respond to 2 discussion posts as a peer response
discussion post 1:
I feel it is only right I take on the role of the nurse since that is may major!
As the nurse caring for a critically ill patient who has arrived in the ER with signs of a severe post-surgical infection, it is important to consider the possibility of MRSA. The patient’s surgical wound is red, swollen, pus-pilled, accompanied by an elevated temperature, all of which are concerning indicators of a serious infection. Below, I will address some key aspects of this case.
Is this infection likely MRSA?- Yes, the infection could likely be MRSA. MRSA is a common cause of post-surgical infections and is characterized by its resistance to standard antibiotics, making it a significant threat in healthcare settings. According to the CDC, MRSA is responsible for a substantial percentage of hospital-acquired infections, especially surgical site infections. The patient’s presentation of severe localized infection and systemic symptoms aligns with what one would expect in a MRSA infection.
What would a MRSA infection look like on a patient?- A MRSA infection often presents as a skin infection with specific characteristics. The wound may appear: red and swollen (check), pus-filled (check), painful and warm, and in severe cases there may be signs of necrotic tissue.
Was the patient exposed to MRSA in the hospital prep, during surgery, or sometime afterwards? – It is challenging to pinpoint the exact time of exposure without further investigation. But the possibilities include: Hospital prep and surgery: MRSA could have been introduced during surgery if there were lapses in sterilization or if the patient was colonized with MRSA and it was not identified and managed properly. Post Discharge- The patient could have been exposed to MRSA post discharge, possibly from improper wound care or exposure to MRSA carriers in the community.
Where does liability for this (potential) infection rest? – Determining liability is complex and involves multiple stakeholders- Patient: must follow discharge instructions meticulously, including wound care and taking prescribed antibiotics as directed. Healthcare team (nurses, surgeons, etc) Responsible for maintaining aseptic techniques and ensuring infection control practices are followed throughout the patient’s care. Hospital support staff- Should adhere to strict sterilization protocols to minimize the risk of infection transmission. Systemic factors- hospitals must have robust infection control policies and continuous education for all healthcare staff to prevent such occurrences.
Discussion post 2:
Hi! I work in the NICU unit at a hospital, and I was recently caring for a baby with MRSA.
A patient has arrived in the ER critically ill. She had a minor surgery the week previously and was discharged home with antibiotics. Upon arrival to the ER, the patient presented gravely ill, the surgical wound red, swollen, puss-filled, and her temperature elevated. A post-surgical infection is suspected. I will be the nurse caring for the patient.
MRSA is a common cause of post-surgical infections. The patient is experiencing redness, swelling, pus, and fever, therefore, it is plausible MRSA is the cause. The symptoms align with those typically seen in MRSA infections. An MRSA infection of a patient would be present with the following characteristics: the wound would be red, swollen, and tender to the touch. There can be the presence of pus or other drainage. Pockets of pus within the tissue, also known as abscesses, might also form. The patient might exhibit fever and chills. This indicates that the infection may be spreading or causing a systemic response. The infected area might also show signs of dead tissue if the infection is severe. Because MRSA is commonly found in hospitals, the patient could have been exposed during preoperative preparation, during surgery, or postoperatively in the hospital. If proper sterile techniques were not followed, the surgery itself could have been a point of entry, however, if the wound care instructions were not followed properly, the infection could have developed after discharge. Liability for the infection can be complex and might involve multiple parties. It is the patient’s responsibility to follow discharge instructions carefully. Noncompliance can contribute to infection risk. The healthcare professionals, such as nurses and scrub technicians, are responsible for maintaining sterile conditions and proper wound care techniques. Physicians and surgeons are responsible for ensuring the surgery is under sterile conditions. The hospital has an overarching responsibility to maintain a sterile environment. Any negligence in these areas can lead to liability. The exact determination of liability would require a thorough investigation. The exposure of MRSA could have occurred at multiple points. While it is a likely suspect in the postsurgical infection, a definitive diagnosis requires further testing.
