Despite the years of specialized training neonatal intensive care unit (NICU) professionals often receive, serious mistakes do occur within the NICUs. Like any other medical errors, these mistakes have the potential to change the life of the victim and their family forever. In the NICU, however, errors carry the added weight of affecting newborn babies and new parents. Errors that commonly occur within the NICU include patient misidentification. NICU patients are at significant risk of being misidentified and therefore receiving a treatment planned for another patient or not receiving a needed treatment. The risk of misidentification is heightened in NICU patients because they cannot self-identify and because characteristics often used to identify patients (height, weight, hair color, etc.) are very similar among NICU patients.
Miscommunication is another issue causing errors. To be truly effective, a medical team must communicate clearly and effectively on all matters relating to the patient. Unfortunately, miscommunication between teams and departments within a hospital and among members of the same team often lead to patient injuries. In many areas of a hospital, the patient can help reduce those errors. For example, an adult patient may remind a nurse that he or she is allergic to a particular medication or that a doctor had said he or she was not supposed to have a particular procedure performed. In the NICU, the patient cannot help prevent such mistakes. It is especially important therefore that doctors and nurses communicate precisely and effectively in the NICU. Written policies and procedures should be implemented to reduce such errors.
Equipment issues can create dangerous situations. NICU patients are often monitored and treated with the use of sophisticated monitors and equipment, including ventilators that are needed to help the baby breathe. When this equipment is not inspected, set up, maintained, connected, or used, babies are put at serious risk of permanent injury, including brain damage and death.
Aligned to ULO(s)
ULO3: Discuss risks associated with clinical staff work overload and burnout (CLO5)
ULO4: Explore state and federal regulations pertaining caregivers weekly working hours (CLO2, CLO5)
ULO5: Prepare a memorandum with recommendations mitigating the risks associated with the problem of nursing scheduling and overload (CLO1, CLO2, CLO3, CLO4)
The submission should reflect higher-level cognitive processing (analysis, synthesis, and evaluation), which is essential for someone being prepared to serve in an operational capacity within the healthcare and related industry.
To earn the maximum number of points, the submission should reflect college-level execution with clear evidence of critical thinking, synthesis of relevant information from credible sources, and clear mastery of the concepts necessary to successfully execute each component of the assignment.
Portoghese, I., Galletta, M., Coppola, R. C., Finco, G., & Campagna, M. (2014).
Burnout and workload among health care workers: The moderating role of job control.
Safety and Health at Work, 5, 152-157. Retrieved from:
Sigma Global Nursing Excellence. (2018). Facts on the nursing shortage in North America. Retrieved from: https://www.sigmanursing.org/why-sigma/about-sigma…
Diana, a neonatal nurse worked 4 twelve hour shifts at Children’s Hospital (CH) per week. She was in personal financial trouble and seeking additional hours to pay for her credit debt. She could add an additional 12-hour shift at CH. Diana also started working at Memorial Hospital (MH) on her days off. She was working 2 twelve hour shifts at MH which has a small Neonatal unit. It appeared there were no breaks in her schedule at the time. In total, she was working 84 hours a week with little rest and no days off. Several days a week she was working 2 twelve hour shifts back-to-back (24 hours straight); one at CH and the second at MH.
At that juncture, one day, she felt particularly burned out and her level of attention was decreased. She misidentified one of the babies in the NICU and did not provide the baby with a needed treatment. As a result of the medical error, the baby suffered injuries.
Assume that this scenario took place at the Obstetrics and Neonatal Care Department of CH located in the city where you reside, and you are the Risk Manager at this facility.
Prepare a memorandum addressing the risks associated with the problem of nursing scheduling and overload. Consider applicable state and federal regulations. Address any considerations about any available guidelines a caregiver may work per week.
Does a caregiver have to disclose their employment at another facility?
Do accreditation organizations consider the amount of time being worked by a healthcare professional and the possible risk management exposure to their facility?
Provide specific recommendations to mitigate the possible exposure in Nurse Diana’s situation.