NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

Case Study of the The Missing Needle Protector

L. Straight is director of clinical services at Hopewell Hospital. As in many hospitals, a few physicians provide care that is acceptable, but not of very high quality; they tend to make more mistakes than the others and have a higher incidence of patients going “sour.” Since Straight took the position 2 years ago, new programs have been developed and things seem to be getting better in terms of quality.

Dr. Cutrite has practiced at Hopewell for longer than anyone can remember. Although once a brilliant general surgeon, he has slipped physically and mentally over the years, and Straight is contemplating taking steps to recommend a reduction in his privileges. However, the process is not complete, and Cutrite continues to perform a full range of procedures.

The operating room supervisor appeared at Straight’s office one Monday afternoon. “We’ve got a problem,” she said, somewhat nonchalantly, but with a hint of disgust. “ I’m almost sure we left a plastic needle protector from a disposable syringe in a patient’s belly, a Mrs. Jameson. You know, the protectors with the red–pink color. They’d be almost impossible to see if they were in a wound.”

“Where did it come from?” asked Straight.

“I’m not absolutely sure,” answered the supervisor. “All I know is that the syringe was among items in a used surgical pack when we did the count.” She went on to describe the safeguards of counts and records. The discrepancy was noted when records were reconciled at the end of the week. A surgical pack was shown as having a syringe, that was not supposed to be there. When the scrub nurse working with Cutrite was questioned, she remembered that he had used a syringe, but, when it was included in the count at the conclusion of surgery, she didn’t think about the protective sheath, which must have been on it.

“Let’s get Mrs. Jameson back into surgery.” said Straight. “We’ll tell her it’s necessary to check her incision and deep sutures. She’ll never know we’re really looking for the needle cover.”

“Too late,” responded the supervisor, “she went home day before yesterday.”

Oh, oh, thought Straight. Now what to do? “Have you talked to Dr. Cutrite?”

The supervisor nodded affirmatively. “He won’t consider telling Mrs. Jameson there might be a problem and calling her back to the hospital,” she said. “And he warned us not to do anything either,” she added. “Dr. Cutrite claims it cannot possibly hurt her. Except for a little discomfort, she’ll never know it’s there.” NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

Straight called the chief of surgery and asked s hypothetical question about the consequences of leaving a small plastic cap in a patient’s belly. The chief knew something was amiss but didn’t pursue it. He simply replied there would likely be occasional discomfort, but probably no life–threatening consequences from leaving it in. “Although,” he added, “one never knows.”

Straight liked working at Hopewell Hospital and didn’t relish crossing swords with Cutrite, who, although declining clinically, was politically very powerful. Straight had refrained from fingernail biting for years, but that old habit was suddenly overwhelming.

 

NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

Summary of case study facts

The case involves a missing needle protector that was most likely left in the patient during surgery. The operating room supervisor argues that a check of the equipment after surgery revealed that a disposable needle used in the surgery lacked a protector during the check. The missing needle protector is pink in color and likely to have been left in the patient’s belly and closed up in the wound after surgery. Dr. Cutrite who was the attending surgeon is getting old and is reported to have been making many mistakes. He was informed of the likely surgery mistake and decided to ignore the issue, indicating that it would unlikely to develop into a complication. The operating room supervisor bring the case before the director of clinical services who decides not to confront Dr. Cutrite because he had significant support in the facility, not to inform the patient, and ignore the issue because the chief of surgery advice that it would unlikely to be an issue.

A review of the case details based on the three components of ethical-decision making model reveals significant ethical concerns. Firstly, there is an absence of moral awareness/sensitivity. Only the supervisor appears to be aware that the situation contains a moral issue and is keen on locating the missing needle protector. Both the director and Dr. Cutrite seem unaware that their actions have the potential to harm or benefit the patient as they are not keen on informing the patient about the missing needle protector or having it removed before it develops into a complication. Secondly, there is a lack of moral judgement in terms of using moral justification to formulate and evaluate possible solutions. In fact, the medical personnel appear more concerned with how the case affects them, than how the missing needle protector would harm the patient. Thirdly, there is a lack of moral intention/motivation in terms of choosing a decision over another with a different value. The parties involved did not commit to choosing the moral value, and were instead more concerned with maintaining personal power than doing what is morally right (Grace, 2018).

