Reference no: EM133900731

Critical incident report

This assignment addresses the following learning outcomes:

Learning outcome 1: Describe and explain the registered nurses' scope of practice, including legal obligations and constraints

Learning outcome 2: Critically analyse incidents involving patient safety and make appropriate recommendations

Learning outcome 3: Use the principles of clinical governance and quality improvement to undertake a root cause analysis related to nursing practice. Get online assignment help from Ph.D. experts!

Learning outcome 4: Demonstrate leadership and management strategies by providing recommendations for systems based solutions (e.g. delegation, performance management) to quality issues

INCIDENT

Samuel lived with his mother Louisa and his sister Imogen aged 8 years in a large regional town of Grantham. Samuel and Imogen regularly saw their father Daniel and both parents contributed to the care and upbringing of both children. The parents had separated only two months prior to this event. Daniel and Louise's mother Leanne were Registered Nurses who worked in the Emergency Department at Grantham Regional Hospital (GRH). Samuel had been a healthy and active young boy until the time of his illness. As is quite common in rural and regional towns, Samuel was well known to the staff at the local hospital on a social level due to the fact that his father and grandmother both worked at the facility and many of the staff had known Samuel and his sister since birth. The following is an account of the events that led up to the death of young Samuel and are provided for your information.

The task in this assignment is to:

From a clinical governance and quality assurance perspective you are to write a report about a critical incident that has occurred. The critical incident scenario will be provided on the Interact2 site.

A critical incident report using the headings below is required. As this is a formal report please use professional language of an academic standard and support your writing with appropriate and current references.

Introduction/ Background to the Incident: A short introduction including an overview/summary of the incident and what the report will contain.

Severity Assessment Code (SAC) rating: - Using the Severity Assessment Code (SAC) matrix allocate a rating and explain why you gave this score.

Analysis of Factors: Review the information presented within the critical incident scenario and identify factors that contributed to the incident occurring. Identify any relationships between contributing factors. Reference to current evidence-based peer reviewed literature and contemporary initiatives should be explored in relation to the incident. Analysing the factors will allow you to discover the ‘root causes' of the incident which will support you to develop a deeper understanding of the why the incident occurred, what should have happened and how it could be prevented in the future.

Patient Safety Model: There will be a range of predisposing factors that have contributed to this critical incident scenario. You are to select one of the patient safety models that have been discussed in the modules and apply this to this critical incident i.e., fishbone model OR Heimlich model OR Swiss cheese model. The ‘patient safety model' diagram should demonstrate the factors that were the root causes that lead to the critical incident.

Links to Professional Standards: From your analysis above discuss the implications for nursing practice. Refer to the NMBA Registered Nurses Standards for Practice, professional codes and other evidenced based contemporary initiatives drawn from either the literature or practice.
Recommendations in relation to Quality Improvement, Clinical Governance Initiatives and RN Professional Standards: Evidence-based recommendations are made, which if implemented correctly would prevent the same critical incident from occurring again. Literature which supports the recommendations needs to be presented, otherwise the report will have little credibility. Any recommendations must address the identified pre-disposing factors, in particular the 'root causes' and explain how the recommendations will mitigate these factors using a clear and logical approach.

Rationale

A Registered Nurse is expected to be able to reflect and analyse their professional clinical practice and to be aware of the systems in which they function. Particpating in quality improvement processes demonstrates principles of leadership and management in the clinical environment.

This assessment task will allow the student to explore these quality assurance processes and to gain an understanding of the importance of their role as a Registered Nurse in regard to patient safety.

References APA style.