Nursing Excellence and Competencies

You are the nurse manager of a dialysis unit that is located within a 500-bed hospital. There are inpatients and outpatients who receive services in your department. You have a staff consisting of registered nurses (RNs) and patient care technicians. You and your staff also collaborate with other disciplines, including social workers, nutritionists, and pharmacists. A large percentage of your patients are Native Americans who live in your community or on a nearby reservation. The unit is generally staffed with 1 RN for 3 patients and 2 patient care technicians, with an average of 18 patients per day receiving services. The hospital has been in the community for over 100 years and has a strong reputation for medical care. There is generally good communication and cooperation between the staff on the unit and for staff between departments; however, there have recently been a lot of ill calls, and staff has been asked to work overtime in all departments throughout the hospital. Because there are outpatients who receive services in your department, the department is located on the first floor of the hospital that is quite a distance from the inpatient part of the hospital. One of your patients recently required a blood transfusion. The patient experienced a hemolytic transfusion reaction, which is a sentinel event. As one of your responsibilities related to quality and performance improvement, you must now lead the root cause analysis. Discuss the following: ***Successful root cause analyses require an interdisciplinary process. What components of the root cause analysis will you include? Make sure to include a comprehensive review in your analysis. ****Identify at least 2 other disciplines that will be on your team for the root cause analysis and the rationale for including them. ****What questions will you ask the team members in conducting this analysis? You may find a Framework for Conducting a Root Cause Analysis on the Joint Commission’s Web site. This will identify many (if not all) of the factors that you should consider when conducting a root cause analysis. Reference( less than 5 years ) The Joint Commission. (2013). Framework for conducting a root cause analysis and action plan. Retrieved from http://www.jointcommission.org/Framework_for_Conducting_a_Root_Cause_Analysis_and_Action_Plan/