M6A4: A Patient with Musculoskeletal Limitations Complicated by a Medical Illness

Surgical complications are highly likely to result from operative procedures, and healthcare providers are required to adhere to evidence-based strategies in order to prevent surgery associated infections. The main reason why the Surgical Care Improvement Project (SCIP) was implemented is to improve the quality of care offered to surgical patients by decreasing surgical complications (Anderson, 2014). During the past decade, health care providers in the United States have demonstrated great concern towards quality improvement and reduction of surgical complications by adhering to the Surgical Care Improvement Project (SCIP) recommendations. One of the SCIP core measures that have greatly impacted the prevention of surgical complications is a recommendation that antimicrobial prophylaxis be administered to the surgery patient within 60 minutes of incision. According to Anderson (2014), pathogenic organisms are most likely to be introduced into the surgical area at the time of incision. It is therefore recommended that the patient’s tissue should have the highest concentration of antibiotics at the time of incision to prevent surgical site infections. This first core measure of the Surgical Care Improvement Project has greatly lowered incidences of surgical complications especially if the healthcare provider gives the appropriate antibiotic within one hour of surgical incision (Anderson, 2014).

Hair removal is one of the preoperative procedures performed on a surgery patient. According to Reichman and Greenberg (2010), hair is often associated with lack of cleanliness and their presence on a surgical site is likely to result into surgical site infection. Methods of hair removal from a surgical site include the use of depilatory creams, shaving, and clipping. The Center for Disease Control recommends that hair should not be removed from the surgical site unless it will interfere with the operation. In the case study provided, no hair removal was required for the surgical procedure because it did not interfere with the operation. Suppose hair removal was ordered, the most appropriate technique is the use of clippers. Clippers are appropriate because they do not cut the patient’s skin when used correctly, thereby preventing skin trauma during hair removal. Shaving should be avoided because it creates cuts and abrasions on the skin which act as entry sited for microorganisms (Reichman and Greenberg, 2010).

Venous thromboembolism, (VTE), or deep vein thrombosis, (DVT), prophylaxis is normally ordered according to the recommended risk assessment tools and the type of surgery to be performed. A number of strategies can be used to implement deep vein thrombosis prophylaxis including the use of aspirin, using a graduated compression stocking for mechanical prevention, and through the use of intermittent pneumatic compression devices (Cohn, 2011). In the case provided, the recommended venous thromboembolism or deep vein thrombosis prophylaxis was implemented long leg TED hose and sequential compression stockings placed on the right leg while in bed. Additionally, lovenox 30 milligrams was administered subcutaneously every morning at 10.00 am. The patient is required to pay great attention to time to ensure that the stockings are used strictly while in bed and lovenox 30 milligrams to be used exactly at 10.00 am. This timing is important because it helps in reducing the risk of development of pulmonary embolism and deep vein thrombosis following an operation (Cohn, 2011).

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