¶ … Application Quality Improvement Models Organizations Systems, Part I Analysis Required Resources Readings Course Text: Applying Quality Management HealthCare: A Systems Approach Review Chapter 9, "Improving Processes Implementing
Root cause analysis
According to Nicolini (2011)
the first step in RCA is identifying the incident to be analyzed. This step requires for the problem or incident to be clearly defined and identified. Identifying the problem will assist in determining what caused the incident and how the incident occurred. In the case study, the mother requested for pain medication, and this was within her right. The nurse performed the request, and it was approved by the pharmacist, but the incident occurred when the nurse did not check the IV line correctly. The nurse confused the infants IV line with the mothers, which resulted in the infant been administered with Morphine. This should be an indicator, and it should be recorded as a fact. This is because the nurse admitted that she might have administered Morphine to the infant instead of the mother.
The second step would be organizing a team that will conduct the RCA. This should be an independent team that will investigate, research, and analyze the incident. This team will be unbiased and will use the information collected to provide solutions and recommendations Siriwardena, 2009.
The third step is studying the work processes. From the case study, it is clear that the systems were fully automated, and the doctor had indicated the mother can be given pain medication upon her request. When the mother requested for the pain medication, the nurse performed the five rights accurately. This is why the medication was authorized by the pharmacist and the correct dosage provided. The hospital did not require physical separation of the infant from the mother, which resulted in the nurse picking up the wrong IV line and tracking its source Cooper, 2009()
The fourth step is collecting the facts....
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