Defenses to Malpractice and Risk Management

Take the malpractice case assigned to your group and discuss the defenses that may be raised in that case. Discuss how the incident could have been prevented. What risk management techniques could have been used before and after the adverse patient occurrence?

 

My Malpractice case is below

 

 

Case Study 2: Wrongful Death by Howard Carpenter on Behalf of Wilma Carpenter, Deceased

People Involved in Case:

Mrs. Wilma Carpenter — patient, deceased

Mr. Howard Carpenter — husband and plaintiff in wrongful death suit

Mrs. Scale, RN, MS — nursing supervisor

Elizabeth Adelman, RN — recovery room nurse

Richard Washington, MD — orthopedic surgeon

Judy Gouda, RN, NP

Joseph Alsoff, LPN — post-surgical unit nurse

Kelly Wheeler, RN — post-surgical unit nurse

David Casler, LRT

Susan Post, JD — risk manager

Amy Green — quality assurance

Michael Parks, RN, MS, CNS — education coordinator

Caring Memorial Hospital

Facts:

The plaintiff, Mrs. Carpenter, was a 55-year-old woman who underwent a total hip replacement at Caring Memorial Hospital. The physician was Richard Washington, MD. Dr. Washington is an orthopedic surgeon. His nurse practitioner is Judy Gouda, RN, NP. Dr. Washington reviewed the consent with Mrs. Carpenter prior to surgery. Joseph Alsoff, LPN, witnessed the consent and Mr. Carpenter was present. Joseph does not remember the doctor ever mentioning that death could be a result of the surgery. The recovery room nurse is Elizabeth Adelman, RN. The respiratory therapist is David Casler, LRT. The nurse on the post-surgical unit was Kelly Wheeler, RN. The supervising nurse was Mrs. Scale, RN, MS.

The patient had an epidural catheter for a post-operative pain management following an episode of hypotension in the recovery room which was treated with Ephedrine. Judy Gouda made rounds on the patient in the recovery room after the hypotensive event and vital signs were stable. The patient, Mrs. Carpenter, was placed on a medical surgical nursing unit with the epidural. The nurse, Kelly, was assigned to the patient and had not worked on that unit before, but had worked in post-acute critical care units. The nurse’s assignment was to provide patient care on the entire floor for that shift. There was also an LPN, Joseph, on the unit. It was a busy day on the unit. Mrs. Carpenter was not the only post-operative patient.

Kelly assessed the plaintiff upon admission, checked the IVs, asked if the patient was in pain, noted that the patient was responsive and understood where she was, and was stable. She then left to care for other patients.

The licensed practical nurse, Joseph Alcoff, had been working on the unit for several years. It had been rumored that Joseph was an alcoholic. There was no evidence that he had been drinking on the unit. Approximately an hour after the patient arrived on the unit, she was unable to tolerate respiratory therapy that was ordered and she became nauseated and vomited. David Casler administered the respiratory therapy. According to Kelly, the registered nurse, 10 minutes after the vomiting episode, Joseph Alcoff, the LPN, found the patient blue and unresponsive and called a code. Joseph is the only person other than the physician that carries his own liability insurance. The hospital also has malpractice insurance.

The code team responded, along with Kelly, the registered nurse. Mrs. Carpenter was intubated and cardiac resuscitation was initiated. The patient responded to resuscitative efforts and she was transferred to the intensive care unit. Subsequently, Mrs. Carpenter did not do well, was unresponsive, and declared brain dead and taken off the respirator. She did not have a DNR in place.

There is a conflict in testimony between Joseph the LPN and Kelly the RN. Joseph indicated that Kelly found the plaintiff to be unresponsive after the vomiting episode and called the code. The record is not clear as to when the vital signs and epidural site were assessed. Kelly said she did a motor and sensory level assessment and they were fine — it is not charted though. The time elapsed between the vomiting episode and finding the patient is in dispute. The final diagnosis was anoxia encephalopathy due to the time lapse between CPR being initiated. The patient was eventually extubated, breathed independently for a period of time, and then subsequently expired.

The vital signs ordered by the physician were hourly. The hypotensive episode in the recovery room had not been reported to the registered nurse.

The risk manager is Susan Post, JD, who works in collaboration with the quality assurance director Amy Green. Amy had noted when doing chart reviews over the last 3 months prior to this incident that the vital signs taken in the recovery room were not charted, not done, or not reported to the units. She was in the process of collecting data from the different units on this observation. She also noted a pattern of using float nurses to several postoperative units. Prior to this incident, the clinical nurse specialist, Michael Parks, RN, MS, CNS, was consulting with Susan Post and Amy Green about the status of staff education on these units and what types of resources and training was needed.

 

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sleek-writer

Employee Production Worker Program 

Design an Employee class that has fields for the following pieces of information:

  • Employee Name
  • Employee Number

Next, design a class named ProductionWorker that extends the Employee class. The ProductionWorker class should have fields to hold the following information:

  • Shift Number (an integer, such as 1, 2, or 3)
  • Hourly Pay Rate

The workday is divided into two shifts: day and night. The shift field will hold an integer value representing the shift that the employee works. The day shift is shift 1 and the night shift is shift 2.  Design the appropriate accessor and mutator methods for each class.

