Name
Chamberlain University
NR-544: Quality & Safety in Healthcare
Prof. Name
Date
Saleema underwent a total hip replacement surgery in March 2015. Within a week after the procedure, she noticed her stitches were bleeding. Concerned, she visited her physician, who diagnosed the issue as a superficial hematoma. Despite reassurance, the bleeding continued for three weeks, which led to two additional physician visits and one emergency room trip. On each occasion, she was discharged with the same diagnosis of a superficial hematoma.
During a home care visit, a visiting nurse became alarmed by the degree of blood loss and immediately arranged for Saleema to be transported to the hospital. Upon further evaluation in the emergency department, clinicians discovered a severe infection that had progressed to the bone. This required emergency surgery, after which a PICC line was placed for intravenous administration of vancomycin. Unfortunately, Saleema developed Steven’s Johnson syndrome from the medication, which initially went unrecognized as the skin on her hands began peeling.
Her condition further deteriorated, leading to acute renal failure that necessitated rehospitalization. Within two days of being admitted, she developed Clostridioides difficile infection along with several vancomycin-resistant bacterial infections. After battling these complications for nearly two months, Saleema succumbed to septicemia, marking a tragic end to what was initially expected to be a routine hip replacement.
As future risk management nurses, it is crucial to evaluate such cases thoroughly to understand system failures, improve safety standards, and prevent similar outcomes. The following discussion explores the approach to interviewing Saleema’s family, preferred methods of data collection, and the appropriate measurement levels for assessing relevant questions.
To understand the circumstances leading to Saleema’s death, it is important to conduct a structured interview with her family. The interview should aim to capture both factual details and the family’s perspective on the care she received. Data collection should include:
Chronology of events as observed by family members.
Communication patterns between healthcare providers and the family.
Family’s perception of responsiveness to Saleema’s worsening condition.
Support provided during her illness and hospitalization.
A compassionate and empathetic approach is essential to build trust and encourage open discussion. The interview should be conducted in a quiet and private setting to respect the family’s emotions while ensuring data accuracy.
The preferred method for interviewing Saleema’s family would be a semi-structured interview. This method provides a balance between guided questions and the flexibility to explore unforeseen issues that may emerge during the discussion. It allows the interviewer to obtain both quantitative data (e.g., number of visits, duration of symptoms, medications used) and qualitative data (e.g., emotional experiences, perceptions of care, concerns about communication).
A semi-structured interview is also beneficial in sensitive cases such as this, as it gives the family space to express their emotions while still ensuring the researcher gathers targeted information.
The following table outlines two relevant questions that could be asked during the interview, along with the corresponding measurement levels and justification.
| Question | Measurement Level | Justification |
|---|---|---|
| 1. “How many times did Saleema visit a healthcare facility after her initial surgery before her condition worsened?” | Ratio | This question collects numerical data that has a true zero point (e.g., 0 visits). It allows for quantitative analysis of healthcare utilization. |
| 2. “How satisfied were you with the communication provided by healthcare professionals regarding Saleema’s condition?” | Ordinal | This question could use a Likert scale (e.g., very satisfied, satisfied, neutral, dissatisfied, very dissatisfied). It measures perceptions of communication quality in ranked order. |
These questions help capture both objective and subjective dimensions of Saleema’s experience, contributing to a more comprehensive risk assessment.
Saleema’s case demonstrates the devastating consequences of delayed diagnosis, miscommunication, and lack of timely intervention. By conducting structured interviews with her family, future risk management nurses can identify systemic gaps in care delivery and communication. Employing semi-structured interviews and using appropriate measurement levels ensures that data collected is both accurate and meaningful. Ultimately, such practices can strengthen patient safety initiatives and reduce preventable harm in healthcare settings.
Agency for Healthcare Research and Quality (AHRQ). (2019). Patient safety and quality: An evidence-based handbook for nurses. U.S. Department of Health & Human Services. https://www.ahrq.gov
Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.
World Health Organization (WHO). (2020). Patient safety incident reporting and learning systems: Technical report and guidance. WHO Press. https://www.who.int
