Case Study: Single-Event Analysis – The Wrong Patient
Review the case study in Chapter 5 (Ross, 2014).
After the initial patient misidentification, what systemic reasons can you identify that lead to subsequent caregivers not recognizing that the patient transferred to, prepped for, and undergoing surgery was not the right patient?
Use the three components of root cause analysis to evaluate the following.
Guidelines for Submission: Your paper should be submitted as a one- to two-page Microsoft Word document with double spacing, 12-point Times New Roman font, one-inch margins, and at least three sources cited in APA format.
How significant was the role of data collection and data analysis in measuring the chronology of events? Explain.
From your perspective, what steps should have been taken to avoid this latent medical error?
Evaluate why and how humans produce errors and what precautions should have been taken in this case study.
