How nurses come up with discharge records

Please answer original forum with a minimum of 300 words

Please respond to both students on seperate pages with a minimum of 100 words each

please follo directions or I will dispute!!!

Page1- original Forum and references

page2- student Response

page 3- studen Response

Original Forum

Antibiotics are commonly used to treat infections. We seldom think about what occurs when we take this medication other than the fact that we will or should get better after a few days. Most are aware that antibiotics have been used for some time and their effectiveness is beginning to wane. In fact, today we have strains of microbes that have developed resistance to antibiotics such that we have named them Superbugs. One such Superbug, methicillin-resistant Staphylococcus aureus (MRSA) has become resistant to most antibiotics available and is a problem in many hospital settings.

Review chapters 14 and 15 of your textbook for a review of Antimicrobial Drugs and Microbial Mechanisms of Pathogenicity.

And then visit the Infectious Disease Society of America

For this forum, please choose to take ONE role in the following scenario.

A patient has arrived in the ER critically ill. She had a minor surgery the week previously and was discharged home with antibiotics. Upon arrival to the ER, the patient presented gravely ill, the surgical wound red, swollen, puss filled and her temperature elevated. A post surgical infection is suspected.

Choose only ONE (Topic) role in this scenario:

Topic 1. You are the patient

Topic 2. You are the spouse of the patient (the person who may be or may become responsible for making decisions)

Topic 3. You are the nurse caring for the patient.

Topic 4. You are the primary physician caring for the patient.

Topic 5. You are the infectious disease specialist on call for the hospital where the patient has arrived.

Compose an exposition to address the following questions;

1. Is this infection likely MRSA?

2. What would a MRSA infection look like on a patient; for example, describe how the wound presents.

3. Was the patient exposed to MRSA in the hospital prep, during the surgery the week previously or sometime afterwards (post-discharge)?

4. Where does liability for this (potential) infection rest? Is it the responsibility of the patient (making sure she followed her discharge instructions, etc), nurse(s), scrub technicians, physicians, surgeons and/or infectious disease specialists to ensure resistant diseases are kept in check in hospitals?

Student Responses

Eric

As the nurse treating the patient, Here are my answers.

1. Is this infection likely MRSA?

This infection has a probability of being MRSA due to the signs and symptoms which are present. The patient may have been prescribed a broad-spectrum medicine that did not target the intended pathogens to prevent the infection or there could be other possibilities. The patient could have also developed a super infection in which the protective microbiota of the body were killed allowing added exposure to bacteria. Lastly, it is possible that the patient was over prescribed medication in which the body became resistant to and had less effect which the bacteria was able to overcome <w:sdt>(Parker, 2016).

2. What would a MRSA infection look like on a patient; for example, describe how the wound presents.

A MRSA infection appears to look like a large bump on the skin which is red, swollen, and warm to the touch. It is sometimes painful, full of pus, and most of the time accompanied by a fever. The common areas in which the infection is usually located include the legs, buttocks, groin, and back of the neck <w:sdt>(CDC).

3. Was the patient exposed to MRSA in the hospital prep, during the surgery the week previously or sometime afterwards (post-discharge)?

All of these options are a possibility as MRSA can be contracted either in the community or in the hospital setting due to improper sterilization of medical equipment or areas in the hospital <w:sdt>(Parker, 2016). Another possibility is that the patient was even given the wrong medication to treat the wound. The patient could have also become resistant due to previous medications which were over prescribed, or perhaps even not following proper instructions for taking enough medication or the correct doses.

4. Where does liability for this (potential) infection rest? Is it the responsibility of the patient (making sure she followed her discharge instructions, etc), nurse(s), scrub technicians, physicians, surgeons and/or infectious disease specialists to ensure resistant diseases are kept in check in hospitals?

The liability of this infection rests ultimately on the hospital and staff members because of the protocols for cleaning and sterilizing equipment properly <w:sdt>(Parker, 2016). There may be other factors such as manufacturers fault in which the equipment allowed for pathogen to enter a persons body and the patient themselves to not follow proper instruction. However, the hospital is the liable one. MRSA used to be known to be contracted through just the hospital setting as a common thing.
-Eric

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References<w:sdtpr>

<w:sdt>

CDC. (n.d.). MRSA Skin Infection Signs and Symptoms.Retrieved October 2018, from cdc.gov: https://www.cdc.gov/mrsa/pdf/MRSA_Broch_Parent.pdf<w:sdtpr>

Parker, N. (2016). Microbiology. OpenStax. Retrieved 2018

Jennifer

Hello everyone,

I will play the Physician for this topic.

How you determine if an infection is MRSA related is by first examining the wound. A MRSA infection displays at the wound site; warm to the touch, red, swollen, painful, full of pus and can also cause you to have a fever. The possible infection site looks awful to say the least and is discolored most times. It almost looks like a nasty “super” pimple.

The patient presents a surgical wound that is red, swollen, filled with pus, and even has a temperature increase or a fever. These point to MRSA, but the description of being gravely ill is suspicious. One of the few ways to definitely diagnose MRSA is to swab the nose or skin.

It does say that the patient was discharged with antibiotics to potentially kill of any impending infections. Although, MRSA can become resistant to antibiotics due to the many different advances in the strain.

It is very possible that the patient could have been exposed during surgery. Everyone involved with surgery scrubs diligently to prevent the spread of harmful microbes. The patient is also advised to keep the wound clean, covered and to not share any personal items. This is to help prevent infections.

The liability for this infection can rest on either the hospital or the patient. The hospital can run tests to confirm if their facility has MRSA or if their staff is carrying it. If those test come back negative then that is on the patient’s lack of self-care and following post-operation instruction.

Personally for me I had surgery at an out-patient facility and I had no issues. My incision site was wrapped up for about 2-3 weeks. I was instructed to keep the dressing dry at all times. Someone I work with had surgery at a hospital and developed staph infection. I am not sure who was at fault for that.

General Information About MRSA in the Community. (2016, March 25). Retrieved October 23, 2018, from https://www.cdc.gov/mrsa/community/index.html

-Jenny