Evidence-Based Paper (EBP) Guidelines for Concept Map Presentation
“A Sentinel Event is defined by The Joint Commission (TJC) as any unanticipated event in a healthcare setting resulting in death or serious physical or psychological injury to a patient or patients, not related to the natural course of the patient’s illness.”
Two sentinel events happened in a hospital in 1 month.
A. 50 year old male in ICU passed away after suffering from Ventilator associated Pneumonia. Patient was vented after surgical removal of right lung lobe. It was post op day #9.
B. 45 year old female passed away from overdose of patient controlled analgesic (PCA). Patient was placed on PCA after laparoscopic bowel resection. It was post op day #3.
Write 1000 word paper on how to prevent any future such sentinel events. Please follow the Grading Rubric below to write your paper.
A hardcopy of EBP with attached Turnitin Report showing Similarity Index of 15% or less must be submitted to your Clinical Instructor.
ONLY DO SECIONS NAMED MECHANISMS AND ROOT CAUSE ANALYSIS
1 page for each of those sections
remaining of paper is done so do not change other sections