Deviation in the Standard of Care During Hand Surgery

Evaluate breaches in the standard of care by using the questions presented herein to determine if there was a Deviation in the Standard of Care During Hand Surgery

Answer the following questions to find out if the standard of care was followed for your case.

  • What type of hand surgery did the patient undergo? Surgery for trauma Surgery of non-traumatic origin Why is this important?
    The evaluation, care, and treatment for hand surgeries differ substantially depending upon the type of injury and condition with which the patient presents.
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  • Did the clinician refer the patient to a hand surgeon/plastic surgeon? Why is this important?
    Answer this question
    
The hand is a very sensitive area and surgeries of the hand are best performed by a hand surgeon or a plastic surgeon.

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  • Did the clinician confirm the diagnosis by examination and assessment? Why is this important?
    Answer this question
    
A complete medical history and carefully focused physical examination serve as the core of the diagnostic process. The information obtained guides the further direction of the patient's evaluation and enables the clinician to make the most judicious use of additional tests and treatment decisions.

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  • Were all the possible complications of the surgery explained? Why is this important?
    Answer this question
    
In certain surgical procedures, such as those involving arthritic joints, the hand function may not be completely restored to normal.

    (2006) 7 EAICMD 12 437-441 



  • Was an informed consent obtained? Why is this important?
    Answer this question
    
The laws of most states require that clinicians obtain informed consent before providing treatment.

    (2011) 23 EOMSCA 3 475-484 



  • Was a thorough pre-operative evaluation performed and documented? Why is this important?
    Answer this question
    
A preoperative basic health assessment is typically performed within 30 days of planned surgery. At least a limited assessment is mandated by the Joint Commission on Accreditation of Healthcare Organizations on all patients, but a more thorough evaluation is necessary to obtain a comprehensive view of patient risk factors.

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  • Did the clinician administer prophylactic antibiotics? Why is this important?
    Answer this question
    
The administration of antibiotics prior to the surgery may help alleviate any risk of post-operative infection.

    (2004) 19 JPANEN 2 111-113 



  • Was the patient evaluated for any co-morbidity? Why is this important?
    Answer this question
    
In most instances there is multiple tissue involvement in a hand disorder. Therefore, the surgical site must be evaluated for involvement of other structures.

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  • Did the clinician take necessary steps to correct the existing co-morbidities? Why is this important?
    Answer this question
    
In the event of a secondary structure involvement in a hand disorder such as a nerve or a vessel involvement, it is necessary that it be corrected during the time of surgery.

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  • Were steps taken to correct the injury sustained during the procedure? Why is this important?
    Answer this question
    
During any surgical procedure it is possible to injure the surrounding structures and it is necessary to identify those injuries immediately and take the necessary steps to correct them.

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  • Did the patient develop any systemic complications as a result of the surgery? Why is this important?
    Answer this question
    
The patient may develop complications during a surgical procedure that cannot always be prevented but they can be detected and treated quickly.

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  • Did the clinician manage the patient’s post-operative pain? Why is this important?
    Answer this question
    
Pain after surgery is un-preventable, but it is necessary that it be managed appropriately by prescribing adequate medications.

    (2004) 5 EACUPN 3-4 89-107 



  • Was the patient monitored for post-operative complications? Why is this important?
    Answer this question
    
Post-operative care is based on the regular observations of physiological vital signs (pulse, respiration, blood pressure, and temperature), general observations of the patient's condition, and specific observations related to the surgical procedure.

    (2005) 20 EBPCOG 1 23-40 



  • Was post-operative rehabilitation recommended? Why is this important?
    Answer this question
    
Rehabilitation is recommended in almost all patients undergoing hand surgery to optimize the return of the hand to normal functionality.

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  • Was the patient instructed to follow-up with the clinician? Why is this important?
    Answer this question
    
Routine follow-up evaluations are necessary to offset any complications that may arise. Regular check-ups ensure that changes in health are quickly assessed and remedied.

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  • Did the patient complain of pain or sensory loss during the follow-up visits? Why is this important?
    Answer this question
    
Patients who had a nerve injury during the surgery may not have complaints of pain during the early post-operative course.

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  • Did the patient’s wound heal uneventfully? Why is this important?
    Answer this question
    
Continued follow-up assessments may be needed to evaluate the progress of the wound healing.

    (2009) 27 ESURGO 10 426 



  • Was the patient conscious when he/she presented to the healthcare facility? Why is this important?
    Answer this question
    
Patients who have experienced a traumatic injury may present to the facility at different levels of consciousness. Patients must be stabilized prior to initiating treatment for hand injuries.

    (2007) 8 EAICMD 10 418-422 



  • Was a thorough medical history obtained and documented? Why is this important?
    Answer this question
    
Although hand surgery may be performed as an emergency procedure, obtaining a thorough medical history will benefit both physician and patient in achieving a positive outcome and avoiding any untoward complications.

    (2009) 27 EANESC 4 787-804