Once you have designed the classes, design a program that creates an object of the ProductionWorker class and prompts the user to enter data for each of the object’s fields. Store the data in the object and then use the object’s accessor methods to retrieve it and display it on the screen.

You are to submit the following for the assignment:

  • Submit your JAVA source code that you generated from RAPTOR with comments added to each line or where necessary to explain program flow.  Also submit the RAPTOR file (flowchart) of your working program.
  • Make sure you run it to make sure it is error free and does what it is supposed to.

You can use the generate dropdown to create example JAVA code based on your working logical flow chart to see what the code would look like.

Remember to follow the guidelines of good program design. Make sure to use meaningful variable names and include comments as needed.

 

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Can you write a five body essay in short time?

Topic: Does the research on the internet have a positive or negative effect on reading comprehension for college students?

 Instructions on the attachemnt FOLLOW CAREFULIY and use the ERAU database as a refrence 

 

 

 

 MLA style 

 

 

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Introduction to Law Enforement

You have been employed as a law enforcement officer for over 5 years after graduating from the American Intercontinental University online campus. You served as a patrolman for the first 3 years, and since you graduated from AIU, the police chief asked you to head up the training department, which includes the police academy and annual training of the police officers. The police chief has asked you to give a class to every police officer concerning the following listed topics, but first, he wants to know your views on these topics and questions, so he has asked you to write a paper of 2–3 pages on these topics and questions.

The development of policing in America was greatly influenced by the developments of the London Metropolitan Police under the leadership of Robert Peel. During his tenure with the department, Robert Peel developed what he termed the principles of policing. Many of the original principles of policing that he developed are still important in contemporary policing. The following are two of these principles (A History of the Nine Principles of Policing, n.d.):

  • No quality is more indispensable to a policeman than a perfect command of temper; a quiet, determined manner has more effect than violent action.
  • The securing and training of proper persons is at the root of efficiency.

Now, the police chief would like for you to write a paper of 2–3 pages concerning the above listed two principles and how they pertain to the following listed questions:

  • Why is the command of temper important to the demeanor of the typical police officer? What can be achieved with it, and what can happen without it?
  • Has enough been done in law enforcement to develop the proper demeanor of law enforcement officers? Can you find research that suggests that demeanor training is a core part of law enforcement training, or is demeanor training needed to be included in law enforcement training?
  • If you were the chief of police of a local law enforcement organization with the opportunity to establish guidelines on developing the demeanor of law enforcement officers, what methods would you utilize? The police chief is really interested in hearing your answers to these questions and principles as they are applied to each other. How would you know that the officers were developing in this area, and what would your metrics be?
  • The selection and training of personnel is perhaps one of the most important areas of responsibility that a department has for its employees. Describe the areas in which you feel your officers would benefit the most from training, and explain briefly why you chose those areas of training.
 

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Why did ordinary citizens want to change the way that tuna are caught?

Why did ordinary citizens want to change the way that tuna are caught?
 

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Statistics Exam

Hello, 

I need someone to do my statsitics exam, its 20 questions, and multiple choice. File is attached. Serious inquires only, obviously there is no way you can have it back to me in an hour and the answers be correct, been scammed before. I have 3 mmore, if good work then I will ask you to do the next 3.

 

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GEN499

week 3

 

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your trash has the dimensions of 4ft,6ft,8ft. How much trash can you put in the can ?

your trash has the dimensions of 4ft,6ft,8ft. How much trash can you put in the can ?
 

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baber makalya

FIGURE 5.1: The Six-Box Organizational Model
The 7-S Framework
the star model
The congruence model
The Burke-Litwin Model
The Four-Frame Model
u can only use these model?
 
Select a Diagnostic Model (see Chapter Five) that you utilize to review aspects of change activities and actions that have been taken by the companies chosen. Here we are looking at the “parts” of the companies as well as their strategies, as surmised by your research in Part 1. It is acknowledged that this information will not be complete, as you are looking at these companies as an outsider; but a thoroughly researched paper will give enough data to allow some (well-defended) assumptions on your part.
Here’s what to do:
1. Choose one Diagnostic Model (i.e. 6-box, 7S, congruence, or etc.) to apply to the two chosen companies. Choose the model which you feel best identifies and measures the relevant aspects of the organization’s performance and therefore the diagnostic choices made will affect your findings.
2. Apply the data obtained in your research through an analysis of the appropriate chosen model. This will allow you to create a diagnosis of where each company is today (as per the criteria of the model).
3. Create a SWOT Analysis for each of the two chosen companies change plans/programs, utilizing information obtained in the diagnosis. (Strengths, Weaknesses, Opportunities, Threats.)
4. Compare the two company analyses to each other and offer your perspective (value judgment) of the effectiveness of the changes made to date in each case.
5. Identify potential areas of resistance that may occur and at least one strategy to respond to each. (This will most likely come from your Weaknesses/Threats section of your SWOT. If not, take another look at your SWOT.)
6. Write your paper including each of the above sections, and analyses
 

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