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Question:

Discuss about the Case Study of ZdenekSelir.
 
 

Answer:

Description:

In this case ZdenekSelir, age 88 years died at Gold Coast nursing home because negligence of the staff. ZdenekSelir was suffering through pressure wounds on his buttocks. Hospital staffs were not taking decision on his treatment. Family members of ZdenekSelir took decision and shifted him to the emergency department of the hospital. There was significant development of pressure wounds. These pressure wounds were measuring 15 centimeters. A year back, he was suffering through stroke. ZdenekSelir was kept on the fallout chair for the longer duration as a result there was no proper blood circulation. Family members of ZdenekSelir were not there during this period. Infection in ZdenekSelir, made almost all his organs deteriorated. In such condition, nurses were neither taking care of ZdenekSelir nor updating his deteriorating condition to the GP. Daughter-in law of ZdenekSelir complained to the Aged Care Complaints Commissioner.

Feelings:

For me, this incidence was shocking. Prior to this incidence, I had strong belief that there would be proper management of the elderly patients in the hospitals. Patients with deteriorating condition like gangrene would be taken care very promptly because such condition mainly occurs due to many complications and management of the all the conditions is very important. During the hospitalization of ZdenekSelir, I felt that he should have been managed in far better way and prevent his deteriorating condition because with proper precautions, medical conditions like his can be effectively managed. Healthcare staff might have felt too unhygienic to treat his wounds. This can be the most probable reason for not treating ZdenekSelir by healthcare staff. Healthcare staff also might have fear of spread of infection to them from ZdenekSelir. In such situation, family members of ZdenekSelir, might have felt absolutely helpless. After this incidence, I felt that negligence and unwillingness of the healthcare staff are mainly responsible for this incidence. Now, I am feeling that proper counseling and the training of the healthcare staff for handling such patients would have been definitely prevented occurrence of this incidence. Now, management of the hospital feeling guilty above the incidence and arranged the training programme for the staff and recruited new staff. Family members of ZdenekSelir wish to take legal action against the hospital management so that such incidence should not occur in the future (Griffin, 2011; Dicken, 2010).

 

Evaluation:

Eventhough, Mr. ZdenekSelir lost his life, there are few positive outcomes from this incidence. Hospital management understands seriousness of this issue and immediately recruited new staff and provided training to the existing staff for improvement in the quality of the nursing practice. There was no application of lateral thinking in handling this incidence. Neither existing staff handled this situation in proper way nor ZdenekSelir was referred to the specialist. Relatives of ZdenekSelir took decision to move to Aged Care Complaints Commissioner against hospital management. This was the right step taken by the relatives. By virtue of this, hospital management took decision to recruit competent staff and train staff to handle such type of patients. Staff members of the facility were neither taking their own decisions to handle this condition on their own, nor listening to the family members. Without implementing any special nursing practice, this healthcare staff was in the impression that his condition can be manageable. Healthcare staffs were arguing with the family members when these family members were trying to give suggestions. However, family members were positive about his improvement and they took their own decision to shift to the emergency department. However, in the emergency department healthcare staff followed negative approach. Moreover, hospital staff didn’t informed about the worsening condition of ZdenekSelir to family members. Ms Selir came to know the deteriorated condition of ZdenekSelir when she reached hospital (Williams et al., 2013; Shyam and Rapsang, 2013).

Analysis:

This incidence of ZdenekSelir could be the great learning experience for each and every stakeholder involved in the care of ZdenekSelir. Healthcare staff and hospital management should not handle such patients with negligence. They should take into consideration suggestions and feelings of the family members of the patients. In this case, if healthcare staff would have listened to the family members and managed ZdenekSelir in proper way results would have been definitely different. If I would have faced this situation, I would have attended the patient with very positive approach. I would not have thought of infection spread due to the wound of the patient. My first priority would have been improvement in the patient condition. I would have considered opinion of patient and family members. I would have called the experienced nurses in the hospital, who already handled such situations. For handling such situations, I should be well versed and well determined to handle all the types of patients. Along with the therapeutic knowledge, I should be well versed with the infection control methods. I should treat patient with patient centered approach (Chien-Feng et al., 2016; Wang et al., 2012).

Conclusion:

Main reason for failure to handle this patient is lack of knowledge and experience in handling such situations. Healthcare staff should undergo proper training to handle such type of critical patients. After completion of the training, this healthcare staff should take more responsibility and handle more number of patients. As a result, healthcare staff would get more experience and confidence in handling such patients. Healthcare staff should adopt holistic approach to manage such type of critical patients. Healthcare staff should bring improvement in their nursing intervention by considering opinions and feelings of patients and family members. Improvements in the procedures for handling should be done in a planned manner and evaluations for the improvements should be done at regular intervals. After provision of the training for one month, healthcare staff should be allowed to handle same type of patients independently (Kahn et al., 2014; Murray, 2017). 

 

References:

Chien-Feng, K., Chon-Fu, L., Chin, C., Wei-Han, H., Hui-Ping, H., Jyh-Seng, W., Shin-Yi, T. (2016). Prognostic Factors of Fournier's Gangrene in the Elderly: Experiences of a Medical Center in Southern Taiwan. International Journal of Gerontology, 10, 151-155.

Dicken, J. E. (2010).  Poorly Performing Nursing Homes: Special Focus Facilities are Often Improving, But CMS's Program Could be Strengthened. DIANE Publishing.

Griffin, D. (2011).  Hospitals: What They Are and How They Work. Jones & Bartlett Learning. 

Kahn, J. H., Magauran, B. G., and Olshake, J. S. (2014). Geriatric Emergency Medicine. Cambridge University Press.

Murray, E. (2017).  Nursing Leadership and Management: For Patient Safety and Quality Care.

F.A. Davis.

Shyam, D.C., and Rapsang, A.G. (2013). Fournier's gangrene. Surgeon, 11, 222-232.

Wang, L., Han, X., Liu, M., Ma, Y., Li, B., et al. (2012). Experience in management of Fournier's gangrene: a report of 24 cases. Journal of Huazhong University of Science and Technology, 32(5), 719-23

Williams, B. C., Malani, P. N., and Wesorick, D. H. (2013).  Hospitalists' Guide to the Care of Older Patients. John Wiley & Sons.

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