Expert answer:Application of Standards of Care
Solved by verified expert:Answer the following Discussion question with 300-350 words. 3 scholarly sources and APA format. Will attach case studyApplication of Standards of CareYour 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?
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Case Study 2
Case Study 2: Wrongful Death by Howard Carpenter on Behalf of Wilma Carpenter, Deceased
People Involved in Case:
Mrs. Wilma Carpenter — patient, deceased
Mr. Howard Carpenter — husband and plaintiff in wrongful death suit
Mrs. Scale, RN, MS — nursing supervisor
Elizabeth Adelman, RN — recovery room nurse
Richard Washington, MD — orthopedic surgeon
Judy Gouda, RN, NP
Joseph Alsoff, LPN — post-surgical unit nurse
Kelly Wheeler, RN — post-surgical unit nurse
David Casler, LRT
Susan Post, JD — risk manager
Amy Green — quality assurance
Michael Parks, RN, MS, CNS — education coordinator
Caring Memorial Hospital
Facts:
The plaintiff, Mrs. Carpenter, was a 55-year-old woman who underwent a total hip replacement at
Caring Memorial Hospital. The physician was Richard Washington, MD. Dr. Washington is an orthopedic
surgeon. His nurse practitioner is Judy Gouda, RN, NP. Dr. Washington reviewed the consent with Mrs.
Carpenter prior to surgery. Joseph Alsoff, LPN, witnessed the consent and Mr. Carpenter was present.
Joseph does not remember the doctor ever mentioning that death could be a result of the surgery. The
recovery room nurse is Elizabeth Adelman, RN. The respiratory therapist is David Casler, LRT. The nurse
on the post-surgical unit was Kelly Wheeler, RN. The supervising nurse was Mrs. Scale, RN, MS.
The patient had an epidural catheter for a post-operative pain management following an episode of
hypotension in the recovery room which was treated with Ephedrine. Judy Gouda made rounds on the
patient in the recovery room after the hypotensive event and vital signs were stable. The patient, Mrs.
Carpenter, was placed on a medical surgical nursing unit with the epidural. The nurse, Kelly, was
assigned to the patient and had not worked on that unit before, but had worked in post-acute critical
care units. The nurse’s assignment was to provide patient care on the entire floor for that shift. There
was also an LPN, Joseph, on the unit. It was a busy day on the unit. Mrs. Carpenter was not the only
post-operative patient.
Kelly assessed the plaintiff upon admission, checked the IVs, asked if the patient was in pain, noted that
the patient was responsive and understood where she was, and was stable. She then left to care for
other patients.
The licensed practical nurse, Joseph Alcoff, had been working on the unit for several years. It had been
rumored that Joseph was an alcoholic. There was no evidence that he had been drinking on the unit.
Approximately an hour after the patient arrived on the unit, she was unable to tolerate respiratory
therapy that was ordered and she became nauseated and vomited. David Casler administered the
respiratory therapy. According to Kelly, the registered nurse, 10 minutes after the vomiting episode,
Joseph Alcoff, the LPN, found the patient blue and unresponsive and called a code. Joseph is the only
person other than the physician that carries his own liability insurance. The hospital also has malpractice
insurance.
The code team responded, along with Kelly, the registered nurse. Mrs. Carpenter was intubated and
cardiac resuscitation was initiated. The patient responded to resuscitative efforts and she was
transferred to the intensive care unit. Subsequently, Mrs. Carpenter did not do well, was unresponsive,
and declared brain dead and taken off the respirator. She did not have a DNR in place.
There is a conflict in testimony between Joseph the LPN and Kelly the RN. Joseph indicated that Kelly
found the plaintiff to be unresponsive after the vomiting episode and called the code. The record is not
clear as to when the vital signs and epidural site were assessed. Kelly said she did a motor and sensory
level assessment and they were fine — it is not charted though. The time elapsed between the vomiting
episode and finding the patient is in dispute. The final diagnosis was anoxia encephalopathy due to the
time lapse between CPR being initiated. The patient was eventually extubated, breathed independently
for a period of time, and then subsequently expired.
The vital signs ordered by the physician were hourly. The hypotensive episode in the recovery room had
not been reported to the registered nurse.
The risk manager is Susan Post, JD, who works in collaboration with the quality assurance director Amy
Green. Amy had noted when doing chart reviews over the last 3 months prior to this incident that the
vital signs taken in the recovery room were not charted, not done, or not reported to the units. She was
in the process of collecting data from the different units on this observation. She also noted a pattern of
using float nurses to several postoperative units. Prior to this incident, the clinical nurse specialist,
Michael Parks, RN, MS, CNS, was consulting with Susan Post and Amy Green about the status of staff
education on these units and what types of resources and training was needed.
Assignment Requirements:
Before finalizing your work, you should:
be sure to read the Assignment description carefully (as displayed above);
consult the Grading Rubric (under the Course Resources) to make sure you have included everything
necessary; and
utilize spelling and grammar check to minimize errors.
Your writing Assignment should:
follow the conventions of Standard American English (correct grammar, punctuation, etc.);
be well ordered , logical, and unified , as well as original and insightful;
display superior content, organization, style, and mechanics; and
use APA 6th Edition format.
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