Deviation in the Standard of Postoperative Care Resulting in Infection

Evaluate breaches in the standard of care when exploring whether or not there was a Deviation in the Standard of Postoperative Care Resulting in Infection

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

  • Was a pre-operative evaluation performed?
    Yes
    No
    Answer unknown
    Why is this important?
    The pre-operative evaluation is used to identify risks to the patient undergoing surgery with the goal of minimizing those risks, optimizing a patient's peri-operative medical condition, and preventing complications.
    (2005) 81 EAORNJ 6 1259-1260,1264,1266-1268,1271-1272

  • With which of the following medical conditions did the patient present? (Choose all that apply) Why is this important?
    Answer this question
    Poorly controlled, symptomatic diabetes may increase risk of hypovolemia peri-operatively. Furthermore, poor glycemic control is associated with increased infection rates and other post-operative complications.
    Click here for additional information at ClinicalKey.com

  • Was a thorough medical history obtained? 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.
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  • Which of the following surgeries did the patient undergo? Why is this important?
    Answer this question
    Procedural risks are associated with the duration and characteristics of the surgery, anesthesia, and anticipated blood loss. Any invasive procedure is associated with a risk of infection.
    Click here for additional information at ClinicalKey.com

  • Were the intravascular (IV) catheters promptly removed? Why is this important?
    Answer this question
    Most cases of nosocomial bacteraemia arise from an intravenous line.
    (2009) 37 EMEDIC 10 557-561

  • Did the patient have a urinary catheters inserted? Why is this important?
    Answer this question
    Urinary catheters are responsible for most nosocomial infections.
    (2009) 89 ESRCNA 2 475-481

  • Did the patient have a surgical drain, post-operatively? Why is this important?
    Answer this question
    The prophylactic implantation of drains during surgical procedures is a common routine to prevent pain, swelling and complications.
    (2004) 18 EBPRCG 5 809-827

  • Were the patient's vital signs monitored for signs of infection? Why is this important?
    Answer this question
    All post-operative patients must be monitored periodically for any signs of infection.
    Click here for additional information at ClinicalKey.com

  • Did the clinician recognize signs of infection? Why is this important?
    Answer this question
    Surgical site infection is suspected when there is erythema, drainage or fluctuance of the surgical incision.
    (2009) 89 ESRCNA 2 365-389

  • Which of the following laboratory investigations were performed? (Choose all that apply) Why is this important?
    Answer this question
    Laboratory investigations must be performed if post-surgical infection is suspected. A complete blood count with differential, a sedimentation rate and a culture and sensitivity screening need to be done.
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  • Were antibiotics administered based upon the culture and sensitivity results? Why is this important?
    Answer this question
    The most effective means of treating a post operative infection is to isolate the organism responsible through a culture and sensitivity screening.
    (2009) 89 ESRCNA 2 365

  • Was the patient monitored after the antibiotic administration? Why is this important?
    Answer this question
    Following the administration of any medication, the patient must be observed for untoward side-effects and allergic reactions.
    (2009) 89 ESRCNA 2 365

  • Was persistent infection managed appropriately? Why is this important?
    Answer this question
    Once the patient’s infection is diagnosed to be persistent it is necessary to perform additional laboratory and diagnostic imaging studies.
    Click here for additional information at ClinicalKey.com

  • Was a closed drainage system maintained after the catheter was inserted? Why is this important?
    Answer this question
    The use of a closed catheter urinary drainage system is the gold standard in the prevention of catheter associated urinary tract infections.
    (2009) 89 ESRCNA 2 475-481

  • Was un-obstructed urine flow maintained? Why is this important?
    Answer this question
    Long-term indwelling catheters must be changed in intervals adapted to the individual patient, but must be changed before blockage is likely to occur.
    (2009) 89 ESRCNA 2 475-481

  • Was the urinary catheter left in place only as long as needed? Why is this important?
    Answer this question
    The duration of catheterization must be minimal. Long-term indwelling catheters must be changed in intervals adapted to the individual patient, but must be changed before blockage is likely to occur.
    (2009) 89 ESRCNA 2 475-481

  • Were prophylactic antibiotics administered for cardiovascular surgery? Why is this important?
    Answer this question
    ICSI guidelines recommend that antibiotic medications for surgical site infection prevention be given within one hour prior to the surgical procedure.
    Click here for additional information at ClinicalKey.com

  • Which of the following prophylactic antibiotics were administered for biliary tract surgery? Why is this important?
    Answer this question
    Cefazolin is the antibiotic agent of choice for most surgeries.
    Click here for additional information at ClinicalKey.com

  • Which of the following prophylactic antibiotics were administered for colorectal surgery? Why is this important?
    Answer this question
    Prophylaxis is necessary for most gastrointestinal procedures.
    (2005) 81 EAORNJ 6 1259-1260,1264,1266-1268,1271-1272