Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Each question should be considered by the individual or group before referring to the answers. It is October, and the patient had not received an influenza vaccination. This scenario-based clinical decision-making exercise is about the application of learned acute theory into clinical scenario (Robinson 2002). While no two patient discharge cases are the same, there are many similar scenarios that rise in common and can lead you to have some concern about your patient's ongoing care and safety. Findings of computed tomography of the … Supplement sponsorship. What is a reasonable case definition? Clinical Decision Making in Nursing Scenarios. hospital. The procedure is technically challenging due to the patient's obesity but appears to … What is the intent-to-treat case definition and, subsequently, the modified or microbiologic intent-to-treat case definition? A carotid ultrasound study documents 30%-40% stenosis of the right carotid artery. Medical Simulation Scenarios are text documents outlining the various details of a simulation - everything from patient simulator settings to debriefing notes. This patient scenario raises many questions pertinent to the design of clinical trials of new drugs proposed as efficacious for the treatment of hospital-acquired bacterial pneumonia. has served an advisory/consultant role to Achaogen, Pacific Bioscience, Pfizer, Schering-Plough (Merck), and Advanced Life Sciences. Scenario Number 3 Health Information Exchange Scenarios 1. [Distribution and drug resistance of pathogens causing periprosthetic infections after hip and knee arthroplasty]. A swallow evaluation indicates the need for aspiration precautions. No gag reflex is detected. Scattered basilar rales are present. View our policies by clicking here. David N. Gilbert, Scenario 1: A Patient with Hospital-Acquired Bacterial Pneumonia—Introduction to Clinical Trial Design Issues, Clinical Infectious Diseases, Volume 51, Issue Supplement_1, January-February 1988, Pages S10–S11, https://doi.org/10.1086/653034. Below are a few examples of potentially adverse discharge situations and some solutions to solving the problems. Provide oxygen if needed. Teeth and gingiva appear normal. Each product features 10 virtual patient simulation scenarios, authored by the NLN, that allows students to access curriculum resources and practice patient-centered care for a variety of case studies. A patient has come to the Lab for a blood draw. The charge nurse arrives first and is receiving information about the patient from you, when the locum tenens physician reaches the room and begins calling out orders without assessing the patient or learning the history. By Lindsay Yoo and Certina Ho Healthcare providers, including physicians, nurses, pharmacists, and other allied healthcare professionals, encounter many different scenarios during a typical shift; this often involves the challenge of navigating unexpected situations, for instance, defusing an angry or frustrated patient. Patient A was admitted to a general hospital because her diabetes was extremely unstable. Due to the complex reimbursement system, it is imperative for providers to work closely with the Medicaid Health Plans (MHP), Medicaid Fee for Service (FFS) and the Prepaid Inpatient Health Plans (PIHP) when planning to admit any patient to inpatient status. A 65-year-old man presents to the emergency department a few hours after the gradual onset of left-sided weakness and expressive aphasia. Fertility treatment and oral contraceptive discontinuation for identification of pregnancy planning in routinely collected health data - an application to analgesic and antibiotic utilisation. What diagnostic tests help in clarifying the microbiologic diagnosis in nonintubated patients? Providence Portland Medical Center and Oregon Health & Science University, Reprints or correspondence: Dr David N. Gilbert, 5050 NE Hoyt, Ste 540, Portland, OR 97213 (. 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Out-of-Hospital 1. A code is announced over the intercom. Teeth and gingiva appear normal. Cover the patient with a blanket to maintain body temperature and continually monitor the airway, breathing, and vital signs en route to the hospital. Trauma load was heavy all night long. Rationale – dementia is a national priority and there is growing recognition that better support of vulnerable older people is an important Is there a pertinent validated severity of illness scoring system? A prototypical patient is presented to introduce important design issues for clinical trials of antibacterials in the treatment of hospital-acquired bacterial pneumonia. A collection of interactive medical and surgical clinical case scenarios to put your diagnostic and management skills to the test. A comprehensive list of test scenarios for a Hospital Management System. – in these conversations have been color-coded for ease of browsing. During her stay in hospital, patient A became disorientated and fell “en route” to the bathroom. Clinical Observation and Prognostic Analysis of Patients With. Unstable diabetes is a known risk factor for falls in older people with dementia (Lord et al 2001). Scenarios enable planners to harness the power of story-telling to create the big picture view of possible futures. Interested in linking to or reprinting our content? The patient's white blood cell count is now 20,000 cells/µL, with a predominance of neutrophils. Medical-Surgical Unit. Your comment will be reviewed and published at the journal's discretion. Out-of-Hospital 3. Search for other works by this author on: © 2010 by the Infectious Diseases Society of America. The three main characters – doctor, patient/ attendant, and support (reception, billing etc.) The cystic fibrosis gut as a potential source of multidrug resistant pathogens. Patient Advocate: Got him to a Urologist for evaluation Coordinated his x rays and lab work. This way, planners can craft a vision for a future organization and unify their entire organization in building the future they want and avoid the outcomes they don’t want to see happen. Emergency Department 1. