Clinical Audit Analysis

T.B. is a 65-year-old retiree who is admitted to your unit from the emergency department (ED). On arrival you note that he is trembling and nearly doubled over with severe abdominal pain. T.B. indicates that he has severe pain in the right upper quadrant (RUQ) of his abdomen that radiates through to his mid-back as a deep, sharp boring pain. He is more comfortable walking or sitting bent forward rather than lying flat in bed. He admits to having had several similar bouts of abdominal pain in the last month, but “none as bad as this.” He feels nauseated but has not vomited, although he did vomit a week ago with a similar episode. T.B. experienced an acute onset of pain after eating fish and chips

After the recovery process was completed, the patient was placed in the care of the discharge nurse. She was given a report and was aware that the mother had not showed up to collect her child and several overhead pagers had been performed. While the interview was taking place the nurse stated that she was unsure how to proceed, with the mother not being located, the nurse stated that she was relieved when she was informed that the patient father was there, the discharge nurse stated that the

You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.

RAFT –Task 2 Root Cause Analysis A-1. Sentinel Event A sentinel event is an event that happens expectantly in a healthcare facility that could result possible death, physical or mental injury to patients unrelated to natural causes of the patients illness as defined by Joint Commission (www.joint commission.org). On the afternoon of Thursday, September 14, at approximately 12:30 p.m. a ‘Code Pink’ (child abduction alert) was called when a minor child/patient, Tina, was discharged to the care of her father without the knowledge of her mother with whom she was admitted with. Tina was registered into the hospital system by Katie Jessup, hospital registrar, who entered all proper demographics and all proper insurance information into the

In January 2015 a patient observation was conducted on an inner city psychiatric male admission ward commencing at 10.30 am and concluding at 11.30am. The observation was carried out by the ward manager and the patient advice liaison service (PALS) manager.

A ) The objective of an audit is to safeguard agreeability with the customer's work benchmarks, assess execution and amplify benefits. Clearly, regardless of how skilful the auditor is, auditing every record is a physical outland possibility. Regardless of the possibility that 100 percent of the data could be tried, the expense of testing would likely surpass the normal advantages (the confirmation that goes with analysing 100 percent of the aggregate to be inferred. What is needed is an examining of the records. There are various techniques used by auditor for decision making during auditing. Auditors will not test all the information available to them because they are uneconomical

In 2008, the Centers for Medicare and Medicaid Services (CMS) announced that they would not be paying for any additional cost incurred for hospital-acquired pressure ulcers (Cooper, 2013). Pressure ulcers continue to be problem for health care organizations, despite their aggressive move to eliminate them in the health care setting. Furthermore, the acute care units pressure ulcers occurrences continues to be one of the most underrated problem that has a major impact on patient outcomes as well as reimbursement of care. Acute care patients are at a higher risk for developing pressure ulcers than other patients within the hospital. Primarily due to the fact that patients are hemodynamically unstable, from the use of vasopressors, the use of life saving devices, population age and other health issues. Health care must continue to place emphasis on the prevention of pressure ulcers in order to reduce co-morbidities and ensuing costs. The aim of this paper is to discuss the cost of pressure ulcers, multiple risk factors associated with the development of pressure ulcers, to show one acute care unit’s current practices to decrease pressure ulcers, look at evidence-based interventions, then to propose a change in current practice to reduce the number of pressure ulcers.

A retrospective cohort study was done on 103,954 elderly Tennessee Medicaid patients, from 1984 to 1986, with conclusion that there were 1,371 patients with upper gastrointestinal bleeding or peptic ulcer disease which were identified by Medicaid hospital claims and medical records.

There were 3 departments audited for Pain Reassessment compliance over a 12 month period, NIGHTINGALE COMMUNITY HOSPITAL averaged

Also, I see that the SAE (Acute Upper Gastrointestinal Hemorrhage) that caused this hospitalization on was reported on 13Apr2017, but the event occurred 05Mar2017 to 14Mar2017 were you aware of this hospitalization prior to the patients week 24 visit on 12Apr2017, as SAEs need to be

Thus allowing me to form a differential diagnosis and rule out certain causes, such as; constipation, and indigestion. Subsequently, the physical examination enabled me to confirm a diagnosis of acute abdomen. As the patient was not experiencing any worrying (red flag) symptoms associated with abdominal emergencies, such as; appendicitis or pancreatitis. However, I did forget certain aspects of the physical examination and had to be prompted by the MO. Although with more practice such incidence would be reduced.

expected. Moreover, the admit source for 19 out of the 27 admissions was an ER visit.

On January 13th 2017, at 15:46 Supervisor Tatiana Kania performed a screening audit. While Security Officer Ruth Gonzalez was on main screen S/S Kania walked away from the desk and came back with her cell phone inside of her hood. Once coming through the metal detectors, S/O Gonzalez instructed her to secondary screening. At secondary screening the S/O instructed her to take out everything from her pockets and began to wand. She was able to find the cell phone in the hood area. I specifically chose this area because with observation I noticed that some guards do not fully go up to the neck on the back side while wanding.

Mr Johan experiences symptoms of panic attack when he feels self-conscious in front of other people when performing certain tasks. He reported feeling faint and had black out of thoughts during those episodes, whereby he was not able to think of anything. Both his hands would tremble and become numb. He would also be sweating but experienced no symptoms of pounding heart or choking

As the recommendation has been established as best practice this chapter will propose a clinical audit to review the extent to which the recommendation is applied in practice. Practitioners have a responsibility to continually improve their standards of care (Nursing and Midwifery Council, 2010). Clinical audits are a valuable tool for professionals to monitor their current practice and promote improvements in care (Benjamin, 2008).