Care Standards in Healthcare Institutions: Case Study


Healthcare institutions’ primary goal is to provide high-quality medical services to sustain or ameliorate patients’ well-being. Therefore, standards of care are established for each direction of healthcare systems. Notably, these standards of practice essentially concern the nurses as they work in clinical patient care settings and are the providers of primary care. However, some of them neglect the fundamental guidelines on how a nurse should or should not act and what they can do to prevent the emergence of legal implications (Halcomb et al., 2016). Violating nursing standards typically results in penalties, actions against an individual, or other legal punishments (Smith & Parker, 2015). The purpose of this paper is to investigate which care standards were violated, establish a person in charge, and explore the methods of alleviating the issue presented in the case study.

Standards of Care and Nursing

Standards of care are the established practices that are presented as necessary conditions within a sphere of nursing. These practices are based on recent scientific researches; therefore, they change over time due to the new technologies. Often these standards apply to every nurse in different settings. Moreover, they have national importance and are officially defined by the government because they are the baseline for quality medical services (Smith & Parker, 2015). There are specific duties a nurse must perform without breaching them: provide care, inform the patient on the form of treatment, and administer the treatment (Halcomb et al., 2016). Malpractice is negligence that implies a violation of professional duties that leads to damaging patients’ health (Kim, 2017). Nurse violates the standards of care when they fail to monitor, document patients’ health, communicate, use the equipment properly, and follow these practices of care.

Nursing comprises three broad divisions: practice, education, and management. Clinical practice includes nurse practitioners who are involved in almost every field of healthcare, from primary care to surgery (Smith & Parker, 2015). The management division is composed of chief nurses who still practice patient care but are also involved in the management of the healthcare system. Nurse educators teach college or university students and already practicing nurses. The case study presented gave an example of a nurse practitioner’s interaction with the patient.

Case Study Review

The case study that involves a 21-year old female student Yolanda Pinellas who was admitted to the hospital for chemotherapy, is one of the instances of nursing malpractice. Ms. Pinellas was administered intravenous (IV) infusion through an infusion pump. In the evening, it started to beep, and the registered nurse (RN) discontinued the infusion, notifying the physician and providing care to the site. However, the patient was unconscious and could not identify the nurse and what she was doing. Later, the documentation stated that there was an infiltration to the IV, which caused the necrosis of the patient’s hand with further several surgical interventions. Ms. Pinellas permanently lost her three fingers and could no longer be a conductor. The hospital lacked staff; therefore, the nurse on the shift had to take action.

Practitioner’s Perspective

The case demonstrates the negligence performed by a nurse practitioner who did not manage to provide care in time. Even though she provided care to the site, the patient could not testify anything. Apparently, the nurse was late on the site; therefore, Ms. Pinellas was already unconscious. In addition to this, the RN did not notify the patient about the interventions taken nor informed her of the treatment process. The documentation stated the infiltration to the IV, which also proves the negligence of a nurse who did not take into consideration the malfunctioning of the equipment (Kim, 2017). As a result of the nurse’s indiscretion, the patient had to suffer surgical interventions and deformity of some fingers.

Another fact demonstrating the negligence of the care standard refers to the aspect that the shortage of personnel significantly affected the patient’s health. The risk manager testified the lack of staff by stating that some nurses had to take double shifts, and float nurses shared several units. Therefore, the nurses who were busing doing their duties could not assist the patient, which lead to severe health damage.

Demanded Risk Manager’s Actions

To avoid the emergence of similar accidents and to alleviate the repercussions of them, the risk manager must take some measures. First and foremost, before any accident takes place, the manager must ensure the staff is on-site or at least close to it to provide primary care for the patients if needed. Moreover, the risk manager is supposed to make sure that each nurse has a certified qualification to provide care services and that each staff member is educated enough for conducting various procedures. Regrettably, the case of Yolanda Pinellas occurred; therefore, the risk manager’s duty now is to alleviate the consequences of the nurse’s negligence that damaged the patient. The first action that should be taken by the manager implies the entire compensating of Yolanda’s treatment. Furthermore, the medical practitioner who was responsible for the procedure must be fined, suspended, fired, or subjected to judicial intervention due to negligence that caused unpredictable harm to the patient.


In conclusion, it is necessary to mention the importance of conforming to the standards of care due to their significance in providing the best quality medical services. Malpractices and negligence in healthcare presume legal implications as their implementation may severely harm a patient. Moreover, ignoring the care standards implies severe penalties up to incarceration. Thus, the Yolanda Pinellas case exposes a nurse to a specific punishment due to the indiscretion that entailed the patient’s detriment.


Halcomb, E., Stephens, M., Bryce, J., Foley, E., & Ashley, C. (2016). Nursing competency standards in primary health care: an integrative review. Journal of Clinical Nursing, 25, 1193–1205. Web.

Kim, Y. (2017). Malpractice and complications. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 43, 1-2

Smith, M. & Parker, M. (2015). Nursing theories and nursing practice. F.A. Davis Company.

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NursingBird. "Care Standards in Healthcare Institutions: Case Study." February 11, 2022.