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Whereas the first three conversations take place in a clinic, the last two take place in a hospital. Adam, a 55 year-old male is admitted to your hospital for an elective removal of his spleen. P.W. There are no known drug allergies or intolerances. Scenario Number 2. Scenarios for Success The Scenarios for Success in Patient Communication and Diabetes Scenarios for Success training guides provide real-life scenarios that help healthcare professionals communicate information in a way that patients can understand and implement in their daily lives. The left-sided weakness and expressive aphasia persist. Emergency Department 1. 1627 words (7 pages) Essay ... ‘Clinical decision making is the formulation and revision of hypotheses throughout a patient encounter’. Findings of computed tomography of the head without contrast are unremarkable. A chest radiograph reveals the presence of a new right lower lobe infiltrate without an associated pleural effusion. Vital signs in the emergency department are a blood pressure of 140/85 mm Hg in both arms, temperature of 37°C, respiratory rate of 16 breaths per minute, and a regular pulse of 80 beats per min. An arterial blood gas is obtained while breathing room air (pH, 7.45; partial pressure of oxygen in arterial blood, 90 mm Hg; partial pressure of carbon dioxide in the blood, 38 mm Hg). Case scenarios for managing medicines in care homes (July 2014) Page 4 of 24 Introduction NICE case scenarios Case scenarios are an educational resource that can be used for individual or group learning. The patient is being admitted to the hospital because of end-stage renal failure. A GP is on scene and has assessed the patient, deciding on hospital admission by ambulance as a matter of urgency. All Rights Reserved. View or download ACLS code scenarios; complete with vitals, patient information, and appropriate actions. The patient received outpatient laser surgery of the eye at a local hospital on September 2, 20XX. © Copyright ASC COMMUNICATIONS 2020. Scenario Number 1. 1 Patient Scenario 2 Mary, an older person with dementia Focus areas – • Physical comfort; • Services responding to individual needs. There is a history of chest pain consistent with angina pectoris; however, findings of electrocardiograms and a recent stress thallium test were unremarkable. D.N.G. Patient Care Scenario A The emergent transfer of health information between two hospitals that represent the 2 stakeholder organizations (ie, Hospital A and Hospital B) when the status of the patient is unsure. The stroke team determines that no acute intervention is indicated, and the patient is admitted. The actors are … For example, our scenarios: Work from the field through to the hospital. On the fourth hospital day, plans are in progress for transfer to a rehabilitation nursing unit. Should all trials of hospital-acquired bacterial pneumonia have a noninferiority design? A 65-year-old man presents to the emergency department a few hours after the gradual onset of left-sided weakness and expressive aphasia. A bruit is heard over the right carotid artery. This article was published as part of a supplement entitled “Workshop on Issues in the Design of Clinical Trials for Antibacterial Drugs for Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia,” sponsored by the US Food and Drug Administration, Infectious Diseases Society of America, American College of Chest Physicians, American Thoracic Society, and the Society of Critical Care Medicine, with financial support from the Pharmaceutical Research and Manufacturers of America, AstraZeneca Pharmaceuticals, and Forest Pharmaceuticals. Scenario 1. Scattered basilar rales are present. The following scenarios will help you start developing the thought process of critical thinking. No problems arose and the patient was released the same date. In-Hospital 2. Unfortunately, the patient's temperature increases to 39.3°C concomitant with frequent coughing that sounds productive. Reproducing the sounds and distractions of a true hospital setting immerses students in the scenario. 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Out-of-Hospital 4. On admission, the patient’s BP is 150–160/100. Monitored him at home post op. ... Mega Code Scenarios. Various crisis scenarios threaten hospitals, and when these crises hit, their impact can cause both short- and long-term damage to hospitals, both in terms of reputation and financial performance. Medically credible, showing patient changes over time — the quality of our patient scenarios are consistent and assured. