1
You do not follow the standards for administering insulin or other injectable medications
Failure to follow standards of care
You attempt to use a bariatric patient lift for the first time without getting help, and the patient falls
Failure to use equipment in a responsible manner
You fail to follow your hospital’s standards for postoperative assessments after receiving a patient from the operating room, and response to a ruptured suture line is delayed
Failure to assess and monitor
You do not speak up about your concerns about an older adult patient being discharged home; this patient lives alone. The patient is soon rehospitalized because no provisions were made to secure the nursing care needed after discharge
Failure to communicate
You believe a patient is in danger of cardiac arrest, but your repeated calls to a health care provider to see the patient are ignored, so you work up the chain of command. Before any health care provider sees the patient, he arrests and, despite a code, dies. You document the arrest, code, and death; however, you failed to document all the steps you took to get the patient the medical attention he needed. Sixteen months later, the family sues, and you try to remember what action you took that evening—most of which was never recorded
Failure to document
You are in the operating room and watch a surgeon break the sterile field twice. No one else seems to notice. You are intimidated by this surgeon and fail to bring this to anyone’s attention. You learn that the patient developed a serious infection postoperatively
Failure to act as a patient advocate or to follow the chain of command