Reference no: EM133606188

Case Study: Registered Nurse Dobson was scheduled for an afternoon shift in a busy High Dependency Unit (HDU), where he had been designated the 'In Charge' nurse for that shift. Registered Nurse Dobson had at the time over 30 years of experience, primarily within the Intensive Care Unit and Emergency department settings. Throughout his career, he had consistently maintained an unblemished record, having worked in various units and hospitals.

Upon his arrival, RN Dobson received handover and noted that there were four Registered Nurses, including himself, assigned to oversee eight beds in the unit. The other RNs for the afternoon shift were RN Jones, RN Gallaway and RN Shipton. The HDU was very busy with a variety of patients coming directly from operating theatres, mostly with orthopaedic and abdominal surgeries. Shortly after handover, one of the morning registered nurses (RN George) was called away to deal with a family crisis and had to leave early. Registered Nurse Dobson agreed to take over RN George's patients, both patients recently returning from theatres.

Prior to leaving, RN George left a kidney dish on the main desk, containing a syringe, and informed RN Dobson that 'this is the fentanyl IV 100mcg for Mr Cunningham.'

Registered Nurse Dobson went with RN Jones to Bed 2 and asked the patient if their name was Mr. Cunningham. The patient made a grunting sound that appeared to be answering yes, so RN Dobson proceeded to administer the medication that was in the kidney dish. After administration of the fentanyl, RN Jones looked for the medication chart to sign for the medication given.

RN Jones reviewed the medication chart and discovered that the patient in Bed 2 (Walter Cunningham) had received fentanyl 30 minutes earlier. Swiftly, RN Jones referred to the in-patient list and observed that Bed 1 was occupied by a patient named Michael Cunningham. Reviewing Michael Cunningham's chart, RN Jones confirmed that Michael Cunningham needed pain relief and had an order for fentanyl charted. It was at this moment that RN Jones realised that the fentanyl had been administered to the incorrect patient. She promptly informed RN Dobson of the error. The medication chart for Walter Cunningham remained unsigned.

Registered Nurse Jones and RN Dobson then proceeded to administer Michael Cunningham a dose of IV Fentanyl as per his medication chart. Registered Nurse Dobson and RN Jones discussed the incident with the other registered nurses on duty at the time but asked them not to report it. Initially, the other two RNs agreed, but then thought better of it and notified their supervisors, which led to the hospital carrying out an internal investigation.

Neither Michael Cunningham nor Walter Cunningham were informed of the fentanyl mix-up, with RN Dobson and RN Jones justifying their decision by noting that the patient was audibly in pain and clearly in need of pain relief. Registered Nurse Jones also pointed out that Mr. Walter Cunningham exhibited no adverse effects as a result of the medication administration, leading them to believe that no further notification was necessary.

The internal investigation noted that RN Dobson and RN Jones both had a previously unblemished record. A notification was made to AHPRA and further investigations were ongoing.

Questions: Assessment criteria and marking rubric

Your submission will be assessed against the following criteria. You are strongly encouraged to review the marking rubric for this assessment task as it provides more detailed information about the assessment criteria. The word limit is 1000 words +/- 10%.

• Identify scope of practice issues that relates to the case study.
• Identify the legal aspects of the case with reference to legislation.
• Identify the ethical aspects of the case in relation to nursing codes and standards.
• Adheres to academic writing principles.