JIPMER: A Randomized Study

Not only did insufficient staffing contribute to the causes of this particular event, but human error also played a significant role. When Mr. B arrived at the ED, he was hyperventilating. His leg “appeared shortened.” He had edema in his calf, ecchymosis, limited ROM, and he rated his pain at a ten out of ten. Mr. B also had a history of prostate cancer, impaired glucose tolerance, elevated cholesterol and lipids, and chronic pain. He was admitted to the ED with a plan to relocate his hip. Dr. T ordered diazepam 5.0 mg to be administered through IVP and then just five minutes later ordered 2.0 mg hydromorphone to be administered because it appeared that the diazepam was not having the intended sedating effect. Again, just five minutes later, Dr. T was still not satisfied with the level of sedation and instructed the nurse to

While there was a policy in place for conscious sedation, even good policies rely on the vigilance of staff to adhere to them. Often times, working conditions allow for distractions, and even the best of practitioners, with the best of intentions, make errors. There were several areas presented in this scenario that require examination and improvement.

Lack of enough trained staff in conscious sedation available at the time of the procedure

5. Poulin,P., et al.(2014) Preoperative Skin Antiseptics for preventing surgical site infections: What to do?

Many factors have contributed to the sentinel event, specifically the current conscious sedation policy. The improvement plan would include revising the conscious sedation policy to ensure the patient is properly monitored post procedure and to intervene when issues arise. The sedated patient should be monitored one on one post procedure by an RN, who is educated on the conscious sedation protocol, for thirty minutes or until the patient reaches his baseline. Also, mandatory monitoring will include EKG, pulse oximetry, blood pressure, heart rate, respirations and level of consciousness. A list of appropriate medications and the dosages should be included in the conscious sedation policy. In addition, reversal agents should be readily

According to the systematic review covered by Apfel, Turan, Souza, Pergolizzi & Hornuss, 2013 there is a significant reduction in postoperative nausea and vomiting and opioid use when using intravenous acetaminophen. The reviewers used Medline and Cochrane databases to conduct their search along with a hand search of abstracts to identify randomized-controlled trials using intravenous acetaminophen. The review was to determine if the acetaminophen was going to have a significant decline in nausea and vomiting following surgical procedures as

This Anaesthetic case study would describes and discussed the scenario of a patient through the anaesthetic role of their surgical procedure. It will include and discuss the anaesthetic safety procedures equipment and drug interventions used to ensure this particular patients maximum safety and comfort before and during the procedure. The case study will include pre and peri-operative assessment in order to describe the involvement contribution of various specialties in the holistic care of the critical care patient. This assignment will focus only on the anaesthetics side of the procedure but will also highlight the importance of the triad of anaesthesia and discuss the administration, maintenance and reversal of

Ketamine can be used for sedation before minor procedures, although this use is not approved by the FDA

The clinician demonstrated evidence based practice in his care. By informing the patient about the procedure and waiting for a clear approval. He demonstrated great communication skills as well as keeping the client’s values and circumstance at the core of his care throughout. In addition, the five moments of hand hygiene, aseptic technique and the rights of medication administration of current best practice were utilised. Furthermore, clinical expertise were demonstrated the clinician completed the task in a timely manner with good dexterity highlighting that he has been administering IV therapy for quite some time and is experienced in the way he handled the

Regardless of the number and type of practitioners involved, the MDA retains virtually all responsibility of the patients. The anesthetic management is delegated by the MDA to any of the team members that participate in this model. The CRNA’s role, in this model, would be to implement the concluded plan formulated through collaboration of the team.

The pre-operative stage is an important phase in patient’s surgery process. This is the time where the patients is experiencing a lot of anxiety issues and have questions regarding the impending procedure. To help ensure good patient outcomes, it is imperative to provide complete preoperative instructions and discharge instructions (Allison & George, 2014). It is the nurses’ duty to safe guard and protects the patient’s welfare during the surgical experience. Effective preoperative preparation is known to enhance postoperative pain management and recovery. Health professionals need to be cognizant of the contextual factors that influence patients’ preoperative experiences and give context appropriate care (Aziato & Adejumo, 2014).

The importance of informed consent and physician-patient communication was highlighted. The procedure to be performed or other treatment options must be well-explained, and the implication and possible conflicts that may arise should be discussed in order to minimize the occurrence of difficult situations like the cases presented in this session. With the current healthcare system, however, where physicians are severely limited in how much they can spend time with the patient

The values such as communication, innovation, quality, and collaboration is key to the growing field of perioperative nursing (AORN, 2015). During surgery communication is important between surgeons, anesthesia and nursing. Surgeons are focused on surgery, anesthesia takes care of breathing and vital signs, nurses are at the bedside or circulating and can assess the OR and what is happening during the procedure. The ARON believes that every patient has the right to receive the highest quality of perioperative nursing care of every surgical or invasive setting; all health care providers must collaborate and strive to create an environment of patient safety; and every patient experiencing a surgical or invasive

Ethical challenges are the most profound when dealing with patient safety; compliance with the prophylaxis antibiotic administration guidelines is paramount to a surgical patient in order to decrease the possibility of a post operative surgical site infection. Antibiotic timing requires

Patients with physical or mental disabilities should be sedated in order for them to get the proper dental care that they need because they may not be able to cooperate during the procedure. As stated by Dr.Bain, D.D.S, Patients with medical conditions such as Down’s syndrome and cerebral palsy may have physical limitations that keep them from sitting comfortably in the patient chair and staying still during dental treatment. Patients with physical disabilities may have a hard time remaining calm. The physical disability of the special needs patient may cause them to fidget and move around a lot. This can make it more difficult for them to keep their head straight or their mouth open for the dentist. In addition, patients that lack good communication skills may also have a hard time cooperating with treatment because they are unable to communicate to the dental staff or their caregiver any discomfort or pain they feel during treatment. This makes it harder for the dentist to complete the treatment correctly because the patient may have a difficult time informing their needs to the dentist or the assistant. As a result, the patient will not be able to cooperate with treatment if they are experiencing pain or discomfort. If the patient can not communicate to the dental staff that something is causing them pain or discomfort the patient is not only going to be very uncomfortable, but they are also going to remember the procedure as a traumatic