Critical Care Nursing.

Dehydration, Medical error, Patient safety


The scenario included in Appendix n.1 shows multiple errors consequently leading to a patient’s deterioration. There was poor communication and record-keeping leading to an incomplete Early Warning Score Chart (EWS) and Fluid Balance Chart, and lack of practical knowledge and skills of the nursing staff in recognizing signs of deterioration of the patient. Furthermore, there is failure to understand the life-saving importance of intravenous antibiotics and the necessity of intravenous access in the case of emergency in acutely ill patients, and failure of the regular review of the patient by the nurses and doctors alike. Identified as the primary issue is the lack of communication and secondary problem an incomplete fluid balance chart, so it is evident that the lack of the communication (verbal and written) lead to a secondary problem and consequently to a deterioration of Mr. Albert.

Essential components in delivering high quality nursing care are good communication and interpersonal skills (Webb, 2011). Nursing and Midwifery Council (NMC, 2010) identified communication as one of the essential skills that students must acquire in order to make progress through their education and training to become qualified nurses. The Department of Health (DH, 2010) initiated The Essence of Care – the government’s strategy to improve the quality of the fundamental aspects of nursing care – which has communication as one of its ten key benchmark areas and stated that staff should communicate effectively with each other to ensure continuity, safety and quality of health care for all. The National Patient Safety Agency (NPSA, 2007) identified communication difficulties as a major factor affecting patient outcomes. Particular concerns included incomplete documentation and nurses not being clear and confident in their reporting. As an outcome of these findings, the essential professional guidelines highlighted health care professional’s legal accountability...
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