According to research, by definition a hernia is a protrusion of tissue through a defect or weakness in the abdominal wall. (Fuller, 485) The type of hernia as well as its location varies in individuals. The regions or locations where hernias may appear include; hiatal (lower portion of esophagus), epigastric (above umbilical), umbilical (umbilicus area), inguinal (above the inguinal ligament), femoral (crease in the leg). This case study focuses on the repair of an incisional (ventral) hernia. This type of hernia normally occurs in the abdominal wall on the ventral surface of the body, excluding the groin or inguinal area. This in fact is why they are referred to as ventral hernias. The structures or organs that surround an incisional hernia depend on where the hernia exists in the body.
Hernias are the most common pathology of the abdominal wall. (Fuller, 485) An incisional hernia is the protrusion/herniation of tissue into the tissue layers around an abdominal incision which most often occurs in the immediate postoperative period or later, after an incision has healed. An individual may have an incision from a previous surgery that failed to heal completely due to obesity, excessive coughing, stress, etc. These factors cause the scar tissue to be aggravated or weakened which generally is the cause of herniation. Statistically, incisional (ventral) hernias have been known to be among the most difficult hernias to treat.
As usual, a review of the patient’s medical history, a physical exam and x-ray are the most common methods used to diagnose and incisional hernia. Physicians may perform additional amounts of testing if needed to rule out other health conditions. These additional tests depend solely on the anatomical site of ...
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...own the patient’s bed. Once everything was wiped down, the two surgical techs and I went out to pull our case. We took a case cart and we went to the sterile supply room and the Instrument supply room to pull these necessities. After we got everything we needed, we rolled the case cart back into the room and got ready to open the case. The two surgical techs and I laid the packaged supplies across the operating room bed. We each started picking up supplies one-by-one and checking the expiration date. Once the expiration date was validated we checked the packages integrity. The integrity is basically what the condition of the pack is. The conditions we looked for was moisture and/or condensation inside the pack and holes, cuts, tears, or scrapes on the outside of the pack. After each item was checked we tossed them one-by-one in a sterile manner on the back table.
Kasie said while she is working she has to reconstitute medication, compounding IV/fluid drips, pull single dose P.O. medications and oral syringes for patients to be delivered to med rooms, check for expired drugs, and package unit dose medication. She said she enjoys working in the environment very much. The dress code is to wear vestex scrubs, which are antimicrobial and bodily fluid/fluid resistant.
The medical supplies that is sourced by Kaiser Permanente headquarters is handled by an governmental agency DME (Durable Medical Equipment) department which handles equipment and supplies that are for repeated use and it may also provide crutches, oxygen equipment, wheelchairs or blood testing strips for diabetics. The rest of the supplies are handled locally by hospitals. Clinical engineering department is responsible for handling the medical supply inventory. They can distinguish which equipment needs to be included in the inventory after following guidelines of some government
Association of Anaesthetists of Great Britain and Ireland (AAGBI). (2012). Checking anaesthetic equipment 2012. Retrieved from http://www.aagbi.org/sites/default/files/checking_anaesthetic_equipment_2012.pdf
One of the most common forms of errors found in the medical field is the recycling of soiled equipment. The repeated use of dirty medical equipment is found commonly in the poor regions of the world
Overall, I retain three goals for this clinical day: Safely and efficently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. This week reflects my assigned time to administer medication in a health care setting for the first time, with a resident who retains nearly twenty medications. I except this experience will be a great learning experience, but it will also subsist slightly stressful. With the assistance of my FOR, my goal is to administer all of my resident 's medications without complications. To ensure that medication safety, I will perform the six medication rights and three checks prior to administration. Along with medication administration, a goal
Depending on the time of surgery, the nurse may admit and discharge the same patient within the timeframe of his or her shift. The nurse obtains a history and physical (H&P) along with the progress notes from the operating surgeon or another licensed personnel written within the last twenty-four hours. The nurse sets the patient up with a peripheral intravenous line before surgery. He or she will interview the patient regarding the last time they ate and/or drank, what medications they take, and when the last medication dose was taken. The nurse also assesses the patient to see if he or she understands the procedure they are there for and asks if they have any questions or concerns. Depending on the health of the patient and what surgical procedure they will be subjected to, either a focused or full health assessment is performed. The nurse also makes sure that all labs pertinent to the patient have been obtained. These labs include a negative pregnancy test (or proof of a negative test within the last seven days) for any patient that could possibly be pregnant, even if the patient is currently menstruating, a finger-stick blood sugar test for all diabetic patients, a blood test for potassium levels for patients with end stage renal disease, and a prothrombin time or international normalized ratio test for patients on Coumadin. The nurse also makes sure that
Retained foreign objects have been a major problem throughout operating rooms, labor and delivery, as well as any other procedural area that perform invasive procedures. Retained foreign objects include soft goods, such as sponges, needles, sharps, instruments and other small miscellaneous items used during a procedure (NoThing Left Behind, 2013). The retention of these items can lead to several complications such as a local tissue reactions, infection, obstruction of blood vessels, and even death (Mathias, 2013, p. 2) According to the OR Manager, the effects of a retained surgical item can lead to patients having a increased mortality rate by 2.14%, an increased hospital stay by 2.08 days, and increased hospital costs by $13,315 (Mathias, 2013, p.1). In response to this, NoThing Left Behind was created. NoThing Left Behind is a national surgical safety project that was created as a system wide policy to help prevent the event of a retained surgical item (RSI). This project estimates that there are 1500-2000 retained surgical items left in patients each year within the United States (NoThing Left Behind, 2013). Furthermore, evidence shows that there has been an increase in retained foreign objects left within patients that undergo invasive procedures that occur outside of the operating room and labor and delivery. Therefore, the focus of this paper is to analyze the negative impact, physically, emotionally, and financially, on patients as well as the hospital, related to retained foreign objects during an invasive procedure. The focus is on areas such as the catheterization lab, endoscopy, emergency room, and other bedside procedures where there is no accounting process in place.
