Week 2: Scholarly Discussion Forum (graded): Data Collection and Risk Management
Saleema had total hip replacement in March 2015. One week later, the stitches started to bleed. She was concerned and went to the doctor’s office and was told it was a superficial hematoma. The bleeding continued on for three weeks and involved two doctor’s appointments and one trip to the emergency room. She was sent home each time with a diagnosis of a superficial hematoma.
Finally, Saleema’s visiting nurse saw her on a home care visit and called an ambulance, concerned about the amount of blood loss. Upon further investigation at the ER, a terrible infection was discovered that had spread into the bone. Saleema went in for emergency surgery and a PICC line was placed in order to administer the medication vancomycin. On this medication, she developed Steven’s Johnson’s syndrome, which was not diagnosed right away as the skin peeled off her hands. She ultimately went into acute renal failure and had to go back to the hospital. Two days post-admission, she developed C-diff and several vancomycin-resistant infections. She died in the hospital, two months after the original surgery. The cause of death was determined to be septicemia. Saleema lost her life over what was supposed to be a routine hip replacement.
As a future risk management nurse, please discuss the following points and questions.
- Discuss your interview plan with Saleema’s family to collect data around her incident.
- Which method of interview do you prefer to use, and why?
- The goal of the interview is to provide accurate answers to questions of interest. Please provide two relevant questions and discuss which measurement levels you would use with your question. Explain your choices. Link to week 3
Solution:
Quality in care delivery leads to the achievement of excellent health outcomes and improvement in patients’ quality of life (Evans & Lindsay, 2017). The case of Saleema is the focus of this week’s discussion.
Interview Plan
The interview plan with Saleema’s family would involve enquiring about her health history before and after the hip replacement surgery. I would also enquire with them how Saleema felt about the care provided at the facility. Another concern would be whether the family feels the facility did their best to help her or they would have done better. The risk involved with misdiagnosis is many including health complications and death as in the case of Saleema and even litigation issues. The family could sue the facility for misdiagnosis and failure to check the patient’s medication allergy prior to administering vancomycin.
Method of Interview
I would use an open interview. This would involve allowing the family to fully communicate and express their thoughts and feelings concerning this incidence. Through this, more information would be collected on how Saleema ended up dying due to just a routine hip replacement injury.
Relevant Questions
- Were any diagnostic tests performed to determine Saleema’s cause of the bleeding during her visits to the doctor and the emergency room?
This question is highly relevant as it helps understand why and how the providers arrived at superficial hematoma as the patient’s primary diagnosis and missed the infection which later spread to her bones, causing hospitalization, other infections, and death. The question would also help determine how well the patient’s family are aware of her situation and educate