Patient Introduction Location: Postoperative surgical unit Time:

Patient Introduction Location: Postoperative surgical unit Time: 1000 SBAR report from the charge nurse: Situation: Jared Griffin is a 63-year-old male who had a right total knee arthroplasty yesterday morning at 0800. Background: Jared Griffin has a history of osteoarthritis, mild hypertension, and irregular heart rhythm. His last incident of irregular heart rhythm was 2 years ago. He is a carrier of MRSA and is currently under contact precautions. Assessment: Jared Griffin is afebrile, and vital signs have been stable during the night. Pain level has been at a 2 to 3 on a 0 to 10 scale. He dangled his feet off the side of the bed yesterday evening, and the physical therapist has just been in to see him. He has been able to bend his knee to a 75-degree angle, and the goal is 90 degrees. His dressing was changed by the surgeon at 0700 on his morning round, at which time the drain was discontinued. His IV fluids have been discontinued, and the IV is saline locked. Recommendation: The physical therapist has reported that Jared Griffin was not feeling well after physical therapy, and you need to go and see how he is doing. I would also like you to review his labs and continue with contact precautions. Diagnostic Tests Electrocardiography Diseases and Conditions Atrial fibrillation Drugs Oxycodone hydrochloride-acetaminophen Procedures 12-lead electrocardiogram (ECG) Pulse assessment Reflecting on Jared Griffin’s case, were there any actions you performed differently when repeating the scenario, or that you would do differently if you were to repeat it? If so, how did/would your patient care change and what differences, if any, did you or would you expect in Jared Griffin’s outcomes? Scenario Analysis Questions* PCC What cues did you recognize when you received the initial SBAR report that prompted you to investigate further? EBP/S When analyzing the relevant initial cues, what priority problem(s) did you identify for Jared Griffin? EBP/PCC Describe the components of a focused cardiovascular assessment. PCC What cardiovascular assessment findings were significant for Jared Griffin? S/T&C Describe the appropriate SBAR communication to the provider. Concluding Questions Describe how you would apply the knowledge and skills that you acquired in Jared Griffin’s case to an actual patient care situation. What opportunities for improvement should you address? SCIENCE HEALTH

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