A patient at your hospital is sent to cardiology department for a routine test. The patient returns without incident, and you document the time and condition of the patient on return to the room. The next day, you are summoned to the unit manager’s office, along with the charge nurse and unit secretary. The manager describes how the patient was given a dose of Glucophage the morning of the test. The physician wrote an order to hold the Glucophage for 2 days prior to the test because of contraindications between the medication and the intravenous contrast dye. The manager wants an explanation for the incident because controls are in place due to similar incidents on the unit, that should flag the medication, requiring the nurse to hold the medication prior to the test. Use the Nursing Today textbook for your responses and cite reference:
1. What is a root cause analysis (RCA) and who is responsible to complete the RCA in this case?
2. How would a root cause analysis be conducted to determine the cause of the problem? Who would you include?
3. The hospital has a nonpunitive policy for mistakes and errors. How does this affect the RCA if the cause of the problem is identified as a mistake by the unit secretary?
4. Which TJC patient safety goal was addressed in this case study?
This is for a discussion post, so no need to do in essay format. Simply answer questions and use intext citations for references.
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A patient at your hospital is sent to cardiology department for a routine test.
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