To file a formal complaint or not?

[Nurseeee]

Hi fellow nurses! I need your opinion. My father was admitted in a hospital S/P Craniotomy Evacuation of Hematoma. There was a JP drain post-operatively. The doctor's order was to maintain the drain on half-press suction. The assigned ward nurse applied full suction on the JP drain. My father's vein collapsed because of the pressure and so there was profuse bleeding until a vascular surgeon did some anastamoses to stop the bleeding. Should I make a formal complaint or just let it go altogether since my father is in a stable condition at present? Thank you for your response.

[Flatline, BSN, RN]

I usually ask myself three things;

1) Why am I making the complaint?

2) What would I like to see happen after my complaint? What outcome do I want to see?

2) What is the likely outcome of the complaint?

Can you answer all three and do they make sense?

[TheCommuter, BSN, RN]

If this were my mother or father, I would file the formal complaint.

Do not get me wrong...I would not do it to get the nurse who made the mistake into trouble. The point of the formal complaint would be to facilitate improvement of the processes, checks, and balances that could prevent these types of errors.

If another patient is saved from the pain and suffering associated with this kind of mishap, formally complaining might be worth the time.

[Oh'Ello, BSN, RN]

Complain. Because "half press" is a stupid, unscientific, and subjective way to pressurize something going into your brain.

[blondy2061h, MSN, RN]

Complain. Because "half press" is a stupid unscientific, and subjective way to pressurize something in your brain.[/quote']

This is my thought too. I have more issue with the order then there nurse apparently compressing a jp too deeply.

[CalArmy]

I have use JP drains a lot and never heard of half press. I agree the order is what bothers me.

[MPKH, BSN, RN]

How do you "half press" a JP drain? I thought you needed to decompress it fully so that it creates a negative pressure to "suck" drainage into the bulb?

I'd complain, mostly because the order isn't clear.

[amoLucia]

The situation needs to be reviewed -

1) the order is a major problem; and

2) staff education is needed so involved staff learn and to prevent future problems.

Hopefully, no punitive action is taken - this is a systems learning situation.

[iluvivt, BSN, RN]

I was thinking the same thing about the JP drain.You are supposed to squeeze it until it is flat and then plug it.If the tissue is so delicate that it cannot tolerate this then perhaps they should have used a different type of drain

[Here.I.Stand, BSN, RN]

This is my thought too. I have more issue with the order then there nurse apparently compressing a jp too deeply.

Our neurosurgeons order "thumbprint suction" on intracranial JPs all the time. You plug it while applying the pressure, same as when you flatten thd bulb -- you just don't flatten the bulb. "Half suction" would mean compressed to half the bulb's diameter.

As shown in the OP's dad, full suction to brain tissue can cause damage that it doesn't in the abdomen or other places JPs are placed.

We're also talking about smaller amounts of drainage (generally) from intracranial JP's. I used to care for postop liver transplants. Those folks would have 2 big JPs that needed emptying q 1 hr. In the brain, the most CSF you'd ever want to come off is about 25 ml/hr. Blood, you only want to evacuate existing extravascular blood -- never encourage new bleeding. So we want much less suction than in the hepatic-diseased belly