Current research indicates that communication breakdown among healthcare profes

Current research indicates that communication breakdown among healthcare professionals is a leading causes of medical errors and patient harm (PSQH, 2017). Choose one patient from this week’s scenario for discussion. Describe a potential error that could occur due to communication breakdown. Discuss evidence based strategies to avoid such errors. Include at least 2 evidenced-based strategies.PEDIATRICS- GI, GU, FLUID & ELECTROLYTE ALTERATIONS You are an RN working the 7a-7p shift on a Renal/GI Pediatric Unit in a community hospital.  The Renal/GI Pediatric Unit has 22 beds.  The day staff consists of a Nurse Manager, 6 RNs, 4 PCTs (Patient Care Technicians), a Child Life Specialist, and a Unit Clerk.  Patient rounds with the pediatricians, nurse practitioners, physician specialists, and charge nurse occur daily at 0800.  After rounds, the charge nurse and nurse practitioner meet with the Nutritionist, PT and OT, Child Life, Certified Teacher, Nurse Case Manager and Social Work to discuss each patient’s daily plan of care. A satellite Pharmacist is assigned to the pediatric unit. You arrive and receive report from the RN on night shift: 100      David York    Age:  5 months            Weight:  12 lbs            Admitting Dx:  Diarrhea/Dehydration            PMH:  Asthma, Failure to thrive           Third admission for dehydration and failure to thrive            EGD and colonoscopy scheduled today at 1100            02 Sats 97% on 2L humidified FiO2 via NC, lungs clear            AM lab results:  Hgb 10, Hct 32.0, NA 134, K 5            NPO since 12MN except breast milk, full NPO at 0600            No wet diapers since 2200, No BM            D5 ½ NS @ 15cc/hr stopped due to IV infiltrate @ 0200 (attempts to replace IV   unsuccessful)            Consent signed            Pre-procedure checklist on chart            Pre-procedure medications ordered            Mother at the bedside. Father at home with 2 yr old sister           102      Charity Williams      Age: 9 yo            Weight:  110 lbs            Admitting Dx:  Gastroesophageal Reflux Disease (GERD), R/O aspiration            PMH:  pneumonia 2x within last year, Cerebral Palsy, developmental delay            CXR: hazy infiltrate RML            Current medications:  Nexium 10mg PO once a day            Diet:  bland thickened liquid feedings in upright position            02 Sats 96% on 2 L 02 via NC            Hgb 11.4, Hct 36.4            No emesis last night            Abd soft BM x2 yesterday            IV Saline lock            OOB to wheelchair as tolerated            Mother primary caregiver and is overwhelmed with Charity’s care.            Consults:  Surgery to evaluate for Nissen Fundoplication and GT insertion                                                      Dietary to evaluate caloric needs and feeding frequency 103      Yolanda Martinez     Age: 15 yo             Wt: 110 lbs            Admitting Dx:  Hemolytic Uremic Syndrome (HUS)            No past medical historyIdentifies as transgenderPHI:  Seen by PMD (primary medical doctor) 5 days ago and diagnosed with viral             gastroenteritis.  Symptoms did not improve and parents brought child to ED after 12 hrs             of no urine output            + Ecoli from stool culture                   lethargic, voided x1 last night 20ml dark urine            Hgb 8.7 Hct 28.2            Plt 67,000            BUN 104  Creatinine 3            Received 1 unit PRBC yesterday after dialysis            Labs drawn this AM @ 0600            IV saline lock            Diet:  as tolerated protein restricted diet (restrict protein intake to 20% of caloric intake)            No family at bedside, father a single parent and is at work 106      Samuel Penn  Age 16 months            Wt: 18.5 lbs            Admitting Dx: Acute Abd pain, R/O Intussusception            Just arrived from ED             PHI:  parents brought child into ED early this AM after several episodes of child drawing            his knees to his chest and screaming, mom stated that child has had vomiting and diarrhea      for 2 days, mom noticed that two stools were mixed with blood and mucus (currant jelly      stool), no PO intake since yesterday evening             PMH: Cystic Fibrosis (CF)             Lethargic, irritable, diaphoretic            Palpable, tender abdominal mass            #24 G IV to R hand – D5 NS @ 53cc/hr            Received NS bolus (20ml/kg) in ED x1            Abd x-ray ordered for 0800            HR 180, RR 28, BP 88/41, Axillary T=101            Mom names daily medications for CF management but cannot remember dosages                         N-acetylcysteine, Albuterol, Creon, Vitamins ADEK, and Motrin as needed for                             pain.            Father lost job and will lose insurance benefits in a month.            Health Science Science Nursing NUR MISC Share EmailCopy link Comments (0)

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