Nursing

Patient safety: Disclosure to a child’s family

Staff Development Weekly: Insight on Evidence-Based Practice in Education, October 14, 2005

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Case scenario: Sam, a six-month-old boy on ventilation in the pediatric intensive care unit, was to undergo a bedside procedure. An experienced nurse named Jeanne gave him intravenous sedation while Dr. Jones was standing by ready to perform the procedure. Almost immediately, Jeanne noticed that she had administered too much medication and she pulled back on the syringe. Sam became hypoxic and bradycardic. A code was called, and the boy responded well to resuscitative measures. Sam's parents were at lunch at the time. Upon their return, they asked to speak to Dr. Jones to find out how the procedure had gone.

What should Dr. Jones tell the parents in this situation?

Dr. Jones could say to the parents, "We didn't do this procedure today because Sam received a larger dose than intended of a medication to sedate him, which caused him to have difficulty breathing and caused his heart rate to slow down. Fortunately, he was monitored, and we were right by his side. We were able to reverse the medication, which brought him around. He appears to be fine now, but I wanted to tell you how sorry I am that this happened to Sam. We will watch him closely, and we hope to be able to do the procedure tomorrow."

What should Dr. Jones not say to the parents at this time?

"I'm sorry Jeanne gave Sam too much sedation medicine." Only disclose factual information when you are certain it is valid.

Editor's note: The above excerpt is from the online course, "Patient Safety Series: Disclosure for the Medical Staff." For more information on this and other courses in our library, go to www.hcprofessor.com and click on Survey Prep/Patient Safety.



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