Dear Members of the Quality Management Dept., Thank you for asking me to provide a response with additional information needed to complete your review of the issue of the case. As to the indication for use of a previous surgical site for insertion of Veress needle this was chosen as this was the best site for the docking, and placement of the ports for the laparoscopic procedure to be completed. It is important to note that this was a previous laparoscopic incision site, i.e. a site of a 10 millimeters
INTRODUCTION Peripheral intravenous catheters show benefit in Cabooltures emergency departments every day, however emergency department has noticed PIC dislodging 48 hours after being inserted. The focus of this research trial is to compare the two types of patient group’s, standard group who used transparent cloth- bordered polyurethane dressing to PIC and skin group who transparent cloth boarded polyurethane dressing + cyanoacrylate glue to hold PIC, comparison was investigated. Patients selected
Abstract The Central Venous Catheres (CVC) are often associate with blood infections. CVC infection are accountable for 14% of the death in hospitalized ICU patients in the United States. Resulting in a significant increment of hospitalization stay and healthcare cost. Central venous catheters has multiple usage in healthcare. However, the increment of CVC insertion in ICU patient directly increasing the incident of central venous access infection. Inappropiate adherence to sterile insertion method
Nurse-Led Central Venous Catheter Insertion Central venous catheters (CVC) have various uses for patients in both the inpatient and outpatient settings. Their purposes range from administration of total parenteral nutrition, to administration of vesicant medication, to providing access to patients with poor peripheral vascularity, as well as hemodynamic monitoring (Alexandrou, Spencer, Frost, Parr, Davidson, & Hillman, 2009, p. 1485). Traditionally, insertion of CVCs have been performed by surgeons
Central Line Clinical Practice Guideline & Rational Central venous catheters (CVCs) are frequently used in intensive care units (ICUs) for a number of reasons (measure central venous pressure, when peripheral veins are unable to be accessed, administration of medications/therapies and aspiration of blood samples) (Conroy, 2006, p. 98). Patients in this environment already have an increased risk of infection because of their treatments. Patient treatments commonly involve invasive devices or interventions
Central lines (CL) are used frequently in hospitals throughout the world. They are placed by trained health care providers, many times nurses, using sterile technique but nosocomial central line catheter associated blood stream infections (CLABSI) have been a dangerous issue. This is a problem that nurses need to pay particular attention to, and is a quality assurance issue, because CLABSI’s “are associated with increased morbidity, mortality, and health care costs” (The Joint Commission, 2012)
Hospital Acquired Conditions (HAC) Baptist Memorial Hospital is in a highly competitive healthcare environment. This capitation is not only the result of efforts of the other healthcare organizations but, also driven by patient consumerism. The government sponsored hospital compare website allows potential patients the ability to compare our clinical outcome data. The targeted group is also the group with the greatest healthcare choice, our medicare population. One of the major reporting categories
Vecuronium-bromide is a drug used prior to and during surgery. It has several benefits in surgical situations which makes it an ideal drug. It has a rapid onset and recovery time, it is easily administered which is a benefit for maintenance doses, it paralyses the trachea which aids in ease of endotracheal tubation, it also has very little cardiovascular or histamine releasing effects. All of these things combined make it an ideal drug in conjunction with other anesthesia medications for surgery
the central catheter insertion. The doctor reassured Chloe through conversation prior to the central venous catheter insertion. During the conversation Chloe was given freedom of choice. Chloe was given the option to have the procedure but Chloe also had the option to not have the procedure. In order to have freedom of choice the patient needs to be offered more than one option of treatment. Chloe’s options were limited, this was an emergency procedure so the central venous catheter insertion was