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Analysis of the case factors

There are five factors revealed in the case details. Firstly, a pink-colored need protector is missing and likely to have been left in the wound during surgery. Secondly, Dr. Cutrite has been slipping physically and mentally, and may be unable to continue with his full range of responsibilities. Thirdly, Dr. Cutrite is politically powerful. Fourthly, if left in the wound, the needle protector is unlikely to threaten the patient’s life, although there is a possibility that it could have negative effects. Finally, the patient has been discharged home and is no longer in the hospital.

Effectiveness of communication approaches

There were four significant communication failures in the case. Firstly, Dr. Cutrite whose clinical capabilities have been digressing was allowed to continue with the full responsibilities. This was a communication failure since he is allowed to continue with surgery responsibilities that he may be unable to competently complete. Secondly, the issue of the missing needle protector was brought to Dr. Cutrite’s attention and he chose to ignore it as a non-issue. Thirdly, the director decided not to follow up with Dr. Cutrite on the possible mistake made thus exposing other surgery patients to potential harm. Finally, the patient was not informed of the possibility that a needle protector was left in the wound during surgery. These are all cases of ineffective communication that place the surgery patient at risk and allow Dr. Cutrite to continue with his surgery responsibilities even when other patients are placed at risk (Butts & Rich, 2020) NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study.

Effectiveness of approach used

Five key actions were undertaken in the case. Firstly, Dr. Cutrite was allow to continue with his surgery responsibilities even as the responsibilities should have been reduced because he was slipping physically and mentally. Secondly, the supervisor become aware that a pink-colored needle protector was missing and informed Dr. Cutrite that the protector may have been left in the wound during surgery. Thirdly, Dr. Cutrite decided not to have the wound opened up and needle protector removed since it was unlikely to cause life-threatening complications. Fourthly, the director decided not to inform the patient about the missing needle protector and not to have the surgery as she was advised that it was unlikely to cause life-threatening complications. Finally, the director did not confront Dr. Cutrite on the missing needle or discuss with him the possibility of reducing surgical responsibilities owing to declining clinical capabilities.

All the five key actions reveal that the decisions made were focused on maintaining and increasing personal power without regard for what was morally right. Another lesson learned is that the individuals involved lacked the moral courage to make the right ethical decision. As a result, the needle protector continues to present a threat to the patient. In addition, Dr. Cutrite continues with his surgery responsibilities and this places the patients at significant risk of harm (DeNisco, 2020). 

Apply ethical principles

This case was a medical error and it presents ethical issues related to four ethical principles. Firstly, principle of veracity requires that the medical personnel provide objective, accurate and comprehensive information to the patient, in a manner that helps the patient understand the information. Informing the patient that a surgery mistake occurred would help to establish trust (DeNisco, 2020). Secondly, principle of disclosure and right to knowledge. The medical personnel have an ethical obligation to disclose all the information that the patient would require to make an informed decision. The patient should be informed about the mistake to enable her make an informed decision on whether to have the needle protector removed through surgery. Thirdly, principles of beneficence and non-maleficence that directs medical personnel towards avoiding harm and doing the best for the patient. The medical personnel should take the necessary steps to minimize the harm. This includes balancing projected personal benefits against possible risk to the patients. This involves taking steps to reduce Dr. Cutrite’s surgery responsibilities so that he does not place other patients at risk (Zaccagnini & White, 2017). Finally, principles of autonomy and right to self-determination that involves allowing the patient to make her own choices and make decisions based on perceived benefits and personal views. The medical personnel have an ethical obligation to inform the patient that a medical error occurred (Connor, 2019). Based on the four discussed principles, the ethically right decision is to inform the patient about the medical error and reduce Dr. Cutrite’s surgery responsibilities so that he does not place other patients at risk (Finkelman, 2019).

References

Butts, J. B., & Rich, K. L. (2020).
Nursing Ethics: Across the Curriculum and into Practice
(5
th
ed.). Jones & Bartlett Learning, LLC.

Connor, J. (2019).
Professional Moral Courage in Nurse Executive Leadership: A Competency Framework
. Springer Publishing Company.

DeNisco, S. M. (2020).
Advanced Practice Nursing: Essential Knowledge for the Profession
(4
th
ed.). Jones & Bartlett Learning, LLC.

Finkelman, A. (2019).
Professional Nursing Concepts: Competencies for Quality Leadership
(4
th
ed.). Jones & Bartlett Learning, LLC.

Grace, P. J. (2018).
Nursing Ethics and Professional Responsibility in Advanced Practice
(3
rd
ed.). Jones & Bartlett Learning, LLC.

