Introductions Broward Health Coral Springs Hospital is a well-known 200-bed healthcare facility that has been providing a wide range of services to South Florida since 1987. This hospital has many educators, clinicians, specialist, that are well trained to service the needs of the community. During my Capstone experience in the labor and delivery department, my preceptor gave me the opportunity to observe a case of vaginal birth and a case of cesarean birth. This was a wonderful experience, but there was a major concern regarding the quantification of blood loss (QBL). During my observations, I noticed that the physicians documented only the estimated blood loss (EBL) instead of obtaining a more accurate QBL. On my first observation, I did not ask any questions. But after the cesarean delivery, I introduced myself to the physician and asked why she had noted the EBL instead of QBL. She immediately asked the nurse for the QBL and there was a significant difference between the two. The physician stated that she was not aware that this facility was utilizing the QBL for deliveries. I also learned that the hospital was not tracking, for purpose of accountability, …show more content…
With the increase in the different methods of determining if a patient is on the brink of PPH, reducing the mortality rate should be much easier than ever before. Current methods such as QBL and EBL are being utilized to determine if a patient is hemorrhaging. Multiple factors should be taken into account such as the volume of blood loss, patient’s vital signs, and general appearance should guide the interventions in recognizing and managing PPH. Interventions include the use of uterotonics, blood transfusions, and crystalloid infusions. Additionally, tranexamic acid can be administered prophylactically. Early recognition and management increase the chances of survival of the subject (Glymph,
During the 1960’s, America’s solution to the growing population of mentally ill citizens was to relocate these individuals into mental state institutions. While the thought of isolating mentally ill patients from the rest of society in order to focus on their treatment and rehabilitation sounded like a smart idea, the outcome only left patients more traumatized. These mental hospitals and state institutions were largely filled with corrupt, unknowledgeable, and abusive staff members in an unregulated environment. The story of Lucy Winer, a woman who personally endured these horrors during her time at Long Island’s Kings Park State Hospital, explores the terrific legacy of the mental state hospital system. Ultimately, Lucy’s documentary, Kings
Lexington Medical Center is located in West Columbia, South Carolina. It is in the heart of the midlands here and is the hospital that everyone knows and loves. They have a 414 bed medical complex along with 60 medical practices, 6 community medical and urgent care centers, an occupational health center, Alzheimer’s care center and the largest extended care facility in the Carolinas. These facilities are served by over 600 physicians and 1,600 nurses within the hospital network.
The fact the patient died from internal bleeding shows there were damages. The patient’s death was directly linked to the time delay finding the proper diagnosis, and inability to find the extent of internal bleeding from which he was
Saunders (2012) states that the treatment of a breech delivery requires the paramedic team to work simultaneously and efficiently to perform several interventions. He states that the paramedic team should undertake a primary survey and introduce themselves to the patient on arrival. From the initial patient contact, the paramedics should begin providing reassurance to the patient and their family, both verbally and non-verbally (Saunders, 2012). Reassurance aims to reduce patient anxiety, create a rapport with the patient and encourage an environment of care, respect and understanding (Pincus et al., 2013). The paramedic team should complete a secondary survey, including vital signs and a complete patient history, particularly pregnancy relevant
Providers must act in the best interest of the patient and their basic obligation is to do no harm and work for the public’s wellbeing. A physician shall always keep in mind the obligation of preserving human life. Providers must communicate full, accurate and unbiased information so patients can make informed decisions about their health care. As a result of their recommendations, providers are responsible for generating costs in health care but do not generate the need for those expenses. Every hospital has both an ethical as well as a legal responsibility to provide care, even if the care may be uncompensated.
At Wildcat Hospital, I performed my first newborn assessment on a baby. I walked into the postpartum room and greeted the mother and family and asked if I could (along with another student) perform and assessment on the baby for the second time. This assessment was different from the initial assessment I performed four hours previously, because the second time around I had more control of the assessment. I listened to the heart, lungs, and stomach. I assessed the newborn’s respirations, reflexes and temperature. After our assessment was over, I was able to swaddle the baby back up and hand the infant back into the arms of an excited new mother.
Our goal was to maintain adequate fluid in the vascular space in order to maintain a blood pressure adequate for each patient while avoiding complications. During our evidenced-based research we obtained information on a Crit-Line Blood Monitoring System. We performed a work flow analysis prior to the implementation of this tool then created a redesign process to evaluate this piece of technology into our practice. We ran into a few obstacles in regard to a time line for training, and the overwhelming feeling of learning a new piece of technology when patient care was so demanding. We worked through the obstacles and utilized the technology towards achieving our goal. We tried to purchase more monitoring systems because it was evident it optimized fluid removal and reduced the frequency of adverse reactions. We ran into financial obstacles with money being tight as we close our fiscal year. It is in our plan to purchase more systems in fiscal year 2016. We need to give all Veterans the same opportunity to benefit from this technology with the ultimate goal of experiencing less symptomatic while achieving better outcomes. The staff had buy-in to this technology from day 1one and with the opportunity for them to learn at a steady pace they were better acclimated to the
In my previous role as a Licensed vocational nurse, I worked in the outpatient setting, Perinatology, where there are high-risk pregnant patients. The patient I helped take care of, was early in her pregnancy, approximately 29 weeks, and was a patient who had been seen in this clinical office
Postpartum hemorrhage is the leading cause of maternal mortality in the world, according to the World Health Organization. Postpartum hemorrhage (PPH) is generally defined as a blood loss of more than 500 mL after a vaginal birth, more than 1000 mL after a cesarean section, and a ten percent decrease in hematocrit levels from pre to post birth measurements (Ward & Hisley, 2011). An early hemorrhage occurs within 24 hours of birth, with the greatest risk in the first four hours. A late hemorrhage happens after 24 hours of birth but less than six weeks after birth. Uterine atony—failure for the uterine myometrium to contract—is the most common postpartum hemorrhage (Venes, Ed.).(2013). Other etiologies include lower genital tract lacerations, uterine inversion, retained products of conception and bleeding disorders (Kawamura, Kondoh, Hamanishi, Kawasaki, & Fujita, (2014).