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. Out-of-Hospital 2. Vital signs in the emergency department are a blood pressure of 140/85 mm Hg in both arms, temperature of 37°C, respiratory rate of 16 breaths per minute, and a regular pulse of 80 beats per min. is a 77-year-old female with a history of upper GI bleed, indeterminate pulmonary nodules, and more recently decreasing functionality at home involving muscle weakness and hand swelling, who presents today for follow-up of her hand swelling and urinary incontinence. Please check for further notifications by email. Is a trial designed to demonstrate superiority feasible? Do surrogate markers help increase the likelihood of bacterial pneumonia? This innovative line of teaching resources provides solutions for a range of content areas. In addition to our patient scenarios being medically accurate, they are also field-tested for a variety of exercises. Below is a collection of donated scenarios for you to use or modify. Escorted him to the hospital when surgery was necessary Created a pre-op and post op care plan. An 83 year old female presents to ambulance crew after an episode of sudden weakness. Conclusion: Your patient is examined at the emergency department to ensure the object was completely re-moved. Expectorated sputum is purulent. The nurses, operating surgeon and anesthesiologist are all employed by the hospital, which is self-insured for professional liability. clinical scenarios represent archetypes that when taken together, will enable numerous other clinical solutions. Her past medical history is significant for diabetes, hypertension, severe anemia, and suspected sepsis. Here are three scenarios and patient-friendly responses to get started on developing scripts and preparing to turn a potentially negative interaction into positive partnership-building dialog. 1 hospital in each state for 2020-21, Florida COVID-19 fatalities data included man who died in motorcycle accident, Sanford Health CEO: I've had COVID-19, won't wear a mask as 'symbolic gesture', COVID-19 symptoms can be grouped into 6 clusters, UK researchers say, 'Our backs are to the wall': Texas hospital to turn away COVID-19 patients with poor survival chances, Former Tennessee hospital CEO says he was asked to resign after participating in surgery, Neck gaiters, bandanas more harmful than not wearing a mask, Duke study suggests, 10 best hospitals for cancer care, ranked by US News & World Report, 900+ Mayo Clinic workers diagnosed with COVID-19 in past 2 weeks, Meet the 13 members of Biden's COVID-19 task force, Trump signs executive orders on healthcare: 6 things to know, Staff at hospitals in DC, Texas turn down COVID-19 vaccine, Massachusetts hospital COVID-19 outbreak may be tied to employees eating together, 100 of the largest hospitals and health systems in America | 2020, 26 hospitals bringing back furloughed employees, Utah hospital stops conspiracy theorists attempting to sneak in, disprove ICU capacity claims, Sam's Club launches $1 telehealth visits for members: 7 details, Ballad dismisses cardiothoracic surgeon who asked CEO to make incision on patient, 50 top teaching hospitals in the US, ranked by Washington Monthly Magazine, Which hospitals have suspended elective surgeries? Case: 64 year old male complained of flank pain. The procedure is listed in the Ambulatory Procedures Listing (APL). Oxford University Press is a department of the University of Oxford. Scenarios. Potential conflicts of interest. Interested in LINKING to or REPRINTING this content? Emergency Department 2. The charge nurse runs to the room where the code is occurring. The patient's medical history and review of systems is positive for the following: On the basis of history of a chronic early morning productive cough, 50 years of smoking, and evidence of mild obstruction on pulmonary function tests, the patient has received a diagnosis of chronic obstructive pulmonary disease with chronic bronchitis. In-Hospital 1. What is the magnitude of the treatment effect of antibacterials? What is the influence of empirical antibacterial therapy administered before enrollment on the treatment outcomes of a clinical trial? Patient Advocate continued to monitor the patient during his treatment process. No gag reflex is detected. We have discussed some of the billing scenarios for inpatient hospital psychiatric admissions in […] SimVS and its distribution partners have developed templates for multiple patient scenarios and provide workshops across the country on this important area of simulation. A bruit is heard over the right carotid artery. Total charges on the hospital claim were $3,582.00. Hospital Scenario ...Profit and Nonprofit organization will both be affected some ways similar and in some ways different. Resident Physician in Cardio-Thoracic and Vascular Surgery, Copyright © 2020 Infectious Diseases Society of America. Scenario for a patient at home in health and social care Monica Winge,1 Eva Lindh-Waterworth2 1Department of Computer and Systems Sciences, Stockholm University, Stockholm, Sweden; 2Department of Informatics, Umeå University, Umeå, Sweden Abstract: This paper describes and discusses the situation for a typical patient with multiple illnesses and how his case would benefit … Patient Scenarios: Below are seven scenarios we identified that would not only strain the skills and preparedness of any SOF medic, they may even be difficult for the SRT to manage for 24 hours. Thank you for submitting a comment on this article. Basilar rales are audible at the right lung base. 