two replies to a discussion post- masters level

Anonymous
timer Asked: Nov 24th, 2018
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reply in a masters level course in 450 words(each) with 3 sources in app format including the Bible.

classmate #1-

The case we were required to analyze and propose an appropriate course of action for tells the story of a certain Mrs. Smith. A patient of Bright Road Hospital, Mrs. Smith was admitted for surgery but later contracted an infection that prolonged her inpatient stay to 30 days rather than the expected five days. In order to determine who, if anyone, was at fault for causing the spread of the infection to Mrs. Smith and the travail she was forced to endure as a result of her condition, an analysis of the entire situation is required.

It is important to first understand, however, what negligence implies. Pozgar & Santucci (2019) state that negligence is a “civil or personal wrong” (p. 65) that can occur as a result of commission or omission of a certain action. After understanding the details of the case and performing interviews with eyewitnesses as well as an expert, my conclusion is that negligence occurred because the surgeon failed to change gloves between different patient examinations. Mrs. Smith developed an infection while recovering from surgery in the post-surgery ward because the surgeon and the residents shadowing the surgeon did not comply with the hospital policies on infection control that required attending physicians to change gloves before and after examining a patient. According to Pozgar & Santucci (2019), this particular type of negligence is referred to as misfeasance and is defined as the “improper performance of an act, resulting in injury to another” (p. 65). In the health care environment, handwashing and glove changing between patients is known to significantly reduce spread of infection between patients.

Whenever a negligence lawsuit is initiated, the plaintiff must prove four elements to win the case. Mrs. Smith, the plaintiff in our case study, must therefore prove the establishment of duty to care between herself, as the patient, and the provider, breach of duty, injury and causation (Pozgar & Santucci, 2019). Duty of care is defined as the obligation to provide care by following established standards of care (Pozgar & Santucci, 2019). The relationship between Mrs. Smith and the surgeon was established when she was admitted into the hospital and was in effect at the time of the incident. The second element of negligence, breach of duty, was also settled and proven by the fact that the surgeon failed to change gloves before he examined the patient. This information was uncovered during the interview with the nurse on duty. According to her, the surgeon did not change gloves before examining Mrs. Smith even though he knew one of the first patients examined was an amputee who tested positive for staph infection. Worthy to note is that the nurse should also be accountable for omitting to encourage the surgeon and residents to abide by hospital policies. This is indeed a difficult task because, as the nurse herself noted, fear of retaliation often prevents employees from taking proper action when necessary. Health organizations should strongly promote a safe environment for employees to disclose actions done by other employees that can jeopardize patients’ health. Injury, the third element of negligence, must be confirmed once the breach of duty was demonstrated. Based on the testimonies of those interviewed, the infection that Mrs. Smith developed post-surgery was caused by the surgeon’s negligence who spread the infectious agent to Mrs. Smith through contaminated gloves. Given that the bacteria was contracted by Mrs. Smith through direct contact with the surgeon’s contaminated gloves, this breach of duty is referred to as the proximate cause of the Mrs. Smith’s injury (Pozgar & Santucci, 2019).

All four elements of negligence were established as a result of the investigation, thus establishing Mrs. Smith’s lawsuit as valid. The next question to be addressed is who should be held accountable for the negligence: the hospital or the physician. Known as vicarious liability, the respondeat superior concept states that an employer is answerable for the actions of their employees (Pozgar & Santucci, 2019). In order for respondeat superior to take effect, Pozgar & Santucci (2019) mention two conditions that must be made evident: the existence of an employer-employee relationship and that the employee’s negligence falls within the established scope of practice. In the lawsuit initiated by Mrs. Smith, both conditions were met.

