Case study scenario
Patient: Mark Green, a 65-year-old male.
History:
Question 1
Part 1 of the scenario takes place in the Emergency Department on the day of admission at 21:30 hours (9:30 pm). The first part of the video shows the Orthopaedic Registrar admitting Mr Green and explaining the planned surgery. An Orthopaedic Registrar is a doctor training to become an orthopedic surgeon. They work under the guidance of senior specialist orthopedic surgeons while they gain hands-on experience and refine their skills Mr Green`s wife is in attendance.
Next, Mr Green is transferred to the Orthopaedic Ward at 01:00 hours (1 am). He is scheduled to have his surgery in the morning Andrew, the wardsperson, helps transfer Mr Green. Meg, the Emergency Department RN gives a beside handover to the Orthopaedic Ward RN.
Question 2
At 13:00 (1 pm) Mr Green was transferred to the operating theatre for an internal fixation procedure. This is major surgery. His preoperative orders did not include the usual venous thromboembolism (VTE) prophylaxis. He did not have TED stockings or an anticoagulant medication, such as Clexane. During surgery, he had VTE prophylaxis of pneumatic calf compression and circulation observations. However, no orders were given to continue this post-operatively because the Orthopaedic Registrar was called to the Emergency Department.
The day after surgery, the new graduate Registered Nurse notices
Question 3
Mr Green went back to the Orthopaedic Ward to recover after his surgery. On day three of Mr Green`s hospital stay there is a ward round. The round consisted of Dr Allan McGorry (the senior Orthopaedic doctor), the Orthopaedic Registrar, the Intern (Junior Medical Officer), and the new graduate RN. Dr McGorry notices that no subcutaneous Clexane has been prescribed for Mr Green. He asks for the pharmacist to join the round. He asks Mr Green if he has any pain in his leg and whether he has had any physiotherapy.