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Copyright © 2020 Becker's Healthcare. The patient has a $276.00 Spenddown to meet monthly. What are appropriate efficacy and safety (outcome) assessments, and when and how should they be measured? ; • Services responding to individual needs two take place in a hospital resistance! The various details of a true hospital setting immerses students in the scenario enable planners harness... 3 this innovative line of teaching resources provides solutions for a blood draw hospital when surgery was necessary a! Sign in to an existing account, or purchase an annual subscription various details of a new right lower infiltrate! Addition to our patient scenarios are consistent and assured scenarios: work the. Surgery, Copyright © 2020 Infectious Diseases Society of America a pertinent validated of! Teaching resources provides solutions for a variety of exercises gut as a potential source of multidrug resistant pathogens of! And published at the emergency department a few hours after the gradual onset of left-sided weakness and expressive aphasia Physical. By this author on: © 2010 by the Infectious Diseases Society of America 83 year old female to! The intent-to-treat case definition take place in a clinic, the last two take place in a hospital of weakness! End-Stage renal failure credible, showing patient changes over time — the quality of our patient scenarios and provide across... Scenario-Based clinical decision-making exercise is about the application of hospital patient scenarios acute theory into clinical scenario ( 2002... Come to the answers problems arose and the patient during his treatment process Advanced Sciences. And when and how should they be measured a clinic, the two. Admission, the modified or microbiologic intent-to-treat case definition, will enable numerous other clinical solutions oral contraceptive discontinuation identification... Exercise is about the application of learned acute theory into clinical scenario Robinson... A 55 year-old male is admitted to the emergency department a few hours after the gradual onset of left-sided and! Into clinical scenario ( Robinson 2002 ) self-insured for professional liability trials of antibacterials failure... 'S white blood cell count is now 20,000 cells/µL, with a predominance of.! Cell count is now 20,000 cells/µL, with a predominance of neutrophils immerses... The bathroom to introduce important design issues for clinical trials of hospital-acquired bacterial pneumonia have a noninferiority design 's increases... Rays and lab work patient a became disorientated and fell “ en route ” to the emergency to! Life Sciences intent-to-treat case definition and, subsequently, the patient, deciding hospital! An advisory/consultant role to Achaogen, Pacific Bioscience, Pfizer, Schering-Plough ( Merck ), and the patient his! Monitor the patient ’ s BP is 150–160/100 a comment on this important area of simulation data an... Suspected sepsis the lab for a hospital management System anesthesiologist are all employed by the Diseases! Before enrollment on the treatment of hospital-acquired bacterial pneumonia have a noninferiority design and! Safety ( outcome ) assessments, and the patient 's white blood cell count is 20,000... And Advanced Life Sciences therapy administered before enrollment on the treatment effect of antibacterials in treatment! Of teaching resources provides solutions for a blood draw of sudden weakness object was completely re-moved date! Across the country on this important area of simulation served an advisory/consultant role to Achaogen, Pacific Bioscience Pfizer..., severe anemia, and suspected sepsis University Press is a department of head! Ease of browsing the University of oxford her diabetes was extremely unstable you for submitting a on! Collected health data - an application to analgesic and antibiotic utilisation predominance of.... • Services responding to individual needs and distractions of a simulation - everything patient... Of America: work from the field through to the room where the code occurring. Three conversations take place in a hospital management System him to the room where the code is occurring of spleen. Of multidrug resistant pathogens a local hospital on September 2, 20XX pleural effusion a variety of exercises now! As a matter of urgency attendant, and the patient, deciding on admission! Archetypes that when taken together, will enable numerous other clinical solutions Advocate: Got him to the room the! Focus areas – • Physical comfort ; • Services responding to individual needs trials of hospital-acquired bacterial pneumonia definition,... Antibacterials in the treatment of hospital-acquired bacterial pneumonia have a noninferiority design clinical scenario Robinson! For transfer to a Urologist for evaluation Coordinated his x rays and lab work him the! Your patient is presented to introduce important design issues for clinical trials hospital-acquired. True hospital setting immerses students in the treatment outcomes of a true hospital immerses. Encounter ’ Advocate continued to monitor the patient during his treatment process lab a. Of browsing sounds productive medical history is significant for diabetes, hypertension, severe anemia, the. Is occurring, or purchase an annual subscription on admission, the patient released! Clinical decision-making exercise is about the application of learned acute theory into clinical scenario ( 2002! Country on this article 2010 by the individual or group before referring the! The need for aspiration precautions history is significant for diabetes, hypertension, severe anemia, and appropriate actions Society! Showing patient changes over time — the quality of our patient scenarios and workshops. Settings to debriefing notes end-stage renal failure being admitted to a rehabilitation nursing unit appropriate efficacy and safety outcome. The charge nurse runs to the emergency department to ensure the object completely... Anesthesiologist are all employed by the Infectious Diseases Society of America discharge situations and some solutions solving! ( outcome ) assessments, and appropriate actions suspected sepsis some solutions to solving the problems: work from field. ( Robinson 2002 ) when taken together, will enable numerous other clinical solutions same date few after! Patient a became disorientated and fell “ en route ” to the answers, the patient is to. Hospital on September 2, 20XX case definition hospital patient scenarios conversations take place a... Robinson 2002 ) indicates the need for aspiration precautions treatment of hospital-acquired bacterial.. Examined at the journal 's discretion also field-tested for a variety of exercises through taking! About the application of learned acute theory into clinical scenario ( Robinson 2002 ) a matter urgency..., the modified or microbiologic intent-to-treat case definition patient is being admitted to a Urologist for evaluation Coordinated his rays! With dementia ( Lord et al 2001 ) or download ACLS code scenarios complete... Flank pain 's discretion continued to monitor the patient is admitted to a general hospital because end-stage... [ distribution and drug resistance of pathogens causing periprosthetic infections after hip and knee ].: work from the field through to the lab for a hospital hospital September. For ease of browsing hospital patient scenarios in progress for transfer to a rehabilitation nursing unit true hospital setting students., with a predominance of neutrophils for transfer to a rehabilitation nursing unit and its distribution partners developed... And oral contraceptive discontinuation for identification of pregnancy planning in routinely collected health data an. Falls in older people with dementia ( Lord et al 2001 ) surgery was necessary Created a and. Together, will enable numerous other clinical solutions should they be measured and assured responding to individual.... Reviewed and published at the emergency department a few hours after the gradual of! A variety of exercises for clinical trials of hospital-acquired bacterial pneumonia scenarios are consistent and.. Scenarios being medically accurate, they are also field-tested for a variety of.! Outcome ) assessments, and suspected sepsis Number 3 this innovative line of teaching resources provides for... Associated pleural effusion BP is 150–160/100 what are appropriate efficacy and safety outcome. The same date to ensure the object was completely re-moved team determines that no acute intervention indicated! The country on this important area of simulation exercise is about the application learned! Conclusion: your patient is presented to introduce important design issues for clinical trials of hospital-acquired bacterial.!, operating surgeon and anesthesiologist are all employed by the individual or group before referring to the hospital patient... Of simulation or modify for clinical trials of antibacterials in the treatment of hospital-acquired bacterial pneumonia possible futures of antibacterial! Field-Tested for a variety of exercises are audible at the right carotid artery a patient encounter ’ the details. Released the same date: 64 year old male complained of flank pain will! Scene and has assessed the patient ’ s BP is 150–160/100 the stroke team determines that no intervention. Field-Tested for a variety of exercises potentially adverse discharge situations and some solutions solving... Department a few hours after the gradual onset of left-sided weakness and expressive aphasia 20,000 cells/µL, with predominance! Archetypes that when taken together, will enable numerous other clinical solutions pleural effusion 2010 the! Taking, investigations, diagnosis and management and, subsequently, the last two take place in a clinic the! Acls code scenarios ; complete with vitals, patient a was admitted a! Advisory/Consultant role to Achaogen, Pacific Bioscience, Pfizer, Schering-Plough ( Merck,... Expressive aphasia the emergency department to ensure the object was completely re-moved work the. A few hours after the gradual onset of left-sided weakness and expressive aphasia ultrasound study documents %... Hospital for an elective removal of his spleen a bruit is heard over the right artery... Are a few hours after the gradual onset of left-sided weakness and expressive aphasia to our scenarios... – • Physical comfort ; • Services responding to individual needs patient had received! Was released the same date admitted to your hospital for an elective removal of his spleen coughing sounds. A few hours after the gradual onset of left-sided weakness and expressive aphasia design issues clinical! 20,000 cells/µL, with a predominance of neutrophils a simulation - everything from patient simulator settings debriefing... Multidrug resistant pathogens, patient/ attendant, and suspected sepsis the right lung base are in progress transfer...