Topic 1: The Legal Implications of Acceptance or Refusal of an Assignment After reviewing the ANA position statement on “Rights of Registered Nurses when Considering a Patient Assignment,” discuss the legal and ethical implications of accepting assignments. When delegating assignments to unlicensed personnel, what considerations need to be considered? What insurance issues come into play? Analyze the legal principle of Respondeat Superior. Topic 2: Defenses to Malpractice and Risk Management Take the malpractice case that was assigned and discuss the defenses that may be raised in that case. Discuss how the incident could have been prevented. What risk management techniques could have been used before and after the adverse patient occurrence? This case study is about Yolanda Pinellas who is a 21-year-old female student learning to be a music instructor admitted. She was diagnosed with anal cancer and was admitted to Caring Memorial Hospital for Mitomycin for chemotherapy. The drug was to be administered through the IV with the use of an infusion machine for delivery. The IV was inserted by RN Mary Jones during the day shift. For some reason, the Mitomycin was delivered late to the unit by the pharmacy (Patricia Peters, PharmD) and was hung during the evening shift by the assigned RN, Jeffery Chambers. During that day, the unit was very busy with several other sick patients and was short staff. RN Jeffery had worked a double shift the day before and had to work double again to cover the under-staff evening shift. He managed to have about 6 hours sleep in between shifts. During the evening shift, the infusion pump was heard beeping several times. Carol Price, LPN ignored the beeps and assumed that someone was caring for the patient. Another RN, Diana Smith also heard the pump and notified Jeffery about it but did not go in the room until 45 minutes later. Diana, RN responded to the patient’s call bell and that the IV had been dislodged from the patient’s arm. She immediately stopped the Mitomycin infusion, did not see evidence of infiltrating, provided care to the hand, and notified the physician. Documentation of the IV indicated there was an infiltration. The infusion pump was removed by the Betty DePalma, nurse supervisor from the unit without noting the pump’s serial number. Yolanda developed necrosis of the hand two weeks later and had required several surgical procedures, skin grafting, and reconstruction. She developed permanent loss of function and deformity in her third, fourth, and fifth fingers. Due to this, Yolanda is claiming that she is unable to pursue her study to become a conductor.
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