HITT 1311 University of North Texas Week 13 An Extended Stay Case Study After reading the case study below (starts on page-2 of this document), please prov

HITT 1311 University of North Texas Week 13 An Extended Stay Case Study After reading the case study below (starts on page-2 of this document), please provide 3-5 sentences on each of the following:1. What happened in this case study?2. What was the final outcome of this mishap? 3. To what extent was any of this preventable?4. How could healthcare information technology be used to help in this situation? (Hint: Think about automated alerts.) 10:26
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HITT-1311_Week 13 and 14_Case Stu…
Case Study
“An Extended Stay”
Mr. Stanley Londborg is a 64-year-old man with a long-standing
history of a seizure disorder. He also has hypertension (high
blood pressure) and chronic obstructive pulmonary disease
(COPD). He is no stranger to the hospital because of his health
issues. At home, he takes a number of medications, including
three for his COPD and three — levetiracetam, lamotrigine, and
valproate sodium to help control his seizures.
Mr. Londborg came to the emergency department (ED) last
week because he was wheezing and having trouble breathing.
The physician in the ED conducted a physical examination that
yielded signs of an acute worsening of his COPD, which is
known as COPD exacerbation. (In many cases, COPD
exacerbation is the result of a relatively mild respiratory tract
infection, but could be due to something more serious, such as
pneumonia.)
The physician in the ED ordered a chest x-ray, which did not
show any signs of pneumonia. He admitted Mr. Londborg to the
hospital for treatment of acute COPD exacerbation, resulting
from a relatively mild respiratory tract infection. Before leaving
the ED, Mr. Londborg also underwent routine blood work,
which showed an elevation in his creatinine, a sign that his
kidneys were being forced to work harder due to his infection.
On the medical floor, the care team treated Mr. Londborg with
oral steroids and inhaled bronchodilators (standard medical
therapy for his condition), which resulted in a gradual
improvement in his respiratory symptoms. Nurses also gave him
IV fluids for the issue with his kidneys, which slowly resolved.
Mr. Londborg was steadily improving, so it seemed this visit to
the hospital would be one of his shorter ones.
But on his third morning in the hospital, Mr. Londborg
complained to the intern (a first-year resident) on the care team
about acute pain in his left leg. This symptom, potentially
indicating deep venous thrombosis (a blood clot in his leg
commonly known as DVT), prompted the team to order an
ultrasound of Mr. Londborg’s lower extremities. (A primary
concern with DVT is that blood clots in the legs may dislodge
and travel to the lungs, causing a pulmonary embolism, which
could be deadly.)
The resident on the care team (who oversees the intern) then
checked Mr. Londborg’s medication orders and was surprised to
see that the admitting doctor had not ordered prophylaxis for
DVT (i.e., blood thinners, such as heparin or enoxaparin). The
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The resident on the care team (who oversees the intern) then
checked Mr. Londborg’s medication orders and was surprised to
see that the admitting doctor had not ordered prophylaxis for
DVT (i.e., blood thinners, such as heparin or enoxaparin). The
resident was surprised because patients admitted to the hospital
typically receive this treatment to prevent blood clots from
forming while they lie in their hospital beds. Further, nothing
about Mr. Londborg’s medical record suggested he shouldn’t
have received this treatment as an important precautionary
measure.
The ultrasound, unfortunately, confirmed the presence of a blood
clot in Mr. Londborg’s left calf. Due to his impaired kidney
function, treatment for the blood clot required him to remain in
the hospital on IV medication.
Mr. Londborg’s stay was going to be longer than expected.
At 10 PM on his eighth day in the hospital, a member of the
environmental services (also known as housekeeping) staff
found Mr. Londborg on the floor of his room. She immediately
alerted the nurses on the ward. The nurses noted seizure activity
and called the overnight medical team to Mr. Londborg’s
bedside. The team responded quickly and gave him intravenous
medication that stopped his seizure.
Because no one witnessed his fall and seizure, Mr. Londborg
underwent an emergent CT scan of his head to check for any
sign of bleeding. After his mental status improved (it is common
for patients to be confused for a time after a seizure), he
complained of pain in his left shoulder and elbow, but x-rays of
these joints showed no evidence of a traumatic fracture from his
fall.