Thus, it is imperative that evidence-based practice is conducted to provide the best current, valid and reliable evidence in an aim to close the gap between non-conformity and coincide with the professional obligation of providing the patient with the best possible care (Liamputtong, 2013).... ... middle of paper ... ... Patient safety and quality of care. Rockville, MD: Agency For Healthcare Research And Quality, U.S. Dept. of Health.
Patient safety must be the first priority in the health care system, and it is widely accepta-ble that unnecessary harm to a patient must be controlled.Two million babies and mother die due to preventable medical errors annually worldwide due to pregnancy related complications and there is worldwide increase in nosocomial infections, which is almost equal to 5-10% of total admissions occurring in the hospitals. (WHO Patient Safety Research, 2009). Total 1.4 million patients are victims of hospital-acquired infection. (WHO Patient Safety Research, 2009). Unsafe infection practice leads to 1.3 million death word wide and loss of 26 millions of life while ad-verse drug events are increasing in health care and 10% of total admitted patients are facing ad-verse drug events. (WHO Patient Safety Re...
The health care is extremely important to society because without health care it would not be possible for individuals to remain healthy. The health care administers care, treats, and diagnoses millions of individual’s everyday from newborn to fatal illness patients. The health care consists of hospitals, outpatient care, doctors, employees, and nurses. Within the health care there are always changes occurring because of advance technology and without advance technology the health care would not be as successful as it is today. Technology has played a big role in the health care and will continue in the coming years with new methods and procedures of diagnosis and treatment to help safe lives of the American people. However, with plenty of advance technology the health care still manages to make an excessive amount of medical errors. Health care organizations face many issues and these issues have a negative impact on the health care system. There are different ways medical errors can occur within the health care. Medical errors are mistakes that are made by health care providers with no intention of harming patients. These errors rang from communication error, surgical error, manufacture error, diagnostic error, and wrong medication error. There are hundreds of thousands of patients that die every year due to medical error. With medical errors on the rise it has caused the United States to be the third leading cause of death. (Allen.M, 2013) Throughout the United States there are many issues the he...
It is shocking to know that every year 98000 patients die from medical errors that can be prevented(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.), 2000). Medical errors are not a new issue in our healthcare system; these have been around for a long time. Hospitals have been trying to improve quality care and patients safety by implementing different strategies to prevent and reduce medical errors for past thirty years. Medical errors are the third leading cause of death after heart disease and cancer in America (Allen, 2013). In addition medical errors are costing our healthcare system an estimated $735 billion to $980 billion (Andel, Davidow, Hollander, & Moreno, 2012).
Class I is a non shock state, such as occurs when donating a unit of blood, whereas class IV is a preterminal event requiring immediate therapy. Massive hemorrhage may be defined as loss of total EBV within a 24-hour period, or loss of half of the EBV in a 3-hour period”(Gutierrez, Clinical Review: Hemorrhagic Shock). As the blood increasingly leaves the body, there becomes not enough blood circulation to the heart and other vital organs. After the blood and organs can not get any blood to the organs the body begins to shut down increasingly fast. As the body begins to shut down this is when Hemorrhagic shock begins. As the body goes into Hemorrhagic shock the patient's blood pressures drops to a life threatening systolic and diastolic pressure. Symptoms of Hemorrhagic shock that are considerably mild are nausea, profuse sweating, headache, dizziness and fatigue. Some symptoms that must taken very serious and you must seek medical attention is clammy skin, cold skin, no urine output, weak pulse, confusion, shallow breathing, pale skin, loss of consciousness, rapid heart rate, blue lips, blue fingernails, and lightheadedness. The signs of
Worldwide, the rate of cesarean section is increasing. According to the CDC, in 2012 the rate of cesarean sections comprised 32.8% of all births in the United States (CDC, 2013). Between 1996-2009 the cesarean section rate has risen 60% in the U.S (CDC, 2013). According to the World Health Organization (WHO), more than 50% of the 137 countries studies had cesarean section rates higher than 15% (WHO, 2010). The current goal of U.S. 2020 Healthy People is to reduce the rate of cesarean section to a target of 23.9%, which is almost 10% lower than the current rate (Healthy People 2020, 2013). According to a study conducted by Gonzales, Tapia, Fort, and Betran (2013), the appropriate percentage of performed cesarean sections is unclear, and is dependent on the circumstances of each individual birth (p. 643). Though often a life-saving procedure when necessary, the risks and complications associated with cesarean delivery are a cause for alarm due to the documented rate increase of this procedure across the globe. Many studies have revealed that cesarean deliveries increase the incidence of maternal hemorrhage and mortality and neonatal respiratory distress when compared to vaginal deliveries. As a result, current research suggests that efforts to reduce the rate of non-medically indicated cesarean sections should be made, and that comprehensive patient education should be provided when considering an elective cesarean delivery over a planned vaginal delivery.