On June 4, 2009, 40 year old Kathy Pagan underwent an abdominoplasty and liposuction of the abdominal flap, at Dr. Rouchdi Rifai’s office in Jackson, MI. She experiences problems from the surgery right from the start. She had “dark-colored drainage, clots, and painful burning sensations and continued to report issues, according to her complaint, first filed in 2011.” She went to Dr. Rifai office where he cleaned the wound area without anesthesia and repeatedly prescribed ointment and pain medication. Pagan requested to be sent to a wound care specialist but that was never done. “By late July 2009, she complained of pain and the wound worsened, according to her lawsuit. The doctor deemed it infected, but still did not refer her to a specialist, the complaint states.” Approximately 8 weeks after surgery Pagan…
Patient 453355 medical record was audited by the Risk Management department to review care and services received through departments from admission through discharge at NCH. This patient was admitted with a post-operative wound infection. The Joint Commission standards were adhered to and a Surgical Patient Tracer worksheet was utilized.…
Jessica McGowan HIM 2330 – Shaw July 2, 2014 Reimbursement Assignment and Case Mix Case #1 Female 66yo 01-Home ICD-9-CM Code Code Description Principal Diagnosis 682.7 Cellulitis, left foot Secondary Diagnosis 892.1 Infected dog bite 041.10 Staph infection E906.0 External cause: dog bite Principal Procedure 86.22 Wound debridement, foot Total Charges $6,245.10 DRG: 0572, SKIN DEBRIDEMENT W/O CC/MCC DRG Wt. 01.0077____ Full Update Hospital Reimbursement___$5,064.79__________ Reduced Update Hospital Reimbursement__$4,762.49…
If Dr. Arafiles did not possess surgical privileges, it should not have been permissible for him to perform a skin graft. Because he performed a skin graft without surgical privileges, his improper surgical procedure with a skin graft was supposed to be documented in peer review records to address the concerns for the poor quality and safety issues and determinations of Dr. Arafiles credentials. The peer review records are important evidence and are often used by plaintiffs in litigation to identify medical negligence. For instance, in chapter 4, on page 77, peer review was used in Adams v. St. Francis Regional Medical Center case to determine medical negligence of a nurse who was responsible for the death of plaintiff’s daughter (Brodnik, Rinehart-Thompson, & Reynolds, 2013).…
She is also a diabetic who is overweight and of a short stature. I would immediately place Ms. G on a broad spectrum IV antibiotic for the cellulitis and the open wound. I would call to order a Doppler study to be done to rule out a DVT because she has been immobile for as many as three days and there is a significant difference between the sizes of her calves. I would order pain medication, antipyretics, and cold packs to provide comfort for the patient. I would immediately have a wound care nurse assist in the care and documentation of the wound and to help provide education to the patient on how to care for the patient. Blood sugars should be checked and a Hemoglobin A1C should be drawn to see how compliant of a diabetic Ms. G is. A diabetic educator should be consulted to help educate the patient on a proper diet, how to test her blood sugars, and how to proper use insulin if it is determined that is needed. I would also contact the case manager to help the patient set up home health visits because depending on the wound she could go home with drains, special dressings or possibly a wound vac. I would also assess the patient’s living conditions. I…
5. Rao N, Cannella B, Crossett L, et al. A preoperative decolonization protocol for staphylococcus aureus prevents orthopaedic infections. Clin Orthop Relat Res (2008) 466: 1343-1348.…
According to Medicare (n.d.), the facility cannot impose the cost of the additional days spent at the facility to Mrs. Zwick. The ethical implications are how this hospital-acquired infection may cause her future medical cost and unintended consequences. Mrs. Zwick’s rehabilitation was delayed because of her nosocomial infection. It is uncertain how this affected her overall recovery and future health. Did the delay in rehabilitation limitfull recovery for Mrs. Zwick? It is unknown how…
Rarely any physician intends to harm patients when he or she provides treatment to them. Patients see physicians and specialists in full faith that they will get help with a condition. What complicates the patient-doctor relationship is that the outcome of each patient’s treatment is different because of individual health conditions and the course of treatment chosen by the doctor. Problems arise when a patient is not satisfied with care provided by the doctor or in extreme cases when a patient dies. Since most of the time it is hard to clearly determine whether the outcome was solely a result of the course of treatment chosen by the doctor or whether other factors played a role too, quite often patients take their grievances to court to seek justice. What makes these kind of cases complicated is the “What would have been if…?” scenarios where one can only guess what the outcome of the treatment would have been had a different course of treatment been chosen because the proximate causes of injuries are not easy to determine.…
