Question

In: Nursing

Mr. Aburu, 81, with a history of cerebral vascular accidents, was hospitalized as an outpatient for...

Mr. Aburu, 81, with a history of cerebral vascular accidents, was hospitalized as an outpatient for a surgical procedure to incise and drain a skin lesion on his chest. After the procedure, he returned to the long term care facility with sterile packing in the partially sutured incision site. The packing was to remain for 3 days, then removed, and the wound covered with a dry dressing. The risk of complications for this type of surgery was considered quite low, and both the nursing home administrator and the attending surgeon saw no reason why the patient could not be adequately cared for in the nursing home immediately after surgery.

Approximately 5 hours after Mr. Aburu returned to the nursing home, blood was observed at the incision site. He was transferred back to the acute care hospital, where he died the following day. Evidence at the trial showed that for the 5 hours that Mr. Aburu was at the nursing home, several licensed and unlicensed personnel attended to him. At lunch time, two aides escorted Mr. Aburu to the dining room; lunch was about 3 hours after his return to the nursing home. None of the personnel examined his dressing until an aide noticed that he was bleeding through his bed sheets. Shortly after discovering the bleeding, the patient was transferred by ambulance to the hospital. His family has filed a lawsuit for the wrongful death of their father, alleging that the care given to the patient after surgery fell below the acceptable standards of care.

What should the standards of care be for such patient?

Even though the nursing care plan did not specify that the wound should be checked hourly, how should the prudent nurse have acted?

Should the lawsuit center primarily on the surgeon for allowing this patient to be sent back to the nursing home for post-operative care rather than insisting he be kept for 24 hours in an acute care facility post-operatively?

How would you decide this case?

Expert Solution

WHAT SHOULD THE STANDARD OF CARE BE FOR SUCH PATIENT?

Bleeding

there can be some bleeding after any operation,if this occurs,apply firm pressure with a sterile gause for 15 minute.if there is a dressing in place,leave it on but press on top of the dressing.

Infection

if the wound becomes hot swollen and very painful or oozes puz,it may be infected. you may require antibiotics.

Care of wound

if patient had a dressing applied remove it after two days. and frequently check the wound condition

Removal of stitches

stitches have to be left in for different periods of time, deppending on the circumstances. certain types of stitches do not need to be removed

NURSING CARE PLAN DID NOT SPECIFY THAT THE WOUND SHOULD BE CHECKED HOURLY HOW SHOULD THE PRUDENT NURSE HAVE ACTED?

Post operative wound management

keeping wounds clean

use an a septic technique

monitor the wound for bleeding upto 48 hour after surgery

provide sterile surgecal wound dressing

SHOULD THE LAWSUIT CENTER PRIMARLY ON THE SURGEON FOR ALLOWING THIS PATIENT TO BE SEND BACK TO THE NURSING HOME FOR POST OPERATIVE CARE RATHER THAN INSISTING HE BE KEPT FOR 24HOUR CARE IN AN ACUTE CARE FACILITY POST OPERATIVELY?

lawsuit primarly on the surgeon for allowing this patient to be send back to 24 hour care in an acute care facility post operatively . post operative care is the care receive a patient after a surgical procedure

HOW COULD YOU DECIDE THIS CASE?

Crime is the act that is a violation of duty or breach of law, punisable by fine or imprisonment.

Nightingale answered 1 year ago

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