of nursing as her actions contravene nursing care. The board can suspend her license and upon resuming work, she must work under supervision for a given period of time. An incident report should be completed in order to document the accident. The nurse in charge of the surgical unit should investigate the accident and make an incident report. Incident Report Patient Details Full Name-------------------------------------------------------------------------------------------------------- Hospital ID -------------------------------------- Hospital bed number-------------------------------------- Patient Diagnosis- Non-cancerous brain lesion Date of incident--------------------------------- Time of incident------------------------------------------- Place of incident- X-ray Department Details of equipment used- Humidifier--------Tag identification----------------------------------------- Incident- The untrained transporter allowed the humidifier to lay on the side and water accumulated in the patient’s lungs. The patient experienced pneumonia and was re-admitted back to the intensive care unit. Patient’s condition before the incident- The patient had a problem swallowing food after undergoing surgery to remove the non-cancerous brain lesion. Full name of reporting officer--------------------------------------------------------------------------------- An expert witness was necessary to clarify on shed light on the issue of patient negligence. The expert witness would explain the systematic flow of authority and operations in a hospital setting. In addition, an expert witness would affirm the credibility of the plaintiff’s case. S/he would heighten juror confidence and persuade the juror to make a decision in favor of the plaintiff. The expert witness would have accomplished this by highlighting the professional standards of patient transport. The transporter is an employee of the defendant and his/her testimony was in support of the hospital. This testimony would be made to absolve the hospital. Thus, the plaintiff should have sought expert testimony to add credibility to the plaintiff’s case. The expert witness would have proven the hospital’s negligence in the care provided to Mrs. M. She developed aspiration pneumonia due to nurse negligence. If proper care had been given, the humidifier would be used appropriately and water would not have accumulated. The expert witness would further establish that aspiration pneumonia is not a risk factor if the oxygen mask and humidifier is used appropriately. The hospital should have covered the cost of treating aspiration pneumonia. In addition, Mrs. M had suffered unnecessary discomfort and was unduly predisposed to contracting a life threatening ailment like lung inflammation or chronic pneumonia. For this reason, the plaintiff should have been awarded punitive damages. The expert witness should be an individual who is knowledgeable on patient care in a hospital setting. Preferably, it should be a registered nurse (RN) who has worked in a hospital for at least 15-20 years. S/he should explain routine patient care especially if the patient has a medical device. In deciding the appeal, I would consider all evidence from the plaintiff and defendant. Most important, I would rely on expert testimony availed by the plaintiff in deciding the appeal. Damages should be awarded to the plaintiff if the testimony is credible in establishing patient neglect and unduly exposing the plaintiff to harm. References RUH.(2012). Oxygen therapy administration policy and guidelines: the administration of short burst, sustained (medium term), and emergency oxygen to patients in hospitals. Retrieved from http://www.ruh.nhs.uk/about/policies/documents/clinical_policies/blue_clinical/Blue_7017.pdf Read More