To conclude the analysis, the lawsuit against the hospital is indeed negligence and the latter is found liable for the surgeon’s actions. During the interviews, both the surgeon and the nurse on duty mentioned that the existing infection prevention policies were not strictly enforced at the time of the incident. It is commendable that preventive measures were swiftly implemented so that similar incidents would be avoided. Minor changes such as having gloves and sinks in appropriate locations as well as visible signage reminding employees of the importance of handwashing were made after the incident with Mrs. Smith. Whenever malpractice claims are made, Sohn & Sonny Bal (2012) estimate that litigation costs fall between $76 and $126 billion each year. Additionally, the reputation of both an organization and physician is harmed and can have detrimental effects on the entire system. Implementing swift changes in policy, just as Bright Road Hospital did in our case study, can help salvaging reputation and avoid such cases to occur in the future (in addition to saving lives, of course). Lawsuits can be prevented if an organization issues an apology as soon negligence is acknowledge. According to Stamato (2008), physicians who apologize for errors they made are more likely to prevent legal action and restore the provider-patient relationship. To encourage physicians to express regret whenever negligence occurs, many apology laws have been enacted throughout the years so that those physicians would be protected if a lawsuit is pursued (Ho & Liu, 2011).

As health care professionals who subscribe to a Christian worldview, we are ethically responsible to protect anyone from harm. Philippians 2:4 states that we are to “look not to our own interests but also to the interests of others.” My prayer is that we always keep in mind that omitting to do certain tasks for whatever reason may result in harm to those around us. Being busy, short staffed or finding ourselves in difficult circumstances does not minimize our responsibility to apply the aforementioned principle at all times.

References:

Ho, B., & Liu, E. (2011). Does sorry work? The impact of apology laws on medical malpractice - ProQuest. Retrieved November 18, 2018, from

https://search-proquest-com.ezproxy.liberty.edu/docview/885470640/abstract/9A108D6B43B7432CPQ/1?accountid=12085

Pozgar, G. D., & Santucci, N. M. (2019). Legal aspects of health care administration (13th edition). Burlington, MA: Jones & Bartlett Learning.

Sohn, D. H., & Sonny Bal, B. (2012). Medical Malpractice Reform: The Role of Alternative Dispute Resolution. Clinical Orthopaedics and Related Research; Rosemont, 470(5), 1370–1378. http://dx.doi.org.ezproxy.liberty.edu/10.1007/s11999-011-2206-2

Stamato, L. (2008). Should Business Leaders Apologize? Why, When and How an Apology Matters. Ivey Business Journal (Online); London, N_A.


classmate #2-

But there are good reasons for hard-hitting hand hygiene campaigns, even if they mean making an investment or giving extra nudges to your staff. Patient safety is always paramount, and the potential tragedy of healthcare-associated infections (HAIs) cannot be overstated: They kill 75,000 patients per year, the CDC reports (Vitalacy 2017).

After analyzing the negligence suit at Bright Road Hospital I find the hospital liable for Mrs. Smith contracting Staph while in post operations at Bright Road Hospital. The hospital failed to provide an adequate place to provide care and failed to meet the standard of care. At the time of the staph infection exposure, Mrs. Smith was having schedule surgery at Bright Road Hospital. While in post operations, Mrs. Smith was last to be assessed of four patients. Witnesses had confused that they did not observed Dr. Patlow change out gloves at assessing the each of the previous patients, violating hospital policy. Dr. Bringham, the pulmonologist, argues that the policies are not clearly written, communicated, or strictly enforced. Lastly, the nursing staff failed to notify the proper personal in a timely manner to begin treating Mrs. Smith staph infection. Bright Road Hospital failed to meet the standard of care causing Mrs. Smith to attract a staph infection. In order to prove negligence, the hospital must have a duty to care, breach of duty, injury, and causation.

Duty of care is defined as a legal obligation of care, performance, or observance imposed on one to safeguard the right of other (Pozgar, 2019). Bright Road had a duty to care for Mrs. Smith. Through informed consent, Mrs. Smith gave consent to treat to Dr. Patlow for surgery and post-surgery treatment. During the staph infection exposure, Mrs. Smith was in continuous care of Dr. Patlow. Dr. Patlow is an employee of Bright Road Hospital, both the surgeon and the hospital had a duty to care for Mrs. Smith.

