Posted by: sayamika, the killer bunny | 2007 December 21

Leapfrog

A patient with multiple medical issues is transferred from Big Smoke Tertiary Care Centre to Little County Hospital where I work. Among his other problems at the time of transfer, he has active C. difficile, and is getting appropriate treatment.

Fastforward two months to failure of first-line treatment, full treatment with second-line drugs with a good clinical response in terms of reduction in number of episodes of diarrhea, though the stool is still soft. The patient is subjected to stool analysis which returns as no C. difficile. Precautions are lifted.

The patient continues to have soft stools. He has a change in his diet to help correct this, but the dietician warns that some people can have further diarrhea.

The patient has further diarrhea.

You are the infection control nurse specialist. Do you:

a. discuss the patient’s status with his nursing team and physicians and decide together on an appropriate course of action which may or may not include reinstating enteral precautions.

or:

b. post a big sign on the patient’s door saying precautions are to be reinstated effective immediately and tell the patient’s family that the test was faulty. Do not speak to the physician involved.

Go on, just guess which one someone here thinks was appropriate.

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Responses

  1. Oh crap, poor patient.. I know the feeling he must be going through too!


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