Anesthesia Patients Observation

As a clinical requirement for my Adult 1: Medical-Surgical course, I had the opportunity to observe a patient in the Operating Room and in the Post Anesthesia Unit of Advocate Good Samaritan Hospital. The procedure that I observed was a left total knee replacement. The patient needed this surgery because she was experiencing osteoarthritis, and this surgery could alleviate her pain and discomfort. I was with the patient from the end of her stay in the pre-operative holding area to the Operating Room, and then to the Post Anesthesia Care Unit. This paper will include background inquiry, preoperative and operative

Dosages of the drug vary from one extreme to another based upon the patients needs.

Looking back on this clinical day, I would state that I effectively met my overall goals for the day - Safely and efficiently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. During medication administration, I did come across some difficulties – dropping a few pills and being unsure of the medication in the med cart – but that did not prevent me from safely administering my medication. I completed the three medication checks, while ensuring that I recognized the six medication rights. This experience sanctioned me to acquire comfort in passing meds, and permitted me to see how to prioritize time when a patient takes numerous medications. Alongside medication

Also, by properly conducting a time-out session where the patient is provided with a standardized briefing prior to the patient is sedated in the OR could also eliminate some the sentinel or adverse events in the OR. Furthermore, follow a checklist, which not only pertains to the surgery itself, but also focuses on the other procedures involved such as admissions, anesthesia equipment, and discharge (Mulloy & Hughes 2008).

[of] a decision, policy or practice" that Khajavi reasonably believed, consistent with the standards of his profession, impaired his ability to provide medically appropriate health care to a patient within the meaning of section 2056. Indeed, the trial court had considered the evidence sufficient to go to the jury on this claim before it erroneously narrowed its interpretation of section 2056.

This Anaesthetic case study would describes and discussed the scenario of a patient through the anaesthetic role of their surgical procedure. It will include and discuss the anaesthetic safety procedures equipment and drug interventions used to ensure this particular patients maximum safety and comfort before and during the procedure. The case study will include pre and peri-operative assessment in order to describe the involvement contribution of various specialties in the holistic care of the critical care patient. This assignment will focus only on the anaesthetics side of the procedure but will also highlight the importance of the triad of anaesthesia and discuss the administration, maintenance and reversal of

The guideline named opioid cumulative dosing override allows for an override for an opioid product equal to or exceeding the hard-stop threshold (60mg morphine equivalent dose) and a 7 day supply. An override will be provided for patients with one of the following conditions: diagnosis of cancer, palliative care, or sickle cell disease, patients enrolled in hospice care, or patients taking an opiate tapering regimen following an orthopedic procedure with an end date not to exceed 21 days. For all other patients, the prescriber must be aware that all of the following criteria must be met: the diagnosis for use of the opiate and reason for continued use are documented, previous trials of non-drug and/or non-opiate use are documented, the patient does not have concurrent use of benzodiazepines

VASNHS Surgical Specialty Outpatient department has a designated pre-operative management unit that oversees the patients undergoing surgery. The predicaments stem from various guidelines or protocol originating from numerous surgeons and clinics. At present, the pre-operative nurses abide simple pre-op instructions (NPO protocol, medications, what to bring, during the surgery, transportation, cancellation instructions) for the entire Surgical Specialty Outpatient department. Surgical procedures are being canceled due to lack of communications and cancelations of patients prior to surgery date.

The Association of Anaesthetists of Great Britain and Ireland (AAGBI, 2010) accentuated that when looking after a patient during anaesthetic care, the anaesthetic nurse must be competent in any circumstances for the safety of patient. On the case of Mrs D, there was an obvious need to communicate, so the anaesthetic nurse needs to be trained and encouraged appropriately (Mellanby, Podmore and McNarry, 2014). It is evident that the anaesthetic nurse needs to be confident enough when looking after patients to voice any concerns to the assembled team, regardless of how senior or intimidating they may appear (NMC, 2015). The anaesthetic nurse said that she communicated with the anaesthetists during this critical incident. Yet, the anaesthetists

The second week of my preceptorship brought many new experiences for me, and I can honestly say that each day I spend with my preceptor is better than the last. This week I focused on time management of a full patient load with continued documentation practice as well as admission and discharge procedures. I’ve had brief experiences in my past rotations assisting with discharge teaching and admission assessments however I have never been able to fully take charge and complete the process from start to finish, so this was a great learning opportunity for me.

My site for my rotation was the Walgreens on Thomasville road. My preceptor was Doctor Marva Bates. I thought my experience during the first two week of the rotation was going to mainly be with the production aspect of retail pharmacy. I thought I would be pulling and staging medications for prescriptions to be filled and eventually take a role in the actual prescription filling process. The goals and objectives I set for myself at the begin beginning my rotation are as followed:

The patient also tells me she uses lorazepam very intermittently. She is almost out of that medication would like a refill today. I did write her for lorazepam 0.5 mg to use p.r.n. #20 with no refills.

Throughout the second half of the semester, I have not made any significant changes to my pre-clinical routine. I still prepare and gather my supplies the evening beforehand, and I try to avoid during schoolwork in order to facilitate restful sleep. However, upon arriving to the unit, I have developed a familiarity with the staff and environment that has reduced my stress and anxiety levels, allowing me to focus more attention on my patient assignment for the day. Although we do not have assigned preceptors, I have developed a mentoring relationship with two of the nurses on the unit and will work with those staff members if available. As we have gotten to know and trust one another, we do not have to spend the first part of our shift familiarizing ourselves,

The improvement plan would start with one patient, one procedure. Afterwards the staff can be evaluated to discuss how they felt the process went. If there was confusion or difficulty in the process that can be changed or re evaluated to make a process improvement. There will also an evaluation of the patient's chart to review to moderate sedation forms to make sure they were filled out appropriately. Once successfully following the moderate sedation policy it would be implemented to everyone in the entire hospital. Making changes to better ensure the process will lead to patient

The anesthetist must serve as the patient’s advocate from the time of induction until it is fully recovered. To serve in this role, it is vital that the anesthetist is constantly aware of the patient’s physiological status. There have been many advances in monitoring technology over the past 20 years, and portable, sturdy monitors are available for use in the field and remote situations. Zoo and wild animals can be particularly challenging to monitor as their diversity in physiology may result in a lack of normal values for commonly monitored parameters.