Question

Background Colin Lake was a 53-year-old business man who presented to a Sydney hospital emergency department one Friday evening with a unilateral, painful red eye. Colin used daily disposable contact lenses and reported that his right eye had been sore for 2 days. He had not removed his lens periodically as required throughout this time, thinking that taking his lenses off and on might make it worse. He presented with a bad headache and was unable to focus on his computer screen. Both contact lenses were removed and sent for culture and sensitivity. On examination, his affected right eye appeared injected (bloodshot) and his cornea was cloudy with a central corneal ulcer that measured 2 mm by 3 mm. The visual acuity in his unaffected left eye was 6/60, but he was unable to see the chart with his right eye and was scored as "can count fingers at 1 meter." Colin admitted that he was not as careful with his contact lenses as he knew he should be, often neglecting to wash his hands before inserting them and exceeding the recommended usage time. Colin had no previous medical history but was overweight and admitted to feeling stressed after a recent acrimonious divorce. Colin's Hospital Stay Colin was admitted to the eye ward and was placed in a single-bed room. He was given 1 gram of Paracetamol for Cephalothin 1% eye drops every hour, and Homatropine 2% eye drops four times a day. Because Gentamicin and analgesia and commenced on a regime of intensive topical therapy consisting of Gentamicin 1% eye drops every hour Cephalothin are known to form a precipitate in the eye if mixed together, the drops were given 30 minutes apart. Eye drops were continued at this half hourly frequency throughout Friday night, Saturday, and Saturday night. Colin was told that the ulcer needed to be treated intensively to prevent any further scarring, because the ulcer was right in the center of his cornea. Corneal damage that penetrates deeper than the superficial epithelial layer of cells, which was the case with the ulcer, results in a milky opacity that it is not possible to see through was significantly myopic (short-sighted) but had left his prescription eyeglasses at home. However, he could see to shower and eat his meals. The rest of the time he rested or listened to the radio. The nurses dimmed the pulled the blinds down over the window during the day to ease his sensitivity to light (o

Answer 1

ANSWER 1 :

Safety of patients is very important to protect them falls either voluntarily or by accidentally. Patients admitted in hospital should secure about their safety during their stay in the hospital wards. A lot of factors or reasons will make a person to fall on grounds. It is important to train patients in how to prevent falls, protect from falls, care of falls. During a stay in hospital patients may fall due to some disease conditions, or due to developed characteristics of that disease. Allowing patients to be independent and self esteem by protecting themselves from falls may become a major conflict in reaching desired goals.

FOR EXAMPLE : Patient admitted in hospital due to chronic diarrhea, receives treatment for a period of four days, where person symptoms are reduced. On fifth day patient is advised to make a casual walk in the corridor of ward to improve the condition. But sudden wake up from bed and walking to a small distance may cause falls in the patient due to weakness in the body caused by fluid loss. They have to depend on other people or assisted walking may be needed.

There fore not all the patients need accompanied when leaving the ward, but safety precautions to be taken to prevent further damages or secondary complications to patient.

ANSWER 2 :

In hospital scenario it is important to document each and every event or incident that has happened to patients and health care professionals. To enter all those incidents documentation is needed for maintaining medical records. Medical records are those which ensures all the important information of patient in a documented form, using an electronic device. All the incidents has to be recorded including falls in hospitals to prevent medico legal cases. But some hospitals maintain a system of colored bracelets flagging to all staff members as risk sign or symbol for such incidents like falls. This system is appropriate at such instances but is not appreciated in all the instances due to their disadvantages than of benefits. This system can be encouraged in easy identification of symbols for patients where they are useful to prevent sudden falls and other complications.

ANSWER 3 :

In intensive eye drop therapy, it depends on drug dosage, frequency in administration of eye drops to patients. For Eye infections, eye accidents, eye problems and all other eye related problems eye drops are made as a treatment of choice in most instances. Drug dosages can be reduced if the rate of infection will reduce, at the same time the ongoing changes has to observe during high doses and decrease of eye drops dosages. Persons who are receiving eye drops instillation treatment may exhibit symptoms of vision changes, blurred vision, difficulty in identifying colors, redness, itching, edema formation in eyes, altered sleep and rest and so on. In some cases patients feels restless, disturbed sleep, delirium , psychosis often restlessness for clock sounds and all may suddenly fall from a position due to confusion and drowsiness. Making use of flag signs it can be controlled symptoms of falls and making protective equipment work in safety of patients, Other cases of treatment regimen where risk of falls are higher are administering psychotic , anti depressants drugs can cause a great risk in falling.

Hence, it is important to maintain proper documentation and appropriate assessment on falls has to be done for safety of patients health.