A nurse is providing teaching with a nursing colleague about sentinel events. Which of the following statements by the nursing colleague indicates an understanding?
"An example of a sentinel event is administering incompatible blood products to a client."
"An example of a sentinel event is administering client medications 30 minutes late."
"An example of a sentinel event is documenting vital signs at the wrong time in the client's electronic health record."
"An example of a sentinel event is administering a prescribed sedative to a client for insomnia."
The Correct Answer is A
A. Administering incompatible blood products is a significant medical error that can result in severe patient harm, including hemolytic transfusion reactions, which can be life-threatening. This type of incident qualifies as a sentinel event because it involves serious injury or death and necessitates immediate investigation and corrective actions to prevent recurrence.
B. While administering medications late is a medication error and can affect patient outcomes, it does not typically qualify as a sentinel event unless it results in serious harm or death. Sentinel events are generally those with more severe consequences or potential for significant harm.
C. Documenting vital signs at the wrong time is a documentation error and could potentially lead to issues in patient care. However, it is not classified as a sentinel event unless it results in significant harm or jeopardizes the patient's safety.
D. Administering a prescribed sedative for insomnia, when done according to a valid prescription and proper protocols, is a routine medical intervention and does not typically constitute a sentinel event. Sentinel events involve unexpected and serious outcomes rather than standard clinical procedures when performed correctly.
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Correct Answer is D
Explanation
A. This is a professional and important action. Ensuring that a client is competent to consent means that the nurse is verifying that the client understands the nature, purpose, risks, and benefits of the procedure. Competence to consent is a legal and ethical requirement, and it is part of the nurse’s role to support and facilitate the informed consent process.
B. This is also a professional and necessary action. It involves checking that the client’s consent is given freely, without coercion or undue pressure. This step ensures that the consent is valid and ethical. It is part of the nurse's responsibility to ensure that the consent process respects the client's autonomy.
C. The nurse as a witness is there to observe that the consent is signed by the client and that the client understands what they are consenting to. However, the nurse should not be the one explaining the procedure or the risks involved unless they are specifically trained and authorized to do so.
D. This is generally not considered professional behavior for a nurse unless they have specific training and authorization to provide detailed information about surgical procedures. Typically, detailed explanations of the procedure are provided by the surgeon or a qualified healthcare provider.
Correct Answer is B
Explanation
A. According to the National Council of State Boards of Nursing (NCSBN), there are actually 5 rights of delegation. These are the Right Task, Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision/Evaluation. Each of these rights helps ensure that tasks are delegated appropriately and safely.
B. This statement indicates an understanding of delegation. While the nurse can delegate tasks, they remain accountable for the outcome. This means the delegating nurse must ensure that the task is completed appropriately and the results are satisfactory. The responsibility for the task remains with the nurse, even though the execution is handled by someone else.
C. It is important for the delegate to ask questions if they are unclear about the task or need additional information. Effective communication and clarification are crucial for ensuring that tasks are performed correctly. The delegate has the right and responsibility to seek clarification to ensure safe and effective task performance.
D. While the nurse manager may oversee and support delegation processes, the responsibility for delegating specific tasks generally falls to the registered nurse (RN) who is managing the care for that shift. The RN assesses which tasks can be delegated and to whom, based on the needs of the patients and the skill level of the assistive personnel.
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