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1 vote
Whose Fault is it?

A 48 year old female patient has recently undergone surgery for a knee replacement. Past medical history of the patient includes Diabetes Type 2, a partial hysterectomy, asthmatic, and Irritable Bowel Syndrome. Two weeks post-op the patient presents in the ER with an elevated temperature, swelling and redness in the surgical incision site. The patient also says that she's experiencing pain at the surgical site and chills. Her sister accompanied her to the ER and said that the patient has started back smoking cigarettes and only cleans the surgical site every couple of days. The nurse who took care of the patient in the recovery room the day of the surgery provided the patient with wound care instructions and used aseptic technique, proper ppe, and instructed the patient on wound care.


How can you determine who is at fault for the infection? (50 points, minimum of 1 paragraph)

2 Answers

3 votes

Answer:

The fault is the patient's.

Step-by-step explanation:

This situation is the patient's fault. This is because, even though the patient was provided care instructions, the patient did not follow them. She also decided to start smoking, which increases the risk of infection. When she was not cleaning the wound for days on end, the more bacteria built up causes a more serious infection. Since the nurse did provide her aftercare information and what to do, this is entirely on the patient.

User Solopiu
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8.3k points
5 votes

Even though it is difficult to pinpoint a single entity solely responsible for the patient's infection, multiple factors likely contributed including the patient.

What factors likely contributed?

Multiple factors likely contributed, which highlights the importance of a systems-based approach to learn from the situation and prevent future occurrences.

Patient factors:

Pre-existing conditions: Diabetes, IBS, and smoking significantly increase infection risk. Addressing these factors before surgery, through proper control and cessation of smoking, could lower the risk.

Wound care compliance: Irregular cleaning increases infection risk. Enhancing patient education on the importance of proper wound care and providing additional support mechanisms, like home care services, could improve compliance.

Surgical factors:

Surgical technique: While the information suggests standard precautions were taken, a thorough review of the surgical protocols might uncover potential vulnerabilities and opportunities for improvement in aseptic practices.

Implant quality: While rare, a review of the implant source and sterilization procedures could be conducted to rule out any unlikely but possible contamination issues.

Healthcare factors:

Post-operative instructions: While instructions were provided, their efficacy and clarity could be reviewed to ensure they were easily understood and actionable for the patient.

Patient education: The effectiveness of patient education on wound care and recognizing signs of infection could be evaluated and enhanced for future cases.

Follow-up care: The schedule and thoroughness of post-operative checkups could be reviewed to ensure timely identification and intervention for any potential issues.

User Trotterdylan
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8.6k points