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Clinical Scenario

S​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​cenario: Resident left facility unassisted by staff or family, he was located laying on the main road between two parked cars. Onlookers had flagged down a passing ambulance and the man was being assessed for injuries, at this point a registered nurse on duty attended the scene and without assessing the resident advised the other staff to bring resident back into facility after the medics had assessed him if they didn’t transfer him to the emergency department. Medics assessed and declined the need for transfer and resident was brought back into facility and returned to his room where care staff assessed and treated wounds which included skin tears and grazes to the face, hands and legs. On commencing duty, the next AM, I was called to this resident’s room as he was vomiting, on entering the room I identified severe bruising to the left side of his face and he was pale and not responding appropriately. On completing neurological observations, I sought the advice of external parties and transfer to hospital was organized. Two days later the facility was notified that the man had passed away from a subdural haemorrhage. Investigation into this incident as there was an obvious head injury as wounds were present on his face included: • why wasn’t he taken to emergency department after being assessed by medics? • why was he not assessed by the registered nurse from the facility who attended the scene? • why did the registered nurse leave the scene and left care staff to evaluate and transfer back into facility? • How did he lea​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​ve the facility with no staff aware of his whereabouts? Questions: Respond to the following questions in relation to the clinical situation identified above. Use sub-headings to identify each of the questions in your response. 1. Describe the short term and long-term impact of this clinical situation on the staff (second victims) involved in the event, in their professional roles and personal lives. 2. As an advanced practice nurse or nurse practitioner: describe the role and responsibilities of unit managers and senior clinicians who may be involved in responding to individual staff involved in an adverse event. What do these staff need in the aftermath of the event? 3. As an advanced practice nurse or nurse practitioner: Consider the impact of the event on team dynamics, communication, trust and perceived competence in the context of the organisational culture at that time. 4. What organisational reporting and/or investigation would be required in response to an event like this? What external reporting and/or investigation would be required in response to an event like this? 5. How should health care organisations support health professionals involved in adverse events? How should these organisations support health professionals during investigations of adverse events? Is there a need for clinical supervision following an adverse event? 6. How can second victims contribute to the prevention of adverse events?

Sample Solution

A reason why facial recognition technologies should be used is because of its contribution to security. There is belief that these technologies can offer solutions, it can for example help by the identification of suspects and thus help prevent crimes. With these systems there is a broader intelligence and security infrastructure [13]. But are the technologies safe enough? There is one big ethical issue, that is the right to privacy. Misuse of data and the problem of error are related to this. i. Privacy Every person has the right to have privacy and protection of his or her personal data. Facial recognition systems are a threat to the individual’s privacy. It can lead to a society in which the government knows everything about an individual. The law should protect individuals against the dangers facial recognition technologies entail. The privacy law in Europe, the GDPR, is as follows: “the use of biometric data for identification is in principle prohibited (Art. 9.1). Article 9.2 GDPR however contains many exceptions to the prohibition of bio-metric data use for identification, including the explicit consent of the person.” [18]. The use of facial recognition data is forbidden, unless a legal justification exists. Whether this law protects persons adequately from violation of their privacy is arguable. The law allows the usage of different technologies, provided that certain principles are being followed in the application of the technology. For example, the facial recognition technology may only be used for a specific purpose and only with consent of the individual. Interpretation of the law remains difficult, especially if there is an increase of new technologies. Since the law does not apply to every specific technology there is a chance that this technology can become a risk, because some technologies can violate the privacy of individuals. ii. Misuse of personal data Law enforcement agencies can use facial recognition technologies to identify criminals and criminal activity [21]. But there is no guarantee that the images and identities are safe. The data can be misused and when the data is shared, the individual’s privacy is gone. The misuse of the technology is one ethical aspect that n

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