NR 544 Week 2 Scholarly Discussion Forum

Student Name

Chamberlain University

NR-544: Quality & Safety in Healthcare

Prof. Name

Date

Week 2: Scholarly Discussion Forum (graded): Data Collection and Risk Management

Saleema underwent a total hip replacement in March 2015. A week after the surgery, she noticed that her stitches began bleeding. Concerned, she visited her physician and was informed that it was a superficial hematoma. Despite this reassurance, the bleeding persisted for three weeks, requiring multiple consultations, including two physician visits and an emergency room trip. Each time, she was discharged with the same diagnosis of superficial hematoma.

Eventually, during a home visit, her nurse became alarmed at the degree of blood loss and promptly arranged for an ambulance. Upon further examination at the emergency department, a severe infection was identified that had advanced into the bone. Saleema was rushed into emergency surgery, and a peripherally inserted central catheter (PICC) line was placed to begin treatment with vancomycin. Unfortunately, while receiving this medication, she developed Stevens-Johnson syndrome, which went unrecognized initially as the skin on her hands began peeling.

Her condition worsened as she developed acute renal failure, necessitating another hospitalization. Within two days of admission, she contracted Clostridioides difficile (C. diff) and multiple vancomycin-resistant infections. Tragically, she passed away in the hospital two months after her original surgery, with septicemia identified as the cause of death. What began as a standard surgical procedure ended in a preventable death, highlighting the importance of effective data collection, communication, and risk management in healthcare.

As a future risk management nurse, it is critical to examine how to approach Saleema’s family, collect reliable data, and identify gaps in care that contributed to this outcome.

Interview Plan with Saleema’s Family

To gather meaningful data regarding Saleema’s healthcare experience, a structured and empathetic interview plan must be implemented. The purpose of the interview is not only to collect facts but also to ensure the family feels heard and respected.

Preferred Interview Method and Rationale

The semi-structured interview method is most appropriate for this situation. This approach combines open-ended and close-ended questions, allowing the interviewer to explore the family’s perspective while maintaining focus on specific aspects of care. Semi-structured interviews are beneficial in risk management because they balance flexibility with consistency, ensuring that essential topics are covered while also permitting new insights to emerge.

Face-to-face interviews are preferred, as they allow observation of non-verbal cues such as body language and emotions, which may provide additional depth to the collected data. However, if in-person meetings are not feasible, video conferencing could serve as an alternative.

NR 544 Week 2 Scholarly Discussion Forum

Relevant Interview Questions and Measurement Levels

To ensure meaningful data collection, questions should be designed with clear objectives and appropriate measurement levels.

Question	Purpose	Measurement Level	Rationale
1. Can you describe the progression of Saleema’s symptoms and how healthcare providers responded at each stage?	To capture the sequence of events and provider interventions.	Ordinal	Responses can be organized in a timeline reflecting order and severity but not measured numerically.
2. On a scale of 1 to 5, how satisfied were you with the communication and explanations given by healthcare professionals?	To evaluate the family’s perception of provider-patient communication.	Interval	A Likert scale allows measurement of satisfaction, providing quantifiable data for analysis.

Explanation of Measurement Choices

• Ordinal Level (Question 1): This level is appropriate because the events and responses can be ranked based on severity and sequence, though the differences between categories are not measurable in exact terms. It provides a structured way to analyze the progression of care failures.
• Interval Level (Question 2): This allows for quantifiable data collection through a satisfaction rating. The use of a scale provides measurable outcomes that can be statistically analyzed to identify communication gaps.

Conclusion

Saleema’s case underscores the devastating consequences of missed diagnoses, delayed interventions, and inadequate communication. As a future risk management nurse, interviewing her family with sensitivity and precision is vital for identifying systemic flaws. Utilizing a semi-structured interview format ensures both structured data collection and space for personal insights. Carefully designed questions, supported by appropriate measurement levels, can transform subjective experiences into actionable data that helps prevent similar tragedies in the future.

References

American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). ANA.

Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.

NR 544 Week 2 Scholarly Discussion Forum

Stang, A. S., Wong, B. M., Shojania, K. G., & Etchells, E. (2018). Improving patient safety through human factors engineering: Risk management strategies in healthcare. BMJ Quality & Safety, 27(8), 637–642. https://doi.org/10.1136/bmjqs-2017-007509