Herniate discs are very common and become more common with age. However, not all herniated discs will cause symptoms. Research shows that 30% of 20-year-old’s have disc herniation with no back pain as well as 84% of 80-year
About 82% of all surgeries at the Hospital are primaries. The remaining 18% involve recurrence of hernias repaired elsewhere. These are more complex,
The materials used in the healthcare supply chain, specifically specialized and high-cost surgical products, have been on a rapid trajectory of cost increases and are becoming as expensive as the cost of staffing and benefits. What can be done to offset these costs is to manage the use and inventory of these expensive materials to enhance revenue, mitigate risk, and ensure that the focus of clinical staff is primarily on patient care (Schneller, 2011).
The use of supplies is a problem because we are spending too much money on them. We are a world-renowned hospital with very high-end robots and equipment. Therefore, our surgeons demand the best and the higher valued machines and supplies. Cost and quality need to be considered. We do not want the quality of care for the patients to be jeopardized because of inadequate planning in regards to low quality supplies (Sullivan, 2009).
However, these side effects can be avoided with the proper amount of vitamin and mineral supplements. Up to 20 percent of patients who undergo the operation will require follow-up surgeries to correct complications. Common problems include abdominal hernias, breakdown of the staple line and stretched stomach outlets. There’s rapid regain of weight and all sorts of medical problems. From vitamin deficiencies to constant illness, stomach upsets, diarrhea, fatigue and horrible wound infections. Many people don’t want to admit they’ve had problems because they’re so happy to be thin; “People who have had the surgery the past couple of years are in a honeymoon state”, states Guthrie, Catherine. The author of “Bariatric Surgery: A Radical Obesity Fix. They is so thrilled to be thin. They believe being thin at all costs is more important than their own lives. Even if the patients have problems although these are some complications, most patients undergo only one surgery and there's an 85 percent success rate.
...s and hoses, control buttons, switches, hand pieces, and X-ray units (Collins). After every patient’s visit, the operatory is to be sterilized and disinfected. All areas that were that were not covered with a barrier, or if the barrier was compromised, must be wiped down with surface disinfectants similarly used in hospitals. OSHA requires disinfectants to be potent enough to fight against HIV and HBV infections (Collins). If there is any blood present on a surface, tuberculocidal type disinfectant should be utilized.
Biosecurity practices, on the other hand, ensure that access to the laboratory facility and biological materials are limited and controlled. An inventory system must also be in place to control and track biological stocks or other potentially hazardous biological agents in both biosafety and biosecurity programs. For biosafety, the transfer and shipping of infectious biological materials must comply with safe packaging, containment and appropriate transport procedures, while biosecurity ensures that transfers are controlled, tracked and documented relative to the potential risks of the materials being transferred. Both programs must involve the laboratory staff in the development of practices and procedures that fulfill the requirements of biosafety and biosecurity initiatives without hindering research or clinical/diagnostic activities. The success of both of these programs is anchored on a laboratory culture that understands and accepts the need for the implementation of biosafety and biosecurity programs in the laboratory environment and the corresponding management oversight.
Circulating nurses must check the expiry date and the integrity of the packaging and wear the correct PPE prior to opening the articles. Each article must maintain its sterility; therefore the setup must be continuously monitored. Instrument nurses must create the sterile field using sterile drapes as they minimise the transference of microorganisms. They must also keep their hands at chest level, as areas below table height can be easily contaminated (Australian College of Operating Room Nurses, 2010).