During the night, a patient fell in the bathroom and sustained a hip injury
The patient was very upset because of being unable to attend a granddaughter's wedding in 2 days. The team looked at the process and determined that the patient had been medicated with a narcotic, had urinary urgency so had not taken the time to put on shoes, failed to turn on the light because the door to the hall let in some light, and stumbled over a towel that had been placed to collect water leaks caused by construction that was in progress to replace damaged sinks. Which factor was a special cause variation?
a. Failure to take time to put on shoes due to urgency
b. Unsteady gait due to narcotic administration
c. Poor lighting that led to decreased vision
d. Improper construction that caused the leak and towel placement
ANS: D
Correct: A special cause variation is an uncommon variation that is unstable and unpredictable, is not under statistical control, and is related to a clearly identified single source, which in this scenario is the construction project.
Incorrect:
a. Urinary urgency is not an uncommon or unpredictable variation.
b. Safety measures should be instituted when a narcotic is administered, especially to older adult patients whose ability to metabolize and eliminate the drug may be altered.
c. Lighting was available, but it was not used.
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