Zaccagnini, M., & White, K. (Eds.) (2017).
The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing
(3
rd
ed.). Jones & Bartlett Learning, LLC.

 

Instructions – NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

Develop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solution in a 3-5 page paper.

Introduction

Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

Access the 
Ethical Case Studies
media piece to review the case studies you will be using for this assessment.

Select the case most closely related to your area of interest and use it to complete the assessment.

Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study.

Include the selected case study in your reference list, using proper APA style and format. Refer to the 
Evidence and APA
section of the Writing Center for guidance.

Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.

Identify who is involved or affected by the ethical problem or issue.

Access the 
Ethical Decision-Making Model
media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.

Apply the three components outlined in the Ethical Decision-Making Model media.

Analyze the factors that contributed to the ethical problem or issue identified in the case study.

Describe the factors that contributed to the problem or issue and explain how they contributed.

Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The 
NHS-FPX4000: Developing a Health Care Perspective Library Guide
will help you locate appropriate references.

Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.

Review the 
Think Critically About Source Quality

Assess the credibility of the information source.

Assess the relevance of the information source.

Discuss the effectiveness of the communication approaches present in a case study.

Describe how the health care professional in the case study communicated with others.

Assess instances where the professional communicated effectively or ineffectively.

Explain which communication approaches should be used and which ones should be avoided.

Describe the consequences of using effective and non-effective communication approaches.

Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Describe the actions taken in response to the ethical dilemma or issue presented in the case study.

Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.

Discuss the key lessons this case provides for health care professionals.

Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Describe the proposed solution.

Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.

Discuss how likely it is the proposed solution will foster professional collaboration.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Apply the principles of effective composition.

NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

Determine the proper application of the rules of grammar and mechanics.

Write using APA style for in-text citations, quotes, and references.

Determine the proper application of APA formatting requirements and scholarly writing standards.

Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 1 Example [PDF]
.

Additional Requirements

Your assessment should also meet the following requirements:

Length: 3–5 typed, double-spaced pages, not including the title page and reference page.

Font and font size: Times New Roman, 12 point.

APA tutorial: Use the 
APA Style Paper Tutorial [DOCX]
 for guidance.

Written communication: Use correct spelling, grammar, and punctuation.

References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.

APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.

Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

Competency 3: Apply ethical principles and academic standards to the study of health care.

Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.

Discuss the effectiveness of the communication approaches present in a case study NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Write following APA style for in-text citations, quotes, and references.

 

Applying Ethical Principles Scoring Guide – NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

CRITERIA

NON-PERFORMANCE

BASIC

PROFICIENT

DISTINGUISHED

Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Does not summarize the facts in a case study or use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Inadequately summarizes the facts in a case study or incompletely uses the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Summarizes the facts in a case study and uses the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Summarizes the facts in a case study and uses the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it. Supports the reasoning with examples from scholarly readings.

Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

Does not apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study.

Identifies academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence but does not apply them to support an analysis of the case.

Applies academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

Applies academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case, and explains how the chosen articles support the analysis.

Discuss the effectiveness of the communication approaches present in a case study.

Does not discuss the effectiveness of the communication approaches present in a case study.

Describes the communication approaches present in a case study but does not discuss their effectiveness.

Discusses the effectiveness of the communication approaches present in a case study NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study.

Discusses the effectiveness of the communication approaches present in a case study, explaining which approaches should be used more and which should be avoided.

Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Does not discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Describes the approach used by a professional to deal with problems or issues involving ethical practice in a case study but does not discuss its effectiveness.

Discusses the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Discusses the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study, and describes consequences of using effective and non-effective approaches.

Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Does not apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Identifies ethical principles involved in a possible solution to an ethical problem or issue described in a case study but does not apply them.

Applies ethical principles to a possible solution to an ethical problem or issue described in a case study.

Applies ethical principles to a possible solution to an ethical problem or issue described in a case study, and explains how the proposed solution is based in ethical principles.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Does not write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Writes clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics with some errors and lapses.

Writes clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Writes clearly and logically, using evidence to support a central idea, with correct use of spelling, grammar, punctuation, and mechanics and ensures the paper contains supporting examples for the main points.

Write following APA style for in-text citations, quotes, and references.

Does not write following APA style for in-text citations, quotes, and references.

Writes following APA style for in-text citations, quotes, and references with some errors and lapses.

Writes following APA style for in-text citations, quotes, and references.

Writes following APA style for in-text citations, quotes, and references without errors, and uses current reference sources.

NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study