Question

1) Please refer to your book or reliable online sources to explain a Sentinal Event. (2 points) 2) Please find an article about an actual patient fall in a medical setting. (Hospital, nursing home, etc.) You will then write a one-page essay describing in detail the facts of the event. Please include in your articles safety precautions that were not taken. (8 points)

Answer 1

A sentinel event is described as a serious happening resulting in a patient's death or a serious physical or psychological injury.resulting from a wrongful or sometimes unexpected or unintended measure.  

Examples of the most commonly occurring sentinel events 1.unintended retention of a foreign object say mop inside the abdomen, 2.performing procedures on the wrong-site e.g surgery of right eye instead of left,3. patient fell from bed or railless wheel chair etc

One patient who was sedated last night and morning for a laparoscopy operation to be done at 10 am ,was bought to the OT in a trolley which was left unmanned near the door of the OT for sometime as the OT was still occupied.The patient fell due to the sedation.and the trolley was not having any rail.

So we should not keep the sedated patient unsupervised.

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