Health Care: Inpatient Setting, Term Paper Example

Outline

Introduction

• Overview of healthcare setting

Interview

• Background information on the interviewee
• Identification of trends and how they are articulated by leadership

Challenges in the department

• Identification and resolution strategies

Conclusion

• Table illustrating trends and interview responses

Abstract

This document gives an overview of a healthcare setting. Results of an interview with the administrator of this inpatient setting will be presented. An account of trends and challenges within the institution will be examined and reported. Strategies of how these trends and challenges have been articulated to benefit the health care setting will also be embraced in this discussion.

Introduction

Overview of inpatient health care setting: Operating theatre

Operating theatre is where surgeries are performed on live patients. Basically, there are two sections within an operating theatre function. They are the non-sterile unit where visitors and students can watch surgeries outside the sterile section and a sterile section where surgeries are performed. A number of rooms make up the operating theatre or unit. These rooms vary in size and amount based on the hospital’s protocol (Deysine, 2003).

Equipment found in a typical operating room consists of a table usually placed in the center of the room. Lights are located over head with an anesthetic machine at the top end of the table. Beside the machine is the anesthetic cart. All sterile instruments for a surgical procedure are arranged on a stainless steel trolley away from the operating table, but close enough for the relay from nurse to surgeon as the procedure is undertaken. An oximeter along with an electronic cardiac monitors and electrocautery machines are mandatory devices found in an operating unit (Macario, 2006).

Operating room management can be considered a science. The focus is to minimize infections and ensure that the right patient is scheduled for the right surgery at the right time and the operating site is the right one. Hence, very member of the team is responsible for a successful, surgery with no or few complications during and after. Therefore, nurses who work in this unit specialize in operating room techniques to perform at a very high level of competence.

Interview

Background information on the interviewee

Mrs. V.B is an Advanced Practice Nurse specializing in anesthesia. She has been the administrator of this operating theatre for ten years. Prior to that time she worked as an anesthetic nurse, runner, and scrub nurse in the operating rooms of this WW hospital and five others. A major portion of her career was spent in operating rooms she recalled. This enterprising career began 20 years ago when she entered the profession as a registered nurse. Mrs. V.B related how during her first rotation in the operating theatre she simply fell in love with the feeling, atmosphere and type of work conducted in this unit. Ever since graduation she asked to work in that unit; subsequently specializing in anesthesia.

Identification of trends and how they are articulated by leadership

Trends were highlighted by citing documentation from Morrit (2012). The administrator pointed out where referencing supportive data that approximately 234 major surgeries are performed internationally every year at an incidence of 1 in every 25 living person. 25% of these patients develop complications. The present crude post-operative death rate for major surgeries is 0.5 -5% (Morrit, 2012).

In industrialized nations 50% of all adverse events following surgery are preventable hospital related surgical errors. She further emphasized that studies have revealed the cause being inconsistent application of surgical principles even in the most sophisticated surgical settings, such as her organization. Predominantly, there have been frequent situations pertaining to wrong site; wrong patient wrong procedure (Morrit, 2012).

Therefore, designing strategies to ensure compliance with related regulations and guidelines for patient surgical safety is imperative at this stage of the prophylactic surgical intervention history according to Mrs. VB perspective on trends in the discipline. She cited aligning the surgical unit with Occupational Safety and Health Administration (OSHA); Association of Perioperative Registered Nurses (AORN) and Joint Commission on Accreditation of Health Care Organizations (JCAHO) regulations

Challenges in the department

Identification of challenges and resolution strategies

Challenges faced in the department’s operations encompass a series of inconsistencies, which include inadequate verification process of patients’ identity before surgery; a high rate of intraoperative emergencies and surgical site infections as well as postoperative venous thrombosis. Measures taken from an administrative level to deal with these challenges is to implement the surgical time out (STO) strategies within the unit.

Surgical time-out strategies have proven worthwhile when considering implementation of an improvement process when considering this challenges which lay ahead, Mrs. B echoed. The core components of surgical time out (STO) are patient identification and verification of operative site inclusive of patient and procedure (Altpeter et.al, 2007).

Specific resolutions strategies entail conducting a preoperative session among surgeons, patients and surgical nurse ensuring this is the correct patient scheduled for surgery. Once a patient is conscious ask his/her name. If unconscious check for patient’s identification band.

Again question patients regarding complain and surgery to be performed for synchronicity with documentation and surgeon’s perception of surgical procedure. Next is to reduce inoperative emergencies application of automatic body temperature monitoring devices during surgery along with 15 minutely observation any significant changes. Referencing Altpeter (2007) Mrs. VB cited that maintenance of intraoperative normothermia has been convincingly related to reduced blood loss, sepsis and mortality rate (Altpeter et.al, 2007).

Pre-screening for predisposing medical conditions is essential to improving outcomes. According to Agnelli (2004) venous thrombosis is a leading postoperative complication, which is preventable, but occurs for 15-30% of postoperative patients(Agnelli, 2004) . Once proper pre- operative care is instituted the crude death rate would be greatly reduced since there would be less surgical errors.

Conclusion

Table illustrating trends and interview responses

References

Altpeter, T. Luckhardt, K. Lewis, J. Harken, A., & Polk Jr, C. (2007). Expanded Surgical

Time Out: A Key to Real-Time Data Collection and Quality Improvement. American College of Surgeons. Elsevier Inc

Agnelli, G. (2004). Prevention of Venous Thromboembolism in Surgical Patients. Circulation.110 (4), 4-12

Deysine, M (2003). Hernia infections: pathophysiology, diagnosis, treatment, prevention. Informa Health Care

Macario A ( 2006) Are Your Hospital Operating Rooms “Efficient”? Anesthesiology. 105,237-40.

Morrit, J. (2012). Documentation Relating to Surgical Errors. Power point Presentation