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Question:

Discuss about the Case Study of Zdenek Selir.
 
 

Answer:

Zdenek Selir also was known as Danny to family and friends is an elderly man who died in hospital due to the failure of the staff at Gold Coast nursing home to treat his wounds properly. June 2015, is when Zdenek Selir moved to the nursing home located in Southport after he had suffered a stroke. Mr. Selir who is an 88-year-old man had arrived in the nursing home with pressure wounds that were minor but his condition had seemed to deteriorate with time as the facility operator had said. Due to lack of proper care and treatment, he developed gangrene and later died in a hospital. The Aged Care Complaints Commissioner says that his death was mainly due to lack of proper care, monitoring, and treatment of his pressure wounds that were both on his buttocks and feet (O’Brien, et. al, 2013).

Feelings

I felt sad about Mr. Selir’s incident because if the nurses at Gold Coast nursing home had followed the Nursing and Midwifery Board of Australia guidelines, his death could have been avoided. I felt that the nurses should have developed a good communication channel between themselves, the patients, doctors, and the patient’s family members. This is because if they could have been talking to Mr. Selir, they could have noticed that his wounds were worsening and they could have reported it to doctors who will have taken an immediate action or referred him to a specialist (Turrell & Mathers, 2014). As a nurse, I felt that the nurses had neglected Mr. Selir because in my profession a nurse should uphold the well-being of a patient and ensure that they are comfortable. In this case, negligence can clearly be seen whereby Mr. Selir was left in his “fall out chair” the whole day without being rotated and the fact that his wounds had also developed a smell. I felt that the nurses should have regularly checked his wounds, dressed them appropriately, and got him the appropriate medication. I felt that the nurses should in future provide close monitoring and treatment to the patients, besides seeking immediate help in case of critical conditions. In this case, an investigation should be done to assess the quality of healthcare offered by the facility in order to prevent such cases in future (Mitchell and Shortell, 2013).

Evaluation

I felt that the Gold Coast nursing home had greatly attributed to Mr. Selir’s death because of lack of monitoring and treatment of his pressure wounds. It is due to ignorance from the nursing home that Mr. Selir had developed gangrene and the infection had thus eaten into his skin. I also felt that he was undergoing elderly abuse because even when the family member who had gone to visit him at Gold Coast nursing home found him laying his bed with a bad smell coming out of his wound, meaning that he was never well dressed and neither did he receive the required treatment. I also felt that the staff at Gold Coast nursing home was refusing to seek immediate help for Mr.Selir even though his health condition was critical. I also saw it right for Selir’s family to put a complaint at the Aged Care Complaints commission so that such future instances to be avoided.

 

Analysis

The situation had been made worse by the fact that the staff at Gold Coast nursing home had failed to give proper care, monitoring, and treatment to Mr. Selir’s wounds. The staff had an insufficient recording of wound care and the monitoring of his pressure wounds. It was also noted that Mr. Selir was left to sit in a “fallout chair” for several hours without being moved or rotated and this worsened his health condition since there was no proper blood circulation in his body. It might have been what led to the infection spreading further and eating to his body and thus his eventual death. I feel that his family was right in the fact they believed that he had died due to elderly abuse because the nursing home had neglected him and had failed to provide him proper care (Meyer, Silow-Carroll, Kutyla, Stepnick, and Rybowski. 2014).

Conclusion

In my case, I could have done several things differently. For instance, in Mr.Selir’s case, I could have saved his life by ensuring that the staff at Gold Coast home was more responsible in terms of offering proper care, monitoring, and treatment of his pressure wounds. This could have prevented the infection from eating into his body and prevented his body organs from shutting down. I could have also helped by to rotating the “fallout chair” that he used to sit on to improve blood circulation in his body. I could have also been keen on the wound dressing and changing of the dressing materials since it would have been a more effective way of preventing further infection. I could have also ensured that there is effective communication between me and Mr. Selir’s family members to ensure that he gets the appropriate health care. I could have also worked closely with other nurse and doctors to ensure that his death has been avoided (McLaughlin and Kaluzny, 2013).

Action Plan

In future, I suggest that new staff, processes, and systems should be put into place in the nursing home. The managing director is to acknowledge the mistakes made in Mr. Selir’s case and in future authorize referrals of critical patients to specialists. The staff is to go mandatory training on wounds management in response to the findings and recommendations that had been made by the Age Care Complaints Commission. The director of the nursing home should also ensure that the nurses accord their patient's proper care, ensure that the residents can access better and improved quality care by creating a patient care center. The director should also ensure that the training would help the nurses to work closely with the families of the patients under their care as this could help avoid critical health cases (Lurie, Merrens, Lee, and Splaine, 2012).

 

References

Lurie, J. D., E. J. Merrens, J. Lee, and M. E. Splaine. (2012). ‘‘An Approach to Hospital Quality Improvement.’’ Medical Clinics of North America 86 (4): 825–45.

McLaughlin, C. P., and A. D. Kaluzny. 2013. Continuous Quality Improvement in Health Care:   Theory, Implementation, and Applications. Gaithersburg, MD: Aspen Publishers, Inc.

Meehan, T.P., M. J. Fine ,H. M .Krumholz, J.D.Scinto,D.H.Galusha,J.T.Mockalis, .F.Weber,M.K.Petrillo,P.M.Houck,andJ.M.Fine. 2014.‘‘QualityofCare, Process, and Outcomes in Elderly Patients with Pneumonia.’’ Journal of the American Medical Association 278 (23): 2080–4.

Mehta, R. H., S. Das, T. T. Tsai, E. Nolan, G. Kearly, and K. A. Eagle. 2010. ‘‘Quality Improvement Initiative and Its Impact on the Management of Patients with Acute Myocardial Infarction.’’ Archives of Internal Medicine 160 (20): 3057–62.

 Meyer, J. A., S. Silow-Carroll, T. Kutyla, L. S. Stepnick, and L. S. Rybowski. 2014. Hospital Quality: Ingredients for Success – Overview and Lessons Learned. New York: Commonwealth Fund.

 Mitchell, P. H., and S. M. Shortell. 2013. ‘‘Adverse Outcomes and Variations in Organization of Care Delivery.’’ Medical Care 35 (11 suppl): N19–32.

O’Brien, J. L., S. M. Shortell, E. F. Hughes, R. W. Foster, J. M. Carman, H. Boerstler, and E. J. O’Conner. 2013. ‘‘An Integrative Model for Organization-Wide Quality Improvement: Lessons from the Field.’’ Quality Management in Health Care 3 (4): 19–30.

Turrell G & Mathers C 2014. Socioeconomic status and health in Australia. Medical Journal of Australia 172:434–8

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