Orthopaedic Surgeons

Katz, J. N., Wright, E. A., Polaris, J. J., Harris, M. B., & Losina, E. (2014, May 22). Prevalence and risk factors for periprosthetic fracture in older recipients of total hip replacement: a cohort study. BMC Musculoskeletal Disorders, 15(1), 1-9. http://dx.doi.org/10.1186/1471-2474-15-168Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Camera, I. M. (2011). Medical-surgical nursing: Assessment and management of clinical problems (8th ed.). St. Louis, MO: else

My practical competencies have been obtained through working with a general and orthopaedic surgeon. Whilst working with my clinical supervisor, (a consultant orthopaedic surgeon) we decided it would be beneficial to review orthopaedic wound infections. I chose to concentrate on wound infections during a Total Hip Replacement (THR). Wound infections is a massive subject so I have selected specific areas to look at, which are:

1. Write a client outcome to help Mrs. Ross resolve the symptoms (i.e., defining characteristics). Refer to Section III (beginning on p. 119) of the Ackley and Ladwig text.

A total knee replacement (TKA) is the most common joint surgery performed in the United States (Turner, 2011, pp. 27-32). Each year, over 650,000 Americans undergo this surgery (Wittig-Wells, 2015, pp. 45-49). It is an invasive surgery that involves an incision on top of the knee and replacing damaged parts of the knee with artificial parts that are either metal, ceramic or plastic. Someone would get a total knee replacement for damage of the joint, osteoarthritic, posttraumatic, or inflammatory arthritis. The cartilage is damaged, wears away and then you develop bony deformity and contracture of ligaments but it starts out with specific defects or wear of cartilage. The top nursing priorities for a total knee arthroplasty is to “prevent complications, promote optimal mobility, alleviate pain, and provide information about diagnosis, prognosis, and treatment needs” (Doenges, 2014, pg. 627). A possible nursing diagnosis from the patient who is undergoing a TKA might be ‘impaired physical mobility related to pain and discomfort as evidenced by reluctance to attempt movement.’ Another one could be ‘acute pain related to chronic joint disease as evidenced by reports of pain’ (Vera, 2014).

5. Poulin,P., et al.(2014) Preoperative Skin Antiseptics for preventing surgical site infections: What to do?

Catheter-Associated Urinary Tract Infection (UTI) 8.Vascular Catheter-Associated Infection 9. Deep vein thrombosis or pulmonary embolism following total knee replacement and hip replacement procedures 10. Certain Surgical Site Infections, including Mediastinitis after Coronary Artery Bypass Graft (CABG), following certain orthopedic procedures, and following bariatric surgery for obesity.

In 1992 Shapiro et al. published their research informing providers prophylactic antimicrobial treatment is not routinely indicated [2] There were a total of 387 patients in the controlled trial, 203 patients assigned to receive amoxicillin and 182 were given a placebo [2]. Either 250mg of amoxicillin or a placebo was given to subjects three times a day for ten days. 15 subjects dropped out and 7

Surgical site infections are considered preventable. Because such infections are considered preventable, there are legal consequences directly connected to such a condition. In this paper, I will discuss what an SSI is and the reasons on why it is considered to be preventable. I will also discuss the role of disclosure and legal implications that are related to SSIs, accreditation expectations, and continuous quality monitoring as it relates to SSIs.

There are different types of nosocomial or healthcare associated infections. These are categorized according to the site of infection and they include pneumonia, gastrointestinal illness, urinary tract infections, bloodstream infections, and surgical site infections (CDC, 2015). This paper seeks to review the current practice of surgical site infection prevention protocol as well as seeks to proffer recommended

Osteomyelitis is a broad and debilitating disease typically triggered by a variety of conditions. Osteomyelitis starts off as inflammation seen within bone and bone marrow that can quickly progress into a large, subclassified infection. The length of time the infection has been present in the body and whether or not there is a pus formation or increased density among the infected bone is commonly used to classify severity. Pyrogenic bacteria or mycobacteria systematically attack the route and anatomic location of the infection evolving acute conditions into chronic ones. “Staphylococcus Aureus is a gram-positive, round shaped, non-mobile cocci typically found in clusters inside these wounds. Staphylococcus Aureus is one of the most common causes of infections after injury or surgery and affects nearly 500,000 patients in hospitals each year. Staphylococcus Aureus belongs to the family Staphylcoccaceae and survives by affecting all known mammalian species including humans” (www.news-medical.net). Osteomyelitis can start in one area of the body while spreading through the blood stream into other bone regions. Typical treatment options for Osteomyelitis includes antibiotics, removal of

Research shows that Surgical site infections are preventable. According to the CDC, hand hygiene is the simplest approach to preventing the spread of infections and needs to be incorporated into the culture of the organization. Ensuring the use of infection control prevention is an important component of nursing care. Infection control prevention policies must be communicated undoubtedly to all employees. Staffers who do not comply must be re-educated to ensure that all are complying. Speaking up and pointing out that a nurse forgot to wash his or her hands, or notifying the surgical team that surgical instruments were not adequately cleaned may seem like small issues; but at the same time, not acknowledging a break in a sterile technique could mean the difference between life and death for a patient. One hospital that was struggling with high levels of infection related to surgical procedures, implemented a pre-procedure huddle as a team. This innovate way decreased the spread of infection and was a great way to improve the quality of care for patients. As mandated by the Joint commission, infection prevention personnel should provide multidisciplinary education on SSI prevention, to all team members, including

Orthopedic implants can be used for internal fixation of bone fractures and prosthetic joint replacement. When internal fixation is used for bone fractures the need for fixation is sometimes only temporarily and can be removed after consolidation of the fracture.1 Infection is an important complication after internal fixation with significant morbidity and even mortality. This is often caused by biofilm-producing bacteria.2 The risk of infection after internal fixation is between 0.4% and 16.1% depending on the fracture type. Infection rates are 1.8% for Gustilo type I fracture, an open fracture with a clean wound (wound <1 cm in length) and 16.1% for Gustilo type III C fracture, a fracture associated with an arterial injury requiring repair, irrespective of degree of

Surgical site infections (SSIs) remain to be a major problem among surgical patients.(Brown et al., 2007)(Mawalla et al., 2011) (Laloto, Gemeda, & Abdella, 2017) (Akoko et al., 2012). High prevalence of ssi has been noted associated with remarkable drug resistance leading to few choice of drug for treatment among clinician(Mengesha et al., 2014).Significant amount of SSIs occur after discharge from the hospital and majority of these patients are detected through telephone interview and other through questionnaire survey(Eriksen, 2003)(Petrosillo et al., 2008)

Ethical challenges are the most profound when dealing with patient safety; compliance with the prophylaxis antibiotic administration guidelines is paramount to a surgical patient in order to decrease the possibility of a post operative surgical site infection. Antibiotic timing requires

Surgical site infections (SSIs) are the leading type of infections among hospitalized patients. There are so many reasons why people go for surgery; it can be an emergency reasons or elective. According to Beaver, (2008) a primary concern in healthcare today is the prevention of infections. Careful handling of the surgical equipment reduces the chances of surgical site infections, for instance equipment sterilization and careful hand hygiene of surgical equipment.