Question

From a healhcare professional point of view, what is the problem in this case? Also, what did the business do wrong to allow this to happen?

Multidrug-Resistant Organism (MDRO) in a Transitional Care Unit-Case for Chapters 7 and 12 Sharon Saracino and Sharon B. Buchbinder Roger Young is a 43-year-old male hospitalized following a motor vehicle accident in which he was an unrestrained driver. Roger sustained a left femur fracture which required an open reduction and internal fixation. Roger is alert and oriented and requires minimal assistance with transfers and ambulation using a rolling walker secondary to a 50% weight bearing restriction on the left lower extremity. His surgical incision has 27 intact staples with scant serosanguinous drainage, is well approximated, and is open to air. His roommate is Joe Garrett, an 82-year-old male hospitalized following a right hemispheric CVA. Jo is a bit forgetful, and Roger often reminds Joe not to get up on his own, helps him adjust his bedding, or hands him personal items to discourage him from crawling out of bed unassisted. Joe had an indwelling urinary catheter, inserted in the Emergency Department upon admission, which was removed on Monday, two days ago. Since then, Joe has been voiding frequent, small amounts with occasional incontinent episodes. The physician was aware and ordered a urine culture and sensitivity, which was collected and sent to the lb for processing on Wednesday evening On Friday evening, the culture report was received via print from the lab just as the RN was leaving the unit for her dinner break. The RN quickly reviewed the report and called the physician with a result of 100,000 E. coli. Orders for antibiotic therapy were obtained and the medication was initiated. The culture report also indicated in the comment section that the specimen was positive for extended spectrum beta-lactamase (ESBL), a multidrug resistant organism. The nurse failed to note the comment and no contact or isolation precautions were implemented. The physician assistant (PA-C) reviewed and signed off on the report on Saturday morning and also overlooked the comment. Roger, with his fresh surgical incision, 572

Answer 1

1.Nosocomial indections are infections that are acquired as a result of exposure to a microorganism in a hospital setting. These infections typically occur within 72 hours of hospitalization. It is often transmitted from patients to patients through direct contact by health care providers. Handwashing between patients and procedures as well as appropriate use of protective equipment such as gloves remain the first lines of defense in preventing the spread of nosocomial infection. If the patient develops an infection that is considered a risk to others ,infection precautions maybe needed. The purpose of these precautions is to prevent the transmission of organisms from patients to health care providers, from health care providers to patients, and from one patient to another. In this situation transmission-based precautions are necessary. This type of precautions are designed for patients suspected of or documented with highly transmissible or epidemiologically important pathogens for which additional precautions beyond standard precautions are needed to interrupt transmission in hospitals. According to OSHA, there is a standard which mandates that any employer whose employees are potentially exposed to blood from needles and other sharps must implement sharps safety devices wherever feasible. In addition ,employees at risk need to be provided with appropriate personal protective equipment.

2.The business didn't provide an isolation room for the client. It is essential to maintain precautions to minimize the risk of transmitting the infecting organism to other clients or to the environment.