Case Study 1: Patient Advocacy

Case Study 1 Questions:

What is patient advocacy according to the Yoder-Wise text and current peer-reviewed journal
literature 2. What is patient advocacy according to the Yoder-Wise text and current peer-reviewed
journal literature?

Patient advocacy is an essential component of nursing practice that involves advocating for the
rights and interests of patients. The Yoder-Wise text defines patient advocacy as “the act of
defending, advocating for, and supporting the rights and needs of patients.” This includes
advocating for their health care decisions, as well as ensuring that they receive the quality care
they need. Patient advocacy encompasses the defense of patient autonomy, confidentiality and
safety. In the same vein, Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2019). They concur in
defining it as patient advocacy is an act of “safeguarding, informing, valuing, mediating, and
upholding social justice in the provision of health care.” (P- 6) understanding this concept can help
to develop educational or management theories, design instruments to evaluate nurses'
performance in patient advocacy.

2. What is the role of an emergency contact?

An emergency contact is a person designated to be contacted in the event that the patient is
unable to make his or her own medical decisions. This applies in situations where the patient is
unconscious, incapacitated or unavailable. In this sense, the emergency contact should be
someone close to the patient who is capable of making decisions on his or her behalf. In this case
study, the patient's daughter was the emergency contact. However, erroneous contact information
prevented her from being contacted during a critical medical situation.

What is the function of a durable power of attorney?

A durable power of attorney (POA) is a legal document that allows one person (the principal) to
appoint another person (the attorney-in-fact) to make decisions on his or her behalf, including
medical decisions, if the principal is no longer able to do so on his or her own. A POA for health
care allows the attorney-in-fact to make health care decisions for the principal in accordance with
his or her expressed wishes. For the case study the implementation of a health care POA would
have been an ideal option, as it would have allowed the patient's nurse friend to make medical
decisions on her behalf when she was not accessible.

What is the nurse's primary responsibility in advocating for the patient in this situation during and
after the incident?

The nurse's primary patient advocacy responsibility in this situation is to ensure that the patient
receives the care she needs and that her rights are protected.

During the incident:

Since the patient's admission, the nurse should have verified the accuracy of her daughter's
contact information. Upon noticing the change in the patient's condition on Wednesday evening,
the nurse should have contacted the daughter immediately, informing her of the situation and
requesting her authorization to transfer her mother to the ICU.

Subsequent to the incident, the nurse had a responsibility to work with the daughter to provide
updates on her mother's condition and help her navigate the care process. In addition, she was to
submit a detailed report of the incident, describing the circumstances and actions taken, and to
participate in a review to identify areas for improvement and prevent similar situations in the
future.

5. How should the nurse have advocated for the patient and family when the patient's condition
changed on Wednesday night?

The nurse, in her role as the patient's advocate, should have acted quickly and responsibly by
contacting the daughter immediately, using the contact information provided, including searching
the chart if necessary. Communication with the daughter should have been clear and concise,
explaining the patient's condition in an understandable manner. In addition, the nurse should have
respected the daughter's decisions about her mother's medical care, even if they did not coincide
with the medical team's recommendations, thus demonstrating true support for patient autonomy.

6. How should the nurse have advocated for the patient and her family when the daughter called
the unit the next morning to ask about her mother?

I believe that the nurse, with a duty to advocate for the patient's rights, should have walked the
daughter through the medical information, explaining her mother's situation within the confines of
HIPAA. This included telling her that she was in the ICU and providing additional information within
medical privacy guidelines. In addition, the nurse should have facilitated access to additional
information, either by directing her to the appropriate ICU staff or by explaining how to obtain the
necessary permission to access her mother's medical record. Finally, the nurse should have
demonstrated empathy and emotional support during this difficult time for the daughter,
acknowledging and understanding her concern.

How should the ICU nurse have advocated for the patient and her family when the daughter called
to find out information about her mother?

In this scenario the ICU nurse, being the patient's spokesperson, should have confirmed the
daughter's identity as an emergency contact and provided information about her mother's
condition, always within the confines of HIPAA. In addition, the nurse should have explained to the
daughter the need to obtain an authorization to access additional medical information, guiding her
through the request process. Finally, the nurse should have shown empathy for the daughter's
concern, providing emotional support and understanding during this difficult time.

How should the nurse have advocated for the patient and family when the friend arrives at the
hospital in less than an hour?
Now in this scenario, the first thing the nurse should have done was The nurse, confirm the friend's
status as a legal proxy, making sure she had the authority to access the patient's medical
information. Next, she should have shared information about the patient's condition with the
friend, respecting HIPAA limits. To facilitate the process, the nurse should have guided the friend
through the health care system, either by directing her to the appropriate staff or by explaining
hospital procedures. Finally, the nurse should have shown empathy and offered emotional support
to the friend, understanding the difficult situation she was going through.

9. How should the nurse have advocated for the patient and family when the daughter arrives in
the afternoon?

In this situation, the nurse, as the patient's advocate, should have provided the daughter with
updates on her mother's condition, responding accurately and compassionately to her questions.
Similarly, considering that this was such a difficult time, the nurse should have offered emotional
support to the daughter,

What two steps should be taken to ensure that this type of situation does not happen again?

Finally, I believe that in order to prevent this type of situation from recurring, the hospital should
implement some measures, which could include the following

Guiding the improvement of its contact information verification protocols. In other words, review
and update processes to ensure that patient contact information is accurate upon admission.
Another measure could be to ask patients to confirm their contact information and provide
alternate phone numbers.

References

Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2019). Patient advocacy in nursing: a conceptual
analysis. Nursing Ethics, 26(1), 1-11. https://doi.org/10.1177/0969733019832950 (p. 6).

Yoder-Wise, P. S. (2018). Leading and managing in nursing. Mosby.