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7 / 9 / 2023
Pressure Injuries

Pressure injuries sustained during hospitalization, especially in the ICU, are not always related to poor nursing care. Acute Skin Failure was first discussed as early as 1993 in the literature. The skin is an organ like the liver, heart, lungs, etc. When patients are in the ICU and diagnosed with multi-system failure pressure injuries, almost 50% of the time are unavoidable. Still, these are rarely diagnosed due to a lack of documentation and research. When analyzing medical malpractice cases, it is essential to report with supporting data that not all pressure injuries are due to poor nursing care. Many Pressure injuries are unavoidable, especially when patients are hypoxic, have poor perfusion or impaired tissue oxygenation, cardiac instability, and are on Vasopressors and mechanical ventilation.

3 / 18 / 2023
Medical Reconciliation

Medication Reconciliation is a process that has been in place to ensure the patient's medications in the hospital setting are safe. Hospitals are notorious for medication errors. Even after the implementation of barcode scanning, which is a two-step process, first scanning of the patient’s name band, then the medication, we are still seeing devastating medication-related errors in hospitals. Medication Reconciliation should happen when a patient is admitted, transferred, or discharged from the hospital.  This process ensures that the patient is on the right medication, the right dose, frequency, and time.  I frequently find that once the patient is admitted to the hospital, all home medications are discontinued.

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As a critical care RN, one of the first things I do at the beginning of my shift is review the patient's home medications. This allows me to compare what the doctors have ordered for their patients and what the patient was on at home.  I FREQUENTLY find that patients are either on the wrong dose or not receiving medications, which can be detrimental to their outcomes while in the hospital setting. 

As a legal Nurse Expert, this is one area I assess early on to ensure any sentinel events are not related to medication errors. 

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