assignment must include Title page, Page Numbers , Running head and Intext-citations.
You are a staff nurse on the observation unit at a community hospital. Your patients are
generally stable ones admitted for a stay that is expected to last 1-2 days. Your facility is
working to decrease emergency department (ED) length of stay. They have implemented
several interventions to accomplish this:
? When the ED provider determines that a patient requires hospital admission, they
contact the hospitalist to inform them of the admission, and then place the initial hospital
orders and send the patient to the unit. The hospitalist provider is notified when the
patient arrives to the unit, and they perform their initial visit (history & physical
examination and orders) at that time.
? The ED nurse attempts to call report to the unit nurse assuming care of the patient;
however, if that nurse is not available to take report at that time, the patient is
transported to the floor and the unit nurse is instructed to call the ED nurse back for
Your patient, Mr. Phillips, is a 66 year old man with no prior history of cardiac disease. He
presented to the ED with chest pain after shoveling snow. His EKG and first set of cardiac
enzymes were normal. He is being admitted to the observation unit for monitoring and stress
Just prior to his transfer, his second set of cardiac enzymes is drawn. He is then transported to
the unit. You were not available to take the call for report from the ED nurse. The second set of
cardiac enzymes comes back with a markedly elevated troponin, indicative of possible
myocardial infarction. The lab tech calls the elevated values to the ED nurse, who informs them
that the patient has left the ED. The lab tech assumes that the ED nurse will call you with the
critical result; the ED nurse assumes that the lab tech will call you with the critical result. As a
result, you are not called with the critical result.
The transport team has been experiencing a staffing shortage lately; as a result they are
constantly rushed and running behind. When the transporter delivers Mr. Phillips to the room,
they do not notify you of his arrival. About 10 minutes after he gets to the room, the CNA notices
that he is there, greets him and performs her admission tasks (height, weight, belongings
checklist). She then finds you and tells you that your patient has arrived.
You greet Mr. Phillips and perform your initial exam. He tells you that he is experiencing chest
pain again. You contact the hospitalist provider, who requests a second EKG and informs you
that they will be down shortly. The provider arrives to the unit, performs a history and physical
examination, and goes to the computer to enter orders electronically. It is at this time that they
see the critically elevated troponin level. The repeat EKG shows ST elevation in three leads.
The cardiac cath team is called in for a stat heart cath. Approximately 70 minutes has now passed
In this case study
1. The Impact of Evidence-Based Practice (EBP)
(a) Provide a basic introduction of the case study scenario you selected and explain why it was selected.( I selected: In effective Inter Professional Health care communication)
(b) Determine the potential and actual risks within the healthcare system and explain the reasons for these risks. You may provide these in a list format.
(c) Identify the greatest risk from your analysis and discuss why it is the most significant risk related to your chosen case scenario.
Choose one (1) of the risks you identified and find a scholarly article on the topic that provides evidence of application to practice. (Possible sites to explore: , Cochrane, National Guidelines Clearinghouse, Innovations Exchange, National Quality Measures Clearinghouse). Discuss how the article you have chosen related to the risks in your selected scenario provides evidence to inform practice.
2. Change and Quality Improvement
(a) Imagine that you are a leader in the setting where the selected case study scenario has happened.
(b) Describe a clinical practice policy that will need to be changed due to the incident in your chosen scenario.
(c) If you were to proceed with this policy change, determine which change model you would select and explain why you chose that model.
(d) Explain how you might empower staff to implement this change. Use the Internet find at least two (2) articles to support your position. Describe how these articles apply to the scenario and incorporate them into your explanation.
3. Teamwork and Collaboration
(a) Discuss at least three (3) strategies for communicating and implementing the policy change that you identified earlier in the Change and Quality Improvement sections of this course.
(b) Explain how you will promote teamwork during the change.
(c) Explain how you will promote collaboration during the change.
(d) Include at least one (1) journal article published within the past five (5) years from the Internet that relates to teamwork and collaboration during change. Describe how this article applies to the scenario and incorporate it into your explanation.
4. Patient-Centered Care
In this section, you must aIDress best practices specific to your case study scenario topic.
(a)List at least three (3) best practices related to the topics (informatics/information technology, transition to practice, evidence-based care, teamwork/collaboration, interdisciplinary care, etc.) you have explored in this course.
Describe how the integration of these best practices can promote patient-centered care.
Include at least two (2) related journal articles from the Internet y that aIDress the relationship between quality and patient-centered care. Describe how your selected journal articles apply to the scenario.
(a) Discuss how informatics did or did not play a role in the scenario.
(b) Research and discuss a technology (program, software, EMR module or element, equipment, etc.) that might have changed the outcome of the scenario.
(c) Include at least one (1) journal article from the Internet as a reference for this section. Describe how your selected journal article applies to the scenario.
6. Synthesis / Conclusion
Describe three to five (3-5) legal and/or ethical points to consider in the context of your chosen case study scenario.
(B) Describe future considerations for quality and safety in your chosen scenario.
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