Question

Please don't copy and paste

Review the below situation. Using the steps in Reason's Organizational Accident Model that were extended and adapted for use in a healthcare setting, write a one - two page paper analyzing this scenario. Include the definitions and essential concepts. Make note what data is missing from the scenario.

Situation 1

Nancy Nurse was working on the orthopedic surgical unit. She had 6 patients that day. One was a fresh post op hip surgical patient. One was a 70-year-old 1-day post op total knee case. 4 patients were 4 days' post-surgery and were planning discharge. It was a busy day. Nancy was working hard to keep ahead of her medications and patient assessments. Right before lunch, one of her co-workers came in on her day off and brought her 2-year-old daughter to see the team. Nancy was so excited to see them. She took her break and sat with the toddler on her lap. The toddler had a runny nose and was complaining of her throat hurting. Nancy made a comment about her runny nose and continue to wipe the baby's drainage. Her mother commented that she had been having bouts of diarrhea as well as the runny nose.

Once her break was over, Nancy went back to taking care of her patients. The first thing she had on her schedule was a dressing change for the 1-day post op patient. Nancy knew that the surgeon typically made rounds at lunch, so she needed to be sure and have the dressing changed before the surgeon showed up. She hurried to the room as soon as her co-worker had left and performed the procedure. Nancy failed to wash her hands before entering the room and doing the dressing change. She chatted with the patient after the dressing change and then left the room to see to her other patients.

On the 3^rd post op day, the total knee patient developed a temperature and a purulent drainage from the knee. Culture showed she had E. coli in the surgical wound. IV antibiotics were administered. This extended the patients stay by 4 days.

Because the patient was infection free on admission, this is considered a Hospital Acquired Infection.

Answer 1

Introduction:

The 3rd post op day of knee replacement patient show symptoms of elevated temperature and drainage is due to the infection at the surgical site. The infection that occurs during hospitalization stay is called surgical site infection. This can be treated by administering proper antibiotics.

Cause for surgical site Infection:

The causative organism is E.Coli which is transmitted to the surgical site while dressing. E.coli is a gram-negative bacteria which is harmful to the persons and cause illness. It is transmitted through contaminated food and water and shows the symptoms of abdominal pain, cramps, diarrhea. As the nurse was chatting with the coworker's toddler who has been with symptoms of a runny nose, throat hurting, and diarrhea. As the child was infected with some bacterial infection is became an agent, and nurse became the host, and the hospital and dressing are the environmental factors that transmit the disease. Thus the organism transmitted from infected toddler to the surgical site.

Prevention:

Once the wound is contaminated, it becomes a risk factor for surgical site infection. Surgical site infection is almost prevented by following the prevention strategies of Handwashing, use of sterile gloves, sterile instruments, wearing of the mask, and maintain sterile technique. In this scenario, It clearly shows that the nurse did not wash her hands before dressing makes the wound contaminated and cause of surgical site infection. The handwashing will prevent the spread of germs to others. As the nurse is in the surgical unit, Handwashing is the ultimate one which the nurse has to do once the hand is contaminated to prevent cross infection.

Analyzation:

While analyzing the above scenario, It shows that the nurse has a lack of knowledge of surgical site infection and the importance of hand washing. All nurses must be taught of purpose and techniques of hand washing with soap and water or use of alcohol-based hand rub. The ignorance of nurse make increases the hospital stay of the patient and increases the healthcare cost. Further, the patient has the need to take more antibiotics. The organization also had a loss of lack of reimbursement due to HCI. The organization has to appoint the wound care manager who should assist the nurse while dressing will prevent this type of incident in the future.