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A group of nurses conducting a systematic review to identify best practice evidence for hemodialysis in patient with anemia.
Which of the following should considered based on level of research evidence?
Randomized controlled trials (RCTs) are considered the highest level of evidence in research because they reduce bias and provide the most reliable results. When conducting a systematic review to identify best practice evidence for hemodialysis in patients with anemia, RCTs should be prioritized. These studies provide strong evidence on the efficacy of interventions. Case-control studies, non-experimental studies, and quasi-experimental studies provide valuable information but are considered lower levels of evidence compared to RCTs.
A nurse is checking laboratory findings of a patient with Sickle Cell Disease (SCD).
Which of the following laboratory values would be MOSTLY seen in this disease?
In patients with Sickle Cell Disease (SCD), a high reticulocyte level is commonly observed.
High Platelet Level: This is not typically associated with SCD.
Low Hematocrit Level: While common in SCD due to anemia, it is not as specific as reticulocyte count.
Low Leucocyte Level: This is not characteristic of SCD.
High Reticulocyte Level: Elevated reticulocyte count indicates increased red blood cell production in response to chronic hemolysis (breakdown of red blood cells) seen in SCD.
National Heart, Lung, and Blood Institute (NHLBI): Sickle Cell Disease
American Society of Hematology (ASH): Sickle Cell Disease and Reticulocyte Count
A staff nurse was entering patient's clinical notes in the computer, and had to leave to attend an immediate call without completion of recording. Another nurse used the account of the previous nurse to enter her notes.
Which of the following BEST describes the ethical issue that was committed?
The situation describes a breach of confidentiality, which occurs when private patient information is accessed or disclosed without proper authorization.
Negligence: This refers to the failure to provide the standard of care that a reasonably prudent person would provide in a similar situation, but it doesn't specifically address unauthorized access to patient information.
Malpractice: This is a type of negligence by a professional, which results in harm to the patient, and usually involves direct patient care rather than record-keeping issues.
Breach of Privacy: This involves the inappropriate disclosure of private information. In this case, using someone else's account does not directly disclose patient information to unauthorized parties.
Breach of Confidentiality: This specifically addresses the unauthorized access or use of patient information, which is exactly what happened when another nurse used the first nurse's account to enter notes.
Health Insurance Portability and Accountability Act (HIPAA) Guidelines
American Nurses Association (ANA): Code of Ethics for Nurses with Interpretive Statements
The doctor heard a staff nurse saying "That doctor is incompetent".
The doctor can file a complaint against the staff nurse for:
The situation described is one where a verbal statement is made that can harm a doctor's reputation. This is best described as slander.
Libel: Libel refers to written defamation, not spoken.
Assault: Assault involves a threat or attempt to physically harm someone, which is not relevant here.
Slander: Slander refers to spoken defamation. The nurse's verbal statement about the doctor's competence falls under this category.
Malpractice: Malpractice involves professional negligence that causes harm to a patient, not defamation.
American Nurses Association (ANA): Code of Ethics for Nurses
Legal Aspects of Nursing: Documentation, Confidentiality, and Defamation
A head nurse of an intensive care unit wants to ensure that the staff are performing Basic Life Support (BLS) based on latest American Heart Association's guidelines.
What will be the head nurse's BEST action?
Ensuring that staff perform Basic Life Support (BLS) according to the latest American Heart Association (AHA) guidelines involves several strategies, but performing regular mock drills is the best approach.
Reviewing the BLS Policy Periodically: While this is important, it alone does not ensure that staff are up-to-date or proficient in BLS techniques.
Performing Regular Mocks on BLS in the Unit: Regular mock drills provide hands-on practice and allow staff to apply the latest guidelines in a simulated environment. This helps in retaining skills and identifying any gaps in knowledge or performance.
Sending Staff to Renew BLS Certification Every Three Years: Certification renewal is necessary, but practical skills can degrade over time if not regularly practiced.
Monitoring the Staff Performing BLS During the Actual Scene: This is reactive rather than proactive and does not provide an opportunity for practice and improvement without the pressure of a real-life situation.
American Heart Association (AHA): Guidelines for CPR and ECC
National Institutes of Health (NIH): Effective Training Strategies in Healthcare