in the change of practice, and to see of all goals have been met. The QI project that will be described in this analysis pertains to catheter related blood stream infections (CR-BSI). CR-BSI and the ability in which they can be prevented is a common focus in the healthcare industry. The Center for Disease Control (CDC) has reported that 5 CR-BSI per 1000 catheter days is the current rate of infection. This translates into 80,000 patients every year will acquire a CR-BSI. This infection can be introduced
and procedures are guidelines that are instituted and followed by organizational staff to perform skills or interventions safely and proficiently. Examined below is the policy and procedure for nursing staff to obtain blood cultures via central catheters. Also mentioned below is the survey of five unit nurses performing this procedure and possible deviations taken from the current Salem Hospital policy. Possible reasons of not following an institution’s policy and procedure guidelines, consequences
Central Line Associated Bloodstream Infections (CLABSI) kills about 33,000 Americans each year, the total cost of treating CLABSI is one billion dollars annually. The cost to treat each patient affected is about 16000 dollars. With patients being discharged home with central lines, CLABSI can occur in the home setting too and not just hospitals. The case study presented in this paper discusses the statistics associated with CLABSI in discharged patients with central lines, and the efforts being
Definition An AAA (abdominal aortic aneurysm) is defined as enlargement of at least 3 cm of the abdominal aorta. The majority of abdominal aortic aneurysms begins below the renal arteries and ends above the iliac arteries. The exact cause of (AAAs) is unknown. However, it is thought to be due to a degenerative process of the abdominal aorta caused by atherosclerosis. Artherosclerosis represents a response to vessel wall injury caused by inflammation, genetically regulated defects in collagen
cases (Kheterpal et al., 2007, p. 893). However, in some serious cases, while the function improves slowly for over a few months, dialysis may be required (Kheterpal et al., 2007, p. 893). One study found that diseases related to liver function, and peripheral vascular disease are risk factors for AKI. Also, in Mr Walter’s case, older age and surgeries with higher risks increase chance of acquiring AKI (Kheterpal et al., 2007, p.
Aside from the motor and sensory impairments as well as independent breathing difficulty (if higher level injury), numerous complications can arise after an individual sustains a SCI. Initially after injury, spinal shock occurs resulting in a phase of areflexia, a disruption of the autonomic nervous system causing irregularities in blood pressure and temperature control, and flaccidity. The initial phase may last approximately 24 to 48 hours with a gradual return of reflexes over time. Ultimate
Introduction Dilated cardiomyopathy (DCM) is “a syndrome characterized by cardiac enlargement and impaired systolic function of one or both ventricles.”4(1175) Through medical technology and proper medical regimen, people afflicted with this syndrome today, are living longer and are undergoing surgeries that may not be cardiac-related. Therefore, anesthesia providers may encounter increasing amounts of patients with DCM as compared in the past. As anesthesia providers, it is important to have an
field covers a variety of therapies ranging from stents to intravascular ultrasounds. Invasive and interventional cardiology began with the birth of catheterization, starting from the early ancient Egyptians, going back to 400 B.C. During 400 B.C., catheters were fashioned by hollow reeds and pipes were used on cadavers to study the function of cardiac valves. Then, in 3000 B.C., ancient Egyptians performed the first types of catheterization which started from the bladder using metal pipes (Choudhury
Peripheral Vascular Disease (PVD) is a generalized term referring to a spectrum of vascular disorders that alter the structure or function on any non-coronary artery. Atherosclerosis is the most common vascular disorder affecting the peripheral arteries (Ali & Carman, 2012). Atherosclerosis, commonly known as hardening of the arteries, is a general vascular disorder that can be located in any blood vessels throughout the body. It causes a reduction of blood flow and loss of function. Peripheral
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
reported that all or almost all of their residents were competent to perform the following ACGME required procedures at the completion of training: intravenous (IV) placement (48%), arterial puncture (51%), umbilical arterial catheter placement (55%), umbilical venous catheter placement (57%), intubation (60%), and venipuncture (61%). In another study, Leone et al2 reported that the median success rates of neonatal intubations were 33% for pediatric level (PL)1 residents and 40% for PL2 and PL3 residents