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.…
+------------------------------------------------+ | CPNE NOTES - LAB SIMULATION MNEUMONICS & STEPS | +------------------------------------------------+ STATION 1: WOUND STATION MNEUMONIC: TIGR Open - Soak Gloves - PAT dry STEPS: *** WASH THY HANDS BEFORE STARTING *** (A) T - Tape (4 strips) - date/time/initial last strip. I - Inspect the dressing & Id the patient. (C) G - Put on non-sterile gloves. R - Remove old dressing & gloves (via one swoop).…
In an interview with the infectious disease nurse, the wound care nurse and the OR manager, it was discussed if infections may have been caused before the operation or post operatively. The patient is prepped on before taken into surgery. This may consist of hair clipping and an antiseptic bath. The patient is then wheeled into the surgery room where they are further prepped on the operating table. At this point, the infection risk should be low.…
The buyers entered this market at a right time and maybe to late but based on the technology jump they are making it was perfect time. Inly problem being is health care plan act passed by Obama is hurting profits due to not getting the insurance money that they get from the past but are getting the minimum pay from the act. This has hurt hospitals, ER, and even private doctors. The act is great for the patience but for the business it hurt you lose money when you are saving lives and can’t pay for the new technology or equipment based on the loss of profit from all the company’s. Rich talked about they have lost interest due to the size of investment it would be to get bought out and they will continue to grow this business due to the lost…
References: Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Camera, I. M. (2011). Medical-Surgical Nursing: Assessment and Management of Clinical Problems (Eighth Edition). St. Louis, MO: Elsevier Mosby.…
Inclusion criteria were addressed by a physician or resident that included assessing for complexity of laceration, location on the body, and if it had occurred within 3 hours from patient’s arrival. A signed a consent was obtained and data was collected through completion of a checklist noting the patient’s age, sex, site of laceration, type of injury, time of injury, time of injury from the time of repair, and technique of repair. The patient was given a self-addressed, pre-stamped envelope that was to be completed by the physician who took the sutures out. This physician filled out an explicit questionnaire using specific guidelines on wound assessment (pus, erythema, fever,) their clinical impressions (infection vs. no infection), and their management plan (topical/oral/IV antibiotic use, or need for referral to wound specialist). The follow up physician was unaware of which gloves were used in initial repair of the wound. The returned questionnaires where coded to collate with the initial assessment…
Surgical Site Infection has a broad spectrum of scientifically attached possible features. The Centers for Disease Control and Prevention (CDC) define it as the infections that take place or occur to the surgically treated site through external effects after the surgery. In the 2010 report done by the CDC where 16 million operative routines were done in a cute center; it was realized that Surgical Site Infections (SSI) were the most usual infections associated to healthcare. This counted to 31% of all the treated patients who were then hospitalized. (Press, 2007) Approaches have been made in coming up with practices in controlling infections. The advances include upgraded ventilation of operation rooms, advancing techniques of surgery, barriers and methods of sterilization and handiness of antimicrobial prevention. Surgical site infections stand out as the major course of morbidness, sustained hospitalization and even death. It has been associated with 3% mortality rate.…
Wound healing is the process of replacing or repairing damaged or devitalized cellular components and tissue. There are four recognized stages including hemostasis, inflammation, proliferation, and maturation or remodeling. These phases are widely overlapping and interconnected.…
Mr. Smith was admitted for surgery on his left knee. However, a surgery of the right knee was performed, resulting in a wrong site surgery. The patient is awake and aware of the current situation. Hospital administration has spoken with the patient and ensured him a team will be formed to do a full analyze in order to identify where the mistake was made.…
These working conditions have deteriorated in this facility because the hospitals have not kept up with the growing demand for medical staff. The Joint Commission along with some state regulations measures some bare minimum level of staffing that all hospitals must meet regardless of the types and severity of patients. Pressure ulcer prevalence vs. nursing care hours was more of a parallel comparison, as the staffing hours increased the pressure ulcer prevalence decreased. While the intensive care unit was very noticeable in relating the falls vs. hours. In September when the nursing hours per patients dropped it was evident that the number of patient falls increased and they came was with VAP vs. hours. The corrective action plan should take this data into consideration to improve the staffing model, to also decrease patient falls which was be shown through this root cause analysis. The hospital requires at least one fire drill per shift per quarter. It seems that only the 1st shift is in compliance. Both the 2nd and 3rd shift have no rhyme or rhythm to how they are conducting the fire drills. This needs to be address immediately by a member of management. Also, a manager or assistant should be required for scheduling the fire drill and must sign off on completion. Moderate Sedation Monthly Audit is overall in the ninety percentile there are still many areas for improvement. Any of the area that was below the ninety marks is an area for opportunity. Such as Mallampati Classification, ASA, Sedation Plan. Reassessment, and oxygen saturation monitored for thirty minutes, all of these area were below ninety percent for all for quarters. Therefore, it’s a trend that needs to be addressed. The number of falls in the 4-East wings is disturbing when it’s put next to the targeted number, this is unacceptable. A substitute process that has the possibility to improve…
Surgical site wound infections is one of the most dreaded complications. A surgical site infection is defined as an infection that occurs at or near a surgical incision within 30 days of the procedure or within one year if an implant is left in place. The Centers for Disease Control and Prevention (CDC) estimates that approximately 500,000 surgical site infections occur annually in the United States. They are the leading cause of nosocomial infections after surgery, accounting for nearly 40 percent of nosocomial infections in surgical patients. It is associated with disability, increased mortality, increased pain and prolonged morbidity. Postoperative infections have an enormous impact on the patient. For some their quality of life is impacted as well as a substantial increase in financial cost. These infections account for 3.7 million excess hospital days and more than 1.6 billion in excess costs annually. Furthermore, patients who develop surgical site infections are five times more likely to be readmitted to the hospital, 60 percent more likely to spend time in the intensive care unit and twice as likely to die…
The benefits of the participation of this study for participants is to see if there can be a more cost effective way of a emergency room visit for sutures in a laceration. The risk is that the authors only had nine months to complete the study and this did not give ample time to assess the final healed laceration properly. With this quantitative study each of the participants agreed to sign a consent form and then randomly put into two experimental groups. The study was approved by the ethical approval from St James’s Hospital ethics committee, management and senior clinicians before starting. It would have seemed that the participants were asked upon emergency room arrival if they would participate in the study. Upon completion of the health record inclusion and exclusion must be met for participants.…
Smeltzer, S. C., & Bare, B. G. (2004). Brunner & Suddarth 's Textbook of Medical Surgical Nursing. (10th ed.). Philedelphia: Lippincott Williams & Wilkins.…
The SCIP core measure is to help improve post-surgical infections. There are several key components that need to be reported. “Nurse Managers and their staff are in a position to play an important role in meeting the SCIP core measure set requirements.” (Booth, Evidence-based nursing: The SCIP core measures: A dizzying array of issues, 2009). Booth further states that the SCIP core measures are rooted in evidence-based practice, and in most cases, they make clinical sense and clearly…
References: Bare, B., Cheever, K., Hinkle, J., & Smeltzer, S. (2010). Textbook of medical-surgical nursing (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.…