Case Analysis - Veterans Health Administration: Nsqip Program

The appropriate assessment of patients prior to surgery to identify coexisting medical problems and to plan peri-operative care is of increasing importance. The goals of peri-operative assessment are to identify important medical issues in order to optimise their treatment, inform the patient of the risks associated with surgery, and ensure care is provided in an appropriate environment secondly to identify important social issues which may have a bearing on the planned procedure and the recovery period and to familiarise the patient with the planned procedure and the hospital processes.(American Society of Anaesthesiologists)

Many residents of long term care, and rehabilitation arrive to a facility as a result of a surgical procedure. Certain surgical procedures have been shown to increase the prevalence of pressure

Since 1991, the 30-day mortality rate after major surgery has decreased from 3.1% to 2.8%, a 9.6% decline.

According to the CDC, in the United States there have been 51.4 million inpatient procedures performed. This shows how relevant surgery is, it is very common for a person in the U.S. to have a procedure

In fact, the postoperative group experienced a successful result. The comparison of patients who had surgery prove that gains in health and physical ability persevere for several years. For example, postoperative patients’ improvements in hearing, breathing, communicating, and mental functioning exceeded the results of others. Although the postoperative group had the worst scores for breathing due to the greater necessity placed on the cardiorespiratory system, this finding is interpreted as a sign of successful treatment. (Rissanen et al., 1995). Overall, physical ability was significantly improved in the postoperative groups. Major improvements were shown for pain, sleep, and mobility. Activities of daily living (ADL) were significantly enhanced after

care received for elderly patients depends on the type of surgery the patient has, as well as their

The elderly population and woman are mostly at risk of having operation. Most patients who undergo

Northwest Medical Center follows Health Insurance Portability and Accountability Act(HIPAA) Privacy rule and a federal privacy law which provides all the guidelines for protecting the privacy of individual health information. It is mandatory for all the staff of the company to follow these protocols and enforce the use of best practices which will be provided to them as a training to keep them updated. We make sure that we provide the staff with regular training to keep them updated with the latest security measures. It is very important to refresh the staff with the guidelines because over the time they get to be very lenient in following the protocol which will result in the violation of the policy. Few of the top violations are that,

In a specific study, following surgery, patients spent time in a rehabilitation center and had frequent, regular check-ups with the health care team. Thankfully, 90% of patients that survived the surgery had significant improvements. Limited functioning was only prevalent in 10% of the post-surgery group. In total, there were 80 people in the study, and ten of them died. Few passed away before and during surgery, while 7 of them died within one month after surgery (Rostagno et al., 2011). Factors that were related to death were: old age, lack of function in the left ventricle, and intense body wide infection. Overall, it has been concluded that the survival rate after surgery is rather high (70-85%) with a low chance of recurrence (Rostagno et al.,

Improved surgical techniques reduce risks and complications and can also increase the demand for surgery given improved cost-benefit analysis for the patient

A study conducted May 16, 2005 and ended March 25, 2006, 351 patients over the age of 65 who were recruited from General and Emergency Surgical Ward of the Unit of General, Emergency and Transplant Surgery. Looked at the increase in delirium in postoperative in the elderly

Doctor Warren V. Ayers is one of the orthopedic surgeons at Maui Memorial Medical Center making a big push for the ERAS protocol because of the known benefits. Teeuwen et al. (2010) explaining that ERAS protocols “aim at reducing the surgical stress response and optimizing recovery, thus reducing the length of hospital stay” (p. 89). Maui Memorial Medical Center (MMMC) has taken in this new approach to preoperative care because it is currently being practiced at outpatient centers at Kaiser Permanente on Maui and Oahu. Current evidence based studies had shown that ERAS protocols result in shorter lengths of stays (LOCs) as well as reducing hospital acquired infections (HAIs) and surgical site infections. Grant, Yang, Wu, Makary, and Wick (2017)

Surgery always comes with a number of risks and when you compound that with any pre-existing medical conditions it often creates a host of post-operative complications that the body has to now try and compensate for. When this stress response kicks in its main goal is to preserve the body’s vital resources to ultimately keep the individual alive by regulating blood pressure, heart rate, electrolytes, oxygen output, respiratory rate, blood volume distribution, coagulation, blood sugar and urine output. Mr Jensen was diagnosed with Diabetes Melitus (Type II) 2 years ago and a history of Hypertension which would create extra burden to regulate the above mentioned vital resources which could potentially be life threatening. A major factor that

The research methodology includes the detailed analysis of the risk of bias evaluation. In an effort to reduce this risk the authors of the research used such criteria as “method of randomization; concealed treatment allocation; blinding during pre-, peri-, and post-operative care; blinded data collection and analysis; blinded adjudication of study endpoints; and completeness of (follow-up) data” (Svircevic et al., 2011, p. 273). It should be stated that the metaregression did not show any associations “between the study outcome and factors varying over the years of execution of the individual studies or risk of bias items for any of the outcomes” (Svircevic et al., 2011, p. 276). Although, the meta-analysis does point out that there is an elevated risk for

Frailty assessment tools have been developed for the estimation of perioperative risks in this particular population. Whereas many tools have emerged both clinical and research settings, there is no consensus for which tool is a good measure. Musculoskeletal and Orthopedic surgical field has been facing frailty problems as other areas. Early detection of frailty is essential for managing and alleviating postoperative complications. Thus, the need of measuring frailty, as a tool for preoperative risk stratification and as a strategy to identify potential factors that can be adjusted to pave the way for better postoperative outcomes, is necessary. Therefore, this scoped review aims to identify frailty assessment tools and the extent of the research