Chapter 16 Case Study Henry McConnell has been an administrator surveyor with th

Question

Chapter 16 Case Study

Henry McConnell has been an administrator surveyor with the Joint Commission for five years. He currently serves on a survey team reviewing a large midwestern tertiary care facility. The survey is going well, and he and the nurse member of the team are visiting the patient care areas of the facility. The chief operating officer (COO) and the chief nursing officer (CNO) accompany the two surveyors to various nursing units. They decide to visit the inpatient psychiatric unit.

This particular inpatient psychiatric unit cares for people with psychotic and other severe emotional disturbances. Many of the patients on the unit frequently suffer hallucinations. Others have had prehospital episodes of violence toward others. The unit is known in psychiatric medicine as a “locked facility,” meaning that special keys are necessary to enter or exit the unit.

As McConnell and his fellow nurse surveyor approach the unit with the COO and the CNO, the COO comments on the level of acute psychiatric patients that the institution commonly houses in the unit. She points out that the double doors are made of metal with wired glass windows and that the doors are locked from both sides. She makes a production of getting out her door access card to the unit so that they can enter, making sure that the two surveyors see that the doorknobs will not open the doors and that one can enter only with an access card. After they all pass through the doors, she turns around to show them that the doors have closed securely behind them.

They then turn to go onto the unit to do the review. The COO and the CNO walk carefully out in front of the surveyors toward the nursing station, the surveyors following a little ways behind. One of the first things McConnell observes is a 3-foot-long red-handled fireman’s axe located about 5 feet inside the doorway and up near the ceiling.

CASE STUDY QUESTIONS

1.How did the axe get there?

2.What common characteristic of healthcare organizations discussed in the “Background and Significance” section (overall discussion of regulations and policies) of this chapter is exhibited in this case?

3.How could a potentially dangerous situation such as this be avoided?

Explanation / Answer

1. Axe would have kept there to break open the doors, in case of an emergency, when the keys are lost or there's a technical fault due which be the doors can't be opened.

2. This is a case of negligence due to burnout. Working in patient psychiatric unit with patients suffering with psychotic and other severe psychological disorders is a very tough job. And if,there's not sufficient number of nurses in such units, the nurses working over there would be loaded with heavy workload and pressure at work. This would result in heavy stress and tension causing burnout in them.

3. Such potential dangerous situations can be avoided, if the nurses working in such units are not overloaded with work pressure. It should be taken care to maintain sufficient number of nurses in such units. Nurses should not be given multi tasks, so that they can focus on their work and are able to give sufficient care and attention to their patients. Creating a favorable working atmosphere would promote job satisfaction in nurses, that would ultimately result in providing effective patient care for their wellness. Thus, they would be vigilant about the potential dangerous situations for their patients and would avoid them.

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