Breach of duty is the failure to conform to or the departure from required duty of care owed to a person. The obligation to perform according to a standard of care can encompass either performing or failing to perform a particular act (Pozgar, 2019). Breach of duty can be difficult to prove. Mrs. Smith’s case, Dr. Patlow is blaming the hospital while other staff is blaming Dr. Patlow. Dr. Patlow claims that the patient contracted a staph infection from the molding ceiling tiles and air vents. Other medical staff believes that the patient contracted staph from Dr. Patlow not changes gloves between seeing patients during post-operations assessment. When assessing for breach of duty, it is important to evaluate the standard of care. The term “standard of care” has been used in law and medicine to determine whether medical care is negligent (Brenner, Brenner, & Awerbuch 2012). Dr. Patlow and Bright Road Hospital failed to establish and maintain the standard for care.

With the breach of duty established, next it to assess for injury and causation. Because Dr. Patlow failed to change gloves and Bright Road Hospital failed to enforce policy, the results of their actions has lead to Mrs. Smith contracting a staph infection. It won’t come as any surprise to infection control directors that the Centers for Disease Control (CDC) estimates 1 in 25 hospital patients acquires an infection (Vitalacy 2017). Dr. Brigham mentioned that Mrs. Smith would had a 5 day stay, but because of the infection, her hospital stay was 40days. Not only did Mrs. Smith contract a staph infection, so did the first patient in the post- operation that Dr. Patlow assessed. Mrs. Smith suffered from a staph infection that lead to an autoimmune disease.

Autoimmune disease are defined as the attacks on host tissue by the immune system. Several factors, e.g. genetic and environmental triggers (in particular, viruses, bacteria, and other infectious pathogens) play a role in the development of autoimmune diseases. Bacterial infections are related to several autoimmune diseases, e.g. chronic inflammations and demyelination. Nowadays, an estimated 20-30% of the general human population carry Staphylococcus aureus (S. aureus). This organism can asymptomatically colonize healthy individuals. (Becker, 2018)

My recommendation to the Chief Council is that the Bright Road Hospital take responsibility for Mrs. Smith contracting a staph infection and developing an autoimmune disease. Because the policies are not clearly written, not communicated with staff, or strictly enforced. The hospital leadership failed to provide a culture that is focuses providing exceptional patient care. It appears that after the lawsuit, Bright Road Hospital began in impalement new policies for hand hygiene and infectious diseases.

For the Lord grants wisdom. From his mouth come knowledge and understanding. He grants a treasure of common sense to the honest. He is a shield to those who walk with integrity. He guards the paths of the just and protects those who are faithful to him. (Proverbs 2:6-8, NLT)

Healthcare leaders must instill honesty and integrity to those that provide patient care. How healthcare leaders lead is how their coworkers with provide care.

Brenner, L. H., Brenner, A. T., Awerbuch, E. J., & Horwitz, D. (2012). Beyond the Standard of Care: A New Model to Judge Medical Negligence. Clinical Orthopaedics and Related Research

Pozgar, G. D., & Santucci, N. M. (2019). Legal aspects of health care administration. Burlington, MA: Jones & Bartlett Learning.

Vitalacy. (2017, March 30). Healthcare Lawsuits And Infection Control: An Expensive Collision. Retrieved November 15, 2018, fromhttps://medium.com/@VitalacyInc/healthcare-lawsuits-and-infection-control-an-expensive-collision-f773107811f3

Becker, K. (2018, July 7). Pathogenesis of Staphylococcus aureus. Staphylococcus Aureus, 13-38. doi:10.1016/b978-0-12-809671-0.00002-4

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SkilledTutorZiss
School: Purdue University

Attached is the full assignmentIt was a pleasure...

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Anonymous
awesome work thanks

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