Intra-operative Phase
Mr. Yu was then transferred to the assigned operating room. Non-invasive blood pressure monitoring, 3 leads electrocardiogram and pulse oximeter were applied to him. Forced-air warming device was given. Large-pore intravenous assess was inserted by anaesthetist. Time-out procedure was performed concurrently with surgeon, anaesthetist and theatre nurse. Right patient, right procedure, right operative site and marking, allergy status and correct prophylactic antibiotic were confirmed by all involved parties. General anaesthesia was started. Prophylactic intravenous Cefazolin 1g was administered as prescribed(30minutes prior incision). Mr. Yu was positioned left lateral for surgical assess. 91
Assessment:
Long operation time( > 2
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Yu, surgical site and marking were verified with surgeon again to prevent wrong site surgery by changing patient position. Grounding pad of electrosurgical unit was placed to left thigh. The operative site was properly disinfected and draped. Operation started smoothly. 43
Assessment:
Burn at grounding pad site was the commonest type of patient injury (Spruce & Braswell, 2012)
Nursing diagnosis:
Potential risk of burn from electrosurgical unit
Desired outcome:
Mr. Yu would be free from burn injury
Nursing interventions:
Assess skin condition before and after with documentation
Use grounding pad with appropriate
Determining the seriousness and appropriate treatment of a burn requires its classification. Burns are classified according to three factors, the depth and number of affected tissue layers, the total percentage of the body surface that is involved, and the presence of homeostasis disruption or destruction such as respiratory distress, fluid loss, or loss of blood pressure control (Patton & Thibodeau, 2014). According to Mr. MacPherson’s appearance and symptoms, his burns are classified as second-degree or partial-thickness burns. The evidence for this diagnosis according to Patton and Thibodeau (2014), are his presenting symptoms of severe pain and the appearance of blisters, edema, and fluid loss. This type of bur...
The Iowa model, developed by Titler in 1994, focuses on organization and collaboration incorporating conduct and use of research, along with other types of evidence (Titler et al, 2001). Since its origin in 1994, it has been continually referenced in nursing journal articles and extensively used in clinical research programs (LoBiondo-Wood and Haber, 2006). This model allows us to focus on knowledge and problem-focused triggers, leading staff to question current nursing practices and whether care can be improved through the use of current research findings (Titler, 2006). In using the Iowa model, there are seven steps to follow: (1) selection of a topic or problem for evidence-based practice, (2) forming a team, (3) Evidence retrieval, (4) Grading the Evidence, (5) Developing an EBP Standard, (6) Implement the EBP, and (7) Evaluation (Titler et al, 2001.
What? The patient is 65-year-old man Mr. John Douglas who is suffering from dysphagia and have been admitted to the surgical ward for insertion of a percutaneous endoscopic gastrostomy (PEG). Apart from that, he is a Type 1 diabetes patient and has weakness in his right leg and arm because of right-sided hemiplegia. He is thin in appearance and has stage 1 pressure sore on his right heel.
Kaiser, L. R., A. C. O. Surgeons, and W. H. Pearce. Acs surgery, principles & practice. 6th. Webmd Prof Pub, 2007. eBook.
The purpose of this paper is to distinguish, outline, and evaluate the affects that workarounds have on patient safety and quality. According to Alexander, Frith, and Hoy (2015), a workaround is defined as when a problems arise within the workflow and a worker uses an unauthorized way around the health information technology system. This being said, workarounds are present in the hustle and bustle of the stressful hospital workflow, and in return can potentially lead to negative consequences. Therefore, it is essential for health care professionals to recognize the workaround, analyze their workflow, and then develop possible solutions.
Although the comorbidities and type of surgery dictate certain decisions in managing patient care, anesthesiologists maintain various modalities for the perioperative period. These consist of anything from local to regional anesthesia, including neuraxial techniques and peripheral nerve blocks, as well as monitored anesthesia care with sedation to general anesthesia. Overlapping of different anesthetic types and combinations of regional analgesics to supplement general anesthesia occur frequently.
The first accident occurred on a 61-year old woman who was at a follow-up appointment after a breast tumor was removed. She felt a burning sensation and told the operator “you burned me”. She developed swelling and reddening, but the AECL declared this a normal treatment reaction and not a machine malfunction. Her condition wor...
Working as a nurse, patient care associate, or any other health care professional is not an easy job. Nursing profession has the highest rate of back and other injuries related to lifting, moving and transporting patients. Hospitals and other nursing facilities were experiencing increased numbers of injuries, which meant many lost work days, worker’s compensation costs and patient safety at risk.
Dr. Tagge, the lead surgeon, finally updated the family over two and a half hours later stating that Lewis did well even though he had to reposition the metal bar four times for correct placement (Kumar, 2008; Monk, 2002). Helen reported wondering if Dr. Tagge had realized how much Lewis’ chest depression had deepened since he last saw him a year ago in the office, especially considering he did not lay eyes on Lewis until he was under anesthesia the day of surgery (Kumar, 2008). In the recovery room, Lewis was conscious and alert with good vital signs, listing his pain as a three out of ten (Monk, 2002). Nurses and doctors in the recovery area charted that he had not produced any urine in his catheter despite intravenous hydration (Kumar, 2008; Monk, 2002). Epidural opioid analgesia was administered post-operatively for pain control, but was supplemented every six hours by intravenous Toradol (Ketorolac) (Kumar, 2008; Solidline Media,
The Quality and Safety Education for Nurses (QSEN’s) goal is to prepare future nurses with the knowledge, skills, and attitudes (KSAs) that are needed to continuously improve the quality and safety of the healthcare systems within which they work. QSEN focuses on six main competencies; patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As we have learned in earlier classes these competencies and their KSAs offer a base to help us and other nurses as we continue our education and become RNs. As we will learn in this class these KSAs go hand in hand with health assessment.
Professional collaboration is an important aspect regarding patient safety in the medical field. This is a time when different kinds off professionals collaborate with one another about a patient’s health status and condition. “Specifically, Interprofessionality is a process by which professionals reflect on and develop ways of practicing that provides an integrated and cohesive answer to the needs of the client/family/population…(involving) continuous interaction and knowledge sharing between professionals” (Black, 2014). The collaboration of different professionals allow for a better decision to be made towards the patient’s health outcomes.
“Living with Burn Trauma,” an online article, states that “human skin is the largest organ of the body.” It provides many functions which assist humans to survive. What happens if this vital organ is destroyed? This is a question with which thousands of Americans are challenged annually. In the United States alone, 4,000 people die in burn accidents or from complications of burn injuries (“Prevention”). One common misconception is that burn victims have all come into contact with flames. Burns result from fires, electricity, hot liquids, chemicals, and even ultraviolet rays. Seeking medical attention for a proper diagnosis is critical to ensuring quality treatment and management of burns. Burn Centers have been established to help patients adapt to life after burns, which can be a great challenge. In today’s society, hospitals and medical professionals can treat burn victims, but the best remedy for burns is prevention.
He is admitted to the ward with the chief complain of pain at right lower quadrant of the abdomen for 8 hours prior to his admission.
converted into heat at the lead tip, which results in edema and tissue damage. “ the
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record