After ensuring that Mr. Londborg was stable, the overnight care
team reviewed the chart and the medication history to try to
determine the cause of Mr. Londborg’s sudden seizure. They
found that one of his seizure medications, levetiracetam, had not
been given earlier in the day when it should have been. There
was a notation in the medication administration record from the
daytime nurse indicating that the ordered dose was not available
in the automatic medication dispensing system on the floor
earlier in the day.
Further discussions the following day with the daily care team of
doctors and nurses revealed that the nurses didn’t notify the
physicians or the pharmacy that the essential medication was not
administered. The medication system didn’t include an
automatic alert, either.
Fortunately, the overnight physicians restarted Mr. Londborg on
his medication, and he suffered no apparent permanent harm.
Mr Landhara was discharged after 10 days in the hasnital Mast
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the hospital on IV medication.
Mr. Londborg’s stay was going to be longer than expected.
At 10 PM on his eighth day in the hospital, a member of the
environmental services (also known as housekeeping) staff
found Mr. Londborg on the floor of his room. She immediately
alerted the nurses on the ward. The nurses noted seizure activity
and called the overnight medical team to Mr. Londborg’s
bedside. The team responded quickly and gave him intravenous
medication that stopped his seizure.
Because no one witnessed his fall and seizure, Mr. Londborg
underwent an emergent CT scan of his head to check for any
sign of bleeding. After his mental status improved (it is common
for patients to be confused for a time after a seizure), he
complained of pain in his left shoulder and elbow, but x-rays of
these joints showed no evidence of a traumatic fracture from his
fall.
After ensuring that Mr. Londborg was stable, the overnight care
team reviewed the chart and the medication history to try to
determine the cause of Mr. Londborg’s sudden seizure. They
found that one of his seizure medications, levetiracetam, had not
been given earlier in the day when it should have been. There
was a notation in the medication administration record from the
daytime nurse indicating that the ordered dose was not available
in the automatic medication dispensing system on the floor
earlier in the day.
Further discussions the following day with the daily care team of
doctors and nurses revealed that the nurses didn’t notify the
physicians or the pharmacy that the essential medication was not
administered. The medication system didn’t include an
automatic alert, either.
Fortunately, the overnight physicians restarted Mr. Londborg on
his medication, and he suffered no apparent permanent harm.
Mr. Londborg was discharged after 10 days in the hospital. Most
hospitalizations for COPD are far shorter. In fact, many last only
a couple days.
Source
The Institute for Healthcare Improvement
Ross Hilliard, MD, IHI Open School Northeast Regional
Chapter Leader
http://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activ
ities/CaseStudyAnExtendedStay.aspx
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Name:
Deliverables:
Purposes:
Assignment Information
Case Study
Case Study Assignment
1. To introduce you to real-world situations in which healthcare information
technology can help
1. Explain analytics and decision support (2)
2. Explain current trends and future challenges in health information
exchange (2)
This week we will review a real-world example of an actual problem in
healthcare and think about how healthcare information technology can help.
CAHIIM
Mandated
Outcomes:
Instructions:
After reading the case study below (starts on page 2 of this document), please
provide 3-5 sentences on each of the following:
1. What happened in this case study?
2. What was the final outcome of this mishap?
3. To what extent was any of this preventable?
4. How could healthcare information technology be used to help in this
situation? (Hint: Think about automated alerts.)
Save your responses in a Word document with your first and last name in the
title and submit it for grading.
Case Study
“An Extended Stay”
Mr. Stanley Londborg is a 64-year-old man with a long-standing
history of a seizure disorder. He also has hypertension (high
blood pressure) and chronic obstructive pulmonary disease
(COPD). He is no stranger to the hospital because of his health
issues. At home, he takes a number of medications, including
three for his COPD and three- levetiracetam, lamotrigine, and
valproate sodium — to help control his seizures.
Mr. Londborg came to the emergency department (ED) last
week because he was wheezing and having trouble breathing.
The physician in the ED conducted a physical examination that
yielded signs of an acute worsening of his COPD, which is
known as COPD exacerbation. (In many cases, COPD
exacerbation is the result of a relatively mild respiratory tract
infection, but could be due to something more serious, such as
pneumonia.)
The nhysician in the ED ordered a chest x-ray which did not
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