NUR30004: Clinical Governance and Quality - Case Study - Nursing Assignment Help

Assignment Task:

Identify why this incident occurred. 

In your poster presentation illustrate how this event could be prevented. You need to demonstrate the link to clinical governance strategies and principles. Use your oral presentation component to emphasise the key areas illustrated and how this will mitigate future occurrences of the quality issue from reoccurring. 

Identify how you will measure the effectiveness of the strategies implemented. 

As this is a poster presentation, you can use your own creativity and innovation to illustrate the story and risk mitigation techniques that can be used to create awareness and educate others. You must be able to narrate your poster in a 10 minute oral presentation.

Nurses have the highest rate of needlestick injury among health care workers. In Australia, it has been estimated that at least 180,000 nurses and other health care employees report needlestick and sharps injuries each year (ANMF, 2013). However, it is also reported that an approximated 36,000 needle stick and sharps injury are not reported (ANMF, 2013). 

Gabrielle Thompson has just started her Graduate Year at Swinburne Base Hospital. Sally is very excited because she was able to secure a position to work in the Infectious Diseases Ward (7 West), as her first clinical rotation. Gabrielle has always had an interest in Public Health and one day wants to work for Médecins Sans Frontières (Doctors without Borders) in Africa. 

Gabrielle is on night duty; tonight is her last 10 hour nightshift in a run of five night shifts. It is now 3am in the morning and Gabrielle hears the IMED ® alarm in room 28. The patient in room 28, Mr Stan Walker, is a middle aged man who is in the terminal stages of Liver Failure related to his Hepatitis C. Mr Walker at times can get very agitated and aggressive towards staff. Gabrielle hurriedly rushes into the room and attempts to troubleshoot and silence the IMED®. Unfortunately, Gabrielle forgets to take her flashlight with her into Mr Walker’s room. 

There is just enough light for Gabrielle to see Mr Walker’s intravenous line, she does not want to turn on the night light in case it wakes him up. Upon inspection of the line, Gabrielle can see that it is backed up with blood and the line has occluded. Gabrielle looks at the clinical stores at the back of the bed to find a syringe and an interlink ® cannula device to allow her to irrigate the line with N/Saline and remove the obstruction. However, there is no interlink ® devices, there is only a 18 G needle. Gabrielle thinks that she should have done her safety checks at the beginning of the shift ....... but she was just so busy. There are also no gloves in Gabrielle’s size in Mr Walker’s room, and she did not want to run out to the store room to get one. She thinks she will be okay without them and begins the procedure. 

Gabrielle inserts a 18G needle attached to a 10mls syringe into the rubber port in Mr Walker’s IV line. While attempting to aspirate the coagulated blood and then flush the IV line, Mr Walker becomes startled and jerks, causing the needle to dislodge from the rubber port of the his IV line. The needle punctures the left palm of her Gabrielle’s hand, some of the blood from the line is also sprays across her face and into her eyes. 

Gabrielle is horrified! Mr Walker is Hepatitis C positive. Later, Gabrielle also learns that he is HIV positive. Gabrielle is uncertain what to do next, she cannot remember the protocol for the treatment of needle stick injuries. She only learnt it last week in her ward orientation. Gabrielle thinks if she tells the Senior Nurse about the incident, she assumes that she will be seen as incompetent and an unsafe practitioner. Also, the ward is really busy tonight, Gabrielle thinks if she goes down to the Emergency Department she will be away from the ward for hours. She thinks if other nurses in the ward will have to pick up her workload they will think she is useless and would look upon her in a favourable light. Gabrielle decides to do nothing and tells no one about her needle stick injury. 

It is now 7 weeks past Gabrielle's needle stick, she is beginning to feel unwell with vague flu-like symptoms, a loss of appetite, fatigue and pain over her right epigastric area. Gabrielle has still not told anyone of the incident that occurred on her week of nights.

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