Answers
1. a) Goal statement for the project - A descriptive study to analyse the cause behind the delay in reporting of X-RAY results .
b) Ideas for two measures to collect data on are :-
- data collection on the reasons for the delay of reporting
- data collection of the number of cases with delayed reporting
c) The tools to be used are :-
- surveillance
- Questionnaire
d) List of eight potential members in the team are :-
- Medical officer
- Chief physician of the department
- Nursing incharge
- Technician
- Attendant
- Patient coordinator
- Billing person
- Informatics department
e) Four ground rules that are important to be a leader are :-
- using a democratic leadership style
- being unbiased
- maintaining ethics
- quick decision maker
2. Risk reduction strategies aimed at preventing wrong site surgeries are :-
- National Patient Safety Goals: Surgical Patients
Universal Protocol for preventing wrong site, wrong procedure, and wrong person surgery :-
Conduct a pre-procedure verification process
Mark the procedure site
A time out is performed before surgery
*Verification: 2 identifiers- Name and date of birth
Label: Dr initials the site
Communication- ask the pt what procedure are you having today and match with consent form
Pre-Op- Procedure, site, signed consent, labs, x-rays, allergies
# Causes of Wrong Site Surgeries
1. Scheduling
- Booking errors
2. Pre-op handling
-Missing / incomplete -documents
-Patient verification errors
-Inconsistent use of site marking
-Changes to consent made in one area and not communicated to operating room
3.
Operating Room
-Site verification inconsistencies (site marking not clear, missing, covered)
-Ineffective Hand off
-Distractions/Rushing
-Time out errors
4. Organizational Culture
-Leadership
---Not actively engaged
-Education
--Changes in policy with inadequate or no education
-Safety
--No or inconsistent safety culture
--Staff-passive or not empowered to speak up
3. The current recommendations that addresses the indication for a cesarean section are :-
# absolute maternal indications for c-section
-failed induction of labour
-failure to progress ; labour dystocia
-cephalopelvic distortion
# relative maternal indication for C-section
elective repeat c-section
-maternal disease; severe preeclampsia, cardiac,DM, cancer
# abolute utero-placental indication for C-section
-previous uterine surgery
-prior uterine rupture
-outlet obstruction (fibroids)
-placenta previa,large placental abruption
# relative uteroplacental indication for c-section
-prior uterine surgery (full thickness myomectomy)
-funic (cord)presentation in labour
# absolute fetal indications for C-section
-fetal distress
-cord prolapese
-fetal malpresantation ; transverse lie
# relative fetal indications for c-section
fetal malpresentation ; breeck,brow,compound presentation
-macrosomia
-fetal anomaly ; hydrocephalus
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