bowel obstruction

Review the following list of latent errors, active errors, and preconditions that could have contributed to the event described in this scenario. Write the errors and risk factors in column 2 beside the appropriate category.

Case study Question 1 Objective: To practice identifying different types of errors described in Reason’s Swiss cheese model. Instructions: Consider the following scenario: In Florida, Clara, an active 94-year-old great-grandmother who still worked as a hospital volunteer two days a week, was admitted to the hospital for a bowel obstruction. She and her family, along […]

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