Title: CC2 - Anatomy of a Sentinel Event: Leadership Response and Teamwork

Disciplines: Professional Issues (PI)

Learning Objectives:
  1. Distinguish between sentinel and adverse Events.
  2. Identify actions taken at multiple levels when a sentinel event occurs.
  3. Describe what can be done both personally and as an organization to develop and sustain a culture of safety.
Submission Description:
An experienced panel from quality, clinical nursing, legal, risk management, and administration will present a Sentinel Event case study addressing the role of the bedside nurse and nursing leadership, especially in debriefing, striving for a culture of no blame while conducting a root cause analysis. The panel will identify effective methods to mitigate Sentinel Events. Strategies for forming a cohesive team to address the event and identify processes to prevent future occurrences will be discussed. In addition, there will be a discussion of the aftereffects of a Sentinel Event, including the emotional components from the moment of the Sentinel Event through the investigation process and resolution.
Wednesday, June 27, 2012: 8:15 AM-9:45 AM
Prince George's Exhibit Hall D (Gaylord National Harbor)
Moderator:
Debra Bingham, DrPH, RN, LCCE
Presenting Authors:
Deborah F. Grimes, RN, JD, CPHQ , Pamela S. Autrey, PhD, MBA, MSN, RN , Renée Byfield, MS., FNP, RN, C-EFM and Penny Monroe, MSHSA, BSN