“Of Mice and Men” by John Steinbeck is known as one of the best novels of the 20th century. This world renown book follows the of a tale of adversity an abnormal friendship endures which, includes, the small, quick witted man affiliated with the name George Milton and the simple minded naive lunk known as Lennie Smalls. Though they may not seem like the quintessential that Bonnie and Clyde may have been or even Sherlock and Watson were, but they had a certain je ne sais quoi about them that could endure through all odds they somehow found a way to develop a strong bond that could only be deteriorated by death. Without the other, the amalgam known as George and Lennie would cause “Of Mice and Men”to be lacking the panache that it so indubitably…
Last week in class we read the Glass Castle by Jeannette Walls. The book showed what's it’s like to overcome adversity at anytime even when times are bad Jeannette Walls overcame her father's alcoholism and her mother's psychoness. The family was also going through a financial crisis so with the weight of everything on her she had to get over so much for her to be able to succeed in her later life. Jeanette was a very strong and determined person and she didn’t allow herself to use the homelessness or her father’s alcohol problems but more as opportunities. She felt as if the hardships were making her who she was and it allowed her to become such a strong and humble person. I have had much adversity but this was the hardest for me. A couple…
The nurse in this case chose to perform a nursing procedure without a physician’s order. The nurse felt she had no other options and chose to place an IV in the right foot of a patient with poor access in the upper extermities. The nurse was unaware of the guidelines from the Center of Disease Control and Prevention (CDC) and the Infusion Nurses Society (INS). The INS states “Cannulation of the lower extremities in adults should be avoided because of the increased risk of phlebitis” (Intravenous Nursing Society,2000). The nurses admitted she was “vaguely aware of the hospital’s policy” (Rosenthall, et al). By performing a procedure without an physicians order, the nurse is acting outside her scope of practice. Additional errors followed involving other nurses. It is the nurse’s responsibility of report to the next shift the patient’s overall patient condition, including signs and symptoms, past history, and findings on assessments. The nurses caring for this patient failure to do a complete nursing assessment, report findings to the next shift nurse or the physician in charge is the patient’s care.…
Patient safety is defined by as the avoidance, prevention, and improvement of adverse outcomes stemming from the healthcare process (Cole, 2011). “Healthcare-associated infection (HCAI), is defined as an infection that is acquired as a consequence of a person’s treatment by a healthcare provider, is an example of an adverse incident” (Cole, 2011, p. 1122). In the surgical area, the…
Health care providers have a responsibility to provide competent and safe care to their patients. When patient care is compromised or the patient does not have a successful medical outcome, sometimes the legal system becomes involved. It is important to be aware of the terms negligence, gross negligence, and malpractice because they are often misunderstood. This paper attempts to provide a definition of each legal term in an effort to distinguish the difference between each term Application of negligence and malpractice will be applied through review of a newspaper article entitled, “Amputation mishap; negligence.” Effective documentation leaves no room for liability of the health care provider. After review of this paper, it is hopeful that the reader will feel well informed of the meanings of negligence, gross negligence, and malpractice and how to effectively chart in a patient’s medical record.…
Wilkes, L.M. et al (2003) The hidden side of nursing: why caring for patients with malignant leg ulcers wounds is so difficult. Journal of Wound Care; 12: 2, 76-80.…
As a hospital, quality care should be a priority for patients that are going to be treated for a sickness, or any type of procedure that is going to take place. A lot of times a patient gets an infection while they were at the hospital, on top of being treated for what they original came in for. Health facilities should be environments of healing, which they are, but they also have tons of various types of germs and infections, which grasp onto individuals that have weak immune systems/are sick. Some infections that are at hospitals are Tuberculosis, VRE, VAP, C-Diff, UTI, and MRSA. Preventive measures to stop the spread of the infections is lacking tremendously in the work and aim to provide safety for all patient’s health. The work conveyed to you is an effort to lower the expansion of the infections talked about above that bring chaos in a patient’s healing process. The main priorities that will help patients’ health and better their outcomes when it comes to their medical needs are detecting causes of the infections, resolutions as well as quality improvement steps.…