What infection prevention measures

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Reference no: EM133841122

CASE STUDY

On April 7, a 65-year-old female was admitted with congestive heart failure from a long-term acute care facility where she was undergoing rehabilitation. Her past medical history included morbid obesity, hypertension, diabetes, and obstructive sleep apnea. Because of deteriorating respiratory status in the emergency room, the patient was intubated and placed on a ventilator. Chest X-ray revealed pulmonary edema. She was taken emergently to the cardiac catheterization laboratory, where left and right heart Can you do my assignment for me? We sure can!

catheterization was performed. A right internal jugular (IJ) catheter was placed to monitor pulmonary wedge pressures and to infuse fluids and medications, and an indwelling urinary catheter was

inserted. She was then transferred to the coronary care unit. On April 8, the patient was afebrile and normotensive, and demonstrated improving ventilatory status after aggressive diuresis. Rales were still present bilaterally in the lung bases on auscultation, with one fingerbreadth of jugular venous distension

noted on the left side of the neck. The right IJ catheter was dry with an intact dressing. A pressure dressing was in place over the cardiac catheterization site in the right groin. The admission rectal swab

screen was positive for vancomycin-resistant enterococcus (VRE). The patient was placed on Contact Precautions. On April 9, the patient had a low-grade fever of 37.5C. She was being weaned from the ventilator. Chest X-ray revealed atelectasis in the right lower lobe, with small pleural effusions bilaterally and resolution of pulmonary edema. The nursing notes reported clear yellow urine with adequate output. After the pressure dressing in the right groin was removed, slight redness of the site was documented. The right IJ catheter site showed no signs of inflammation through the transparent dressing. On April 10, the patient was successfully extubated, and the IJ catheter was removed. Her activity was increased to walking with assistance. During transfer from the bed, the patient complained of pain in the right groin. Examination of the site revealed increased redness with swelling and purulent drainage. The patient's temperature was 38.3C, and a fever workup was initiated. Blood, urine, and groin drainage cultures were sent for laboratory analysis, and empiric antibiotic therapy was started.

QUESTION:

What infection prevention measures do you think would have altered the outcome of this scenario? Why do you think those measures would be effective?

Reference no: EM133841122

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