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Purpose: Discussion MN506 Unit 4 (M)

Things to remember:

Discussion post is at least 200 words.

Answers all questions with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

3 References, try to find resources that are 5 years or less

No errors with APA format 6thEdition

Please review the Discussion Board Participation grading rubric under Course Resources in the Grading Rubrics section.

This is important information that will ensure that you earn maximum points. Your postings should be qualitative and provide substantive depth that advances the discussion.

Please see the Kaplan Writing Center located in the student portal for assistance with writing, APA, and online communication.

To Discuss:

· Unit 4 Discussion 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.

· Unit 4 Discussion Topic 2
: Defenses to Malpractice and Risk Management. Take the malpractice case assigned to your group 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? Respond to the other case scenario.

· Unit 4 Discussion Topic 3
: WebQuest Approval

WebQuest Topic
Submit the name of the topic for your WebQuest for your instructor’s approval. You do not have to respond to this Discussion Board and it is not graded.

Case Study 1: Malpractice Action Brought by Yolanda Pinnelas

People involved in case:

Yolanda Pinnelas — patient

Betty DePalma, RN, MS — nursing supervisor

Elizabeth Adelman, RN — recovery room nurse

William Brady, M.D. — plastic surgeon

Mary Jones, RN — IV insertion

Carol Price, LPN

Jeffery Chambers, RN — staff nurse

Patricia Peters, PharmD — pharmacy

Diana Smith, RN

Susan Post, JD — risk manager

Amy Green — quality assurance

Michael Parks, RN, MS, CNS — education coordinator


Brand X infusion — pump

Caring Memorial Hospital


The patient, Yolanda Pinellas, is a 21-year-old female admitted to Caring Memorial Hospital for chemotherapy. Caring Memorial is a hospital in upstate New York. Yolanda was a student at Ithaca College and studying to be a music conductor.

Yolanda was diagnosed with anal cancer and was to receive Mitomycin for her chemotherapy. Mary Jones, RN, inserted the IV on the day shift around 1300, and the patient, Yolanda, was to have Mitomycin administered through the IV. An infusion machine was used for the delivery. The Mitomycin was hung by Jeffery Chambers, RN, and he was assigned to Yolanda. The unit had several very sick patients and was short staffed. Jeffery had worked a double shift the day before and had to double back to cover the evening shift. He was able to go home between shifts and had about 6 hours of sleep before returning. The pharmacy was late in delivering the drug so it was not hung until the evening shift. Patricia Peters, PharmD, brought the chemotherapy to the unit.

On the evening shift, Carol Price, LPN, heard the infusion pump beep several times. She had ignored it as she thought someone else was caring for the patient. Diana Smith, RN, was also working the shift and had heard the pump beep several times. She mentioned it to Jeffery. She did not go into the room until about 45 minutes later. The patient testified that a nurse came in and pressed some buttons and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done.

Diana Smith responded to the patient’s call bell and found the IV had been dislodged from the patient’s vein. There was no evidence that the Mitomycin had gone into the patient’s tissue. Diana immediately stopped the IV, notified the physician, and provided care to the hand. The documentation in the medical record indicates that there was an infiltration to the IV.

The hospital was testing a new IV infusion pump called SAFE-INFUSE. The supervisory nurse was Betty DePalma, RN. Betty took the pump off the unit. No one made note of the pump’s serial number as there were six in the hospital being used. There was also another brand of

Class 6 Unit 3 Discussion Topic 1 (M)

Application of Standards of Care: Your instructor has placed you in groups and assigned a case study for the Unit 7 group Project. Look at the legal malpractice case study that has been assigned to your group. Describe the case and discuss the standard of care that the parties will be held to in this case. How will the standards of care and the Nurse Practice Act be applied in a court of law if the case is sued?
Peer review at least two colleagues’ posts and try to review students that do not have feedback. Use Chapter 16, Effective Peer Reviews, in the Kaplan Guide to Successful Writing Handbook as a guide to review.

Yolanda Pinnelas case study is an exemplification of malpractices that nurses face, most of which are preventable. As Buppert (2017) notes, nursing standards of care provide a framework by which nurses practice nurses to ensure competence and prevent ethical and legal violations. Standards of care in nursing are found in different sources, including nursing practice act, nursing board declaration statements, journals and other forms of credible researches, textbooks and nursing education among others. Often, they are usually very basic and general, applicable across settings and adjusted to make them specific to specialty, at time. In the case of Pinnelas, malpractices can be seen due to failure to comply with nursing standards of care in reference to poor insertion of IV tube and failure to monitor patient when giving the IV chemo drug by the nurse in charge leading to failure to notice the wrong insertion (leaking IV fluids to nearby tissues). This also goes for poor collaboration skills among nurses and communication of critical patient care information by nurses who had the Beep alert from IV pump but never bothered to check and/or inform the nurse/physician in charge. All these events lead to surgery and her losing the functionality of her hand meaning that she will never get to practice her career as a music conductor.

The Nursing Practice Act-NPA stipulate legal standard of care that nurse must employ to decrease legal issues that may emerge. This implies doing what reasonable nurse under similar practice and offering care to a similar patient may do. When applying NPA, focus would be evaluating whether the nurses have complied with nursing standards of care as under the Act. This is in reference to negligence of patient rights and needs (constant monitoring), inability to practice while being reasonable of safety of patients, and knowingly violating provisions/rules of board of nursing in relation to patient care. Due to these violations, the Act allows for disciplinary actions against the nurses, including denying them renewal of licenses, suspending, denying and revoki