Mr. B Case Study
The case study in question which saw the loss of MR. B suggests many practical learning points in developing successful hospital emergency department (ED) procedures. This writing will propose a complete root cause analysis that takes into consideration of nine causative factors that led the sentinel event Mr. B's outcome. The factors will be listed in decreasing order of importance as it relates to the event.
Factor
The hospital appeared to be understaffed from all perspectives. At least 3 to 4 nurses and another 2-3 LPN's appeared to have been needed to suffice all the demands that were going on at that time. A simple back up staff was not enough.
Factor
Mr. B.'s narcotic addiction severely contributed to his ability to be sedated and complications were sure to follow.
Factor
The sedation policy must be reexamined as it may not be applicable any more. This policy should be continually monitored and updated.
Factor
The efficacy of the Code Team and its procedures played a significant role in the progression of Mr. B's health. Their actions and resources should also be reexamined..
Factor 5:
The alarm system on the equipment and its ability to detect trouble and provide immediate and helpful feedback.
Factor 6:
Mr. B's multitude of prescriptions denotes a troubling sign in allopathic treatments where over prescribing medicine is too commonplace.
Factor 7
The mystery behind Mr. B's fall that led him to the ED played a large, but elusive causal role in the events.
Factor 8:
Mr. B's prior conditions of hypertension depression and gastric problems also played a causal role in the events.
Factor 9
In terms of life and death, little is known about the many circumstances behind either. In Mr. B's case the least important but most interesting idea behind the circumstance revolving around his death are of a spiritual and esoteric quality that defies medicine, logic or rational understanding.
Emotional reactions to the onset of injuries as well as a patient's attitude toward the injury itself and the proposed treatment have great impacts on the length of time it will take for the patient to recover (VAN RIJN 2007). Therefore, it is in the medical staff's best interest to maintain the patient in a positive, reinforcing paradigm in order to create an atmosphere of positive goal-orientation so the
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According to the vocabulary defined Geert Hofstede, America and Japan do not merely speak different languages; they also speak in different cultures. America is a low-context culture, which values someone who is plain-spoken. 'What you see is what you get' is a compliment in America: according to one interview subject, Mr. B, who had done extensive travel back and forth from America to Japan on business, such an ideal is
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