Instructions:
This is a critique, you are to critique the below thread.
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Please read the attached Rubric file to follow the grading format, because the last two did not follow the formats.
Overview
You are the risk manager at a tertiary care hospital. The director of surgical services has just informed you that they are seeing an alarming increase in the number of orthopedic surgical site infections (SSIs). After preliminary investigations, you discover a multitude of issues including: an increased number of revision surgeries, high turnover rate amongst sterile processing department staff, increased average patient BMI, several surgeons with inordinately long operating times, low staff morale, a recent change in the linens contractor, and several surgeons who have recently switched implant vendors. At first glance, the surgical services department appears to be a hot mess. How do you plan on addressing the reported problem of increased SSIs?
Consider these items when crafting your post: Can the issue be solved by one person, or is a team approach more ideal? What other departments or personnel would be of help to find a solution? Are all of the identified issues contributing factors to SSIs, or are some non-contributing incidental findings? How would you differentiate between the two? Are SSIs a never event, or an inevitable consequence of surgery? Does the concept of relative risk apply? What degree of risk is appropriate?
Write 300 words critique for the below thread, below are what must be presented:
1. Must support assertions with at least one scholarly citation.
2. One biblical citation, in APA format. Each must incorporate at least one, Scholarly citation(s) in APA format.
3. Peer-reviewed publication cited must have been published within the last five years.
5. Acceptable sources include the textbook, peer-reviewed publications, and the Bible a must.
6. Please this is at the PHD level, because the last two papers the grades I got did not reflect that, I have had real good writers in the past, so I would like to continue having those, because this is at the PHD level and the papers must reflect that please.
7. Please not negative comments.
Textbook:
Read: Kavaler & Alexander: Chapters 8 — 10
Critique this thread:
Aldalati et al. (2021) presents an article on the New Jersey malpractice case of the Estate of Fischel vs Mujic M. In this case, a 39-year-old male arrived at the emergency department (ED) with difficulty breathing. An electrocardiogram (ECG) revealed irregularities suggestive of myocardial infarction (MI), which the emergency physician (EP) communicated to a cardiologist. Despite this, the EP diagnosed and discharged the patient with bronchitis. The patient subsequently collapsed at home and died. As a result, a lawsuit was filed, stating that the EP should not have discharged the patient, particularly given the cardiologist’s assessment of the ECG received in the ED. (Aldalati et al., 2021) The cardiologist indicated that the entire problem was with the EP. (Aldalati et al., 2021) The EP’s defense was that his care was reasonable, and the cardiologist did not inform him of his reading. The EP settled the lawsuit for $2 million and acknowledged a breach of care. (Aldalati et al., 2021)
Various protocols and procedures critical for managing patients with suspected acute myocardial infarction (AMI) were not followed, resulting in adverse outcomes. First, when the patient was presented with difficulties breathing, an electrocardiogram (ECG) was done, which revealed findings consistent with myocardial infarction. (Aldalati et al., 2021) Despite this significant diagnostic indication, the emergency physician (EP) released the patient with a diagnosis of bronchitis. This decision ignored established guidelines requiring timely recognition and care of AMI to reduce morbidity and mortality. (Aldalati et al., 2021)
Additionally, the EP’s failure to immediately start reperfusion therapy, such as thrombolytics or percutaneous coronary intervention (PCI), for the patient with suspected AMI is a significant deviation from routine procedures. (Aldalati et al., 2021; Promes et al., 2017) Guidelines underscore the need for prompt action in restoring blood flow to the ischemic myocardium and avoiding negative effects. (Promes et al., 2017) Furthermore, the lack of communication between the EP and the cardiologist, regarding the ECG and consistent results with MI, also indicates a breakdown in interdisciplinary communication standards. ((Aldalati et al., 2021; Promes et al., 2017) Effective communication among medical professionals is critical for providing effective coordination of treatment and quality care. (Promes et al., 2017)
Three major protocols and procedures that could have prevented or mitigated the adverse outcomes were not followed:
- Recognition and Management of AMI: Protocols should have been in place to ensure timely recognition and treatment of acute myocardial infarction (AMI). This includes immediate evaluation of irregularities in the electrocardiogram (ECG) indicating AMI and prompt initiation of reperfusion therapy (thrombolytics or PCI). (Promes et al., 2017)
- Communication: There should have been established protocols for effective communication between emergency physicians (EPs) and consultants. Clear communication channels are critical for conveying critical diagnostic information and ensuring appropriate patient management. (Aldalati et al., 2021)
- Training and Education: To ensure high-quality care, EPs should receive regular training and instruction on the detection and management of AMI, including the interpretation of ECG results. Continuous medical education (CME) programs can assist in reinforcing the information and skills required for patients experiencing cardiac crises. (Aldalati et al., 2021)
The event is the result of individual failure, particularly on the part of the EP who discharged the patient with a misdiagnosis of bronchitis despite ECG findings consistent with AMI. However, there may have also been systemic failures in terms of inadequate protocols or communication channels. (Aldalati et al., 2021)
To prevent similar incidents in the future, healthcare administrators should conduct regular reviews and implementation of protocols and assess current guidelines and best practices, to ensure that measures ensure quality of care and best outcome in AMI diagnosis and treatment. Also improving cross-team or interdisciplinary communication is vital. (Aldalati et al., 2021) Effective handoff should be emphasized by standardized reporting mechanisms, and enhanced communication protocols to ensure coordination of care. (Aldalati et al., 2021) Furthermore, implementing quality improvement initiatives, such as regular audits and feedback sessions, can help identify systemic issues and areas for improvement in clinical practice. (Aldalati et al., 2021; Promes et al., 2017)
By implementing these multifaceted measures and recommendations, healthcare institutions can improve patient care quality, mitigate risks, and prevent similar incidents from occurring in the future, ultimately improving patient outcomes and safety. (Aldalati et al., 2021
The Bible provides insights on the importance of following obeying rules in Romans 13:1
“Let everyone be subject to the governing authorities, for there is no authority except that which God has established. The authorities that exist have been established by God.”
This verse highlights the importance of obeying the laws that govern society. In a malpractice case, healthcare professionals must adhere to set standards of care and guidelines. Failure to abide by these standards can result in legal consequences. This verse serves as a reminder to us as public health professionals and healthcare workers to fulfil our responsibilities by delivering moral and ethical care while respecting the authority of the laws and rules that regulate our professions.
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