[Answered]: Common teamwork barriers that can lead to a sentinel…

Common teamwork barriers that can lead to a sentinel event incluevMetropolitan Hospital has a large dialysis program. Many patients have dialysis access issues where they need to have their access sites fixed on an urgent or emergent basis. These access sites are catheters, arterial venous fistulas, or arterial venous grafts that have been placed in the patient for connection to the dialysis machine. Dialysis is life-sustaining for patients with renal failure; access sites are lifelines. Mr. Cavanaugh presented to the hospital dialysis center with a clotted dialysis graft. The surgeon was contacted, and the patient was sent to the preoperative area. The patient had not been dialyzed in four days and the patient had not eaten that day. When the nurse received the results of the required routine blood work, she noted that the potassium was quite elevated. The nurse called the operating room and stated the case had to be canceled. Dr. Jones, the surgeon, was outraged. He phoned the operating room and the nurse. An argument ensued, and words were exchanged. The nurse stated that it was unsafe to send the patient to the operating room with a high potassium level because the patient could be arrested. The surgeon stated the patient needed dialysis to lower the potassium. If Dr. Jones did not fix the dialysis access, the patient’s potassium would only get higher, which could be life-threatening. Finally, after a lengthy discussion with the anaesthesiologist, the patient, and the nurse, reason prevailed, and the dialysis access was appropriately repaired. The patient was monitored throughout the procedure by an anaesthesiologist with no adverse outcome. Discussion Questions: A. What are the facts in this situation? What could have been done to avoid this confrontation? B. What steps should be taken in the future to prevent such problems from occurring again? Should other people have been involved in resolving this dispute? Provide your reflections and rationale for your responses.