A 76-Year-Old Man Is Brought to the Emergency Department from a Nursing

question 116

Multiple Choice

A 76-year-old man is brought to the emergency department from a nursing home in critical condition due to fever and confusion.  His nursing home records were not transferred with him.  On initial evaluation, his temperature is 38.9 C (102 F) , blood pressure is 75/50 mm Hg, and heart rate is 120/min.  The patient is obtunded and cannot provide a history.  He is immediately intubated and placed on mechanical ventilation.  An internal jugular venous central line is placed and infusion of normal saline boluses is initiated.  The covering clinician places a STAT order for cefepime and contacts the on-call pharmacist to expedite order approval.  The antibiotic is administered as soon as it arrives in the emergency department.  Shortly thereafter, the patient develops profound hypotension, skin rash, and respiratory distress.  Despite resuscitation efforts, he expires.  Retrospective review of the nursing home paperwork shows documentation of severe penicillin and cephalosporin allergy.  Which of the following interventions would improve patient safety during similar high-risk situations?

• A)Add redundancy and double checks
• B)Avoid automating key functions
• C)Avoid standardized patient handoffs
• D)Modify processes only after errors occur
• E)Restrict communication between specialties

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Definitions:

Fixed Costs

Expenses that do not vary with the level of production or sales within a certain range.

Traceable Fixed Expenses

Fixed costs that can be directly associated with a specific business segment or operation.

Segment Margin

The amount of profit or loss generated by a particular segment of a business, after accounting for the direct costs and traceable fixed costs associated with that segment.

Absorption Costing

A method of costing that includes all manufacturing costs - direct materials, direct labor, and both variable and fixed manufacturing overhead - in the cost of a product.