Читать книгу Kelly Vana's Nursing Leadership and Management - Группа авторов - Страница 222

Providing patient‐centered care is an important part of building a high reliability culture. Chris, a nurse on the Pediatric ICU, is caring for a 3‐month‐old with a history of supraventricular tachycardia, cough, and congestion. Chris reviews the patient's EHR and finds an order for Propranolol 20 mg TID. As an experienced pediatric nurse, Chris realizes this dose is high. She knows pediatric doses are weight‐based and consults a drug reference book to determine the appropriate dose. Chris also talks with the mother and learns that the infant was taking 2 mg of Propranolol three times a day at home. She then speaks to the physician, who changes the medication order and thanks Chris for her diligence.

1 Why did Chris consult a drug reference book?

2 Why did Chris talk with the patient's mother?

3 How might Chris best present this information to the physician?

4 How does Chris's diligence and the thank you from the physician help to build a culture of high reliability?

In this scenario, Chris took two positive safety actions: she demonstrated a questioning attitude while providing patient care, and she involved the patient's mother in his investigation. Chris carefully considered the patient care situation and asked herself some key questions. Is this what I expected to see? Does this fit with what I know? Does this make sense to me? She then investigated by checking with independent, expert sources, competent people, and written materials that could help resolve the question.