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 surgery, she noticed that her stitches began bleeding. Concerned, she visited her physician and was informed that it was a superficial hematoma. Despite reassurance, the bleeding persisted for three weeks, resulting in multiple consultations, including two physician visits and an emergency room trip. Each time, she was discharged with the same diagnosis of superficial hematoma.

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

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

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

Interview Plan with Saleema’s Family

To obtain meaningful data regarding Saleema’s healthcare experience, a structured and empathetic interview plan must be developed. The goal of this interview is not only to gather factual information but also to ensure the family feels acknowledged and respected throughout the process.

Preferred Interview Method and Rationale

The semi-structured interview method is most suitable for this case. This approach integrates both open-ended and close-ended questions, allowing the interviewer to explore the family’s perspectives while maintaining focus on critical aspects of care. Semi-structured interviews are valuable in risk management as they combine flexibility and consistency—ensuring essential topics are addressed while allowing unexpected insights to surface.

Face-to-face interviews are preferred because they allow for observation of non-verbal cues such as facial expressions and emotions, which can provide deeper context to the collected data. However, when in-person meetings are not feasible, video conferencing can be used as an effective alternative.

NR 544 Week 2 Scholarly Discussion Forum

Relevant Interview Questions and Measurement Levels

To ensure meaningful and valid data collection, questions should be designed with clear objectives and assigned 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 chronologically, reflecting order and severity, but cannot be numerically measured.
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 quantifiable measurement of satisfaction, supporting statistical analysis of communication effectiveness.

Explanation of Measurement Choices

Ordinal Level (Question 1):
This measurement level is appropriate because it allows for ranking the progression of events and care responses according to severity and sequence. Although the differences between categories are not numerically measurable, this structure helps identify where in the timeline of care the most significant failures occurred.

Interval Level (Question 2):
This level allows for quantifiable analysis using satisfaction ratings. A Likert scale facilitates measurable comparisons of communication effectiveness, helping to statistically evaluate where communication may have broken down between healthcare professionals and the patient’s family.

Conclusion

Saleema’s case highlights the devastating effects of misdiagnosis, delayed interventions, and poor communication. For future risk management nurses, conducting a sensitive yet structured family interview is essential for uncovering systemic flaws that lead to adverse outcomes. Utilizing a semi-structured interview approach ensures a balance between data consistency and emotional sensitivity, allowing families to share experiences while enabling collection of actionable data. By developing clear, well-measured questions, subjective experiences can be transformed into evidence that drives safer, more effective healthcare practices.

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