Patient Safety Case Study

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Patient Safety

Assignment

Marwa Ghabra U00020161

Patient safety blood transfusion
Assignment

What is patient safety?
Patient safety is defined as a new healthcare discipline that emphasizes the reporting, analysis, and prevention of medical error that often leads to adverse healthcare events
Case:
Subjective: a 35 year old married female comes to the clinic to review her thyroid function tests and CBC that were ordered as part of her routine annual periodic health check-up.
Objective: TFT results were normal.
CBC results though showed a Hg of 6.6. pale skin, lining mucosa, conjunctiva and nail beds. No murmurs heard on auscultation. Rest of cardiovascular system exam normal. Abdominal examination was also normal. On review of symptoms
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She was prescribed iron tablets which she stopped taking because of the side effects she experienced. She describes her diet as healthy. Her LMP was 3 and a half weeks ago. She says her period is regular, normal flow with heavy 4 days long.
Assessment: Blood results of her CBC point to iron deficiency anemia.
Plan: a repeat CBC was repeated for the patient. Advice that the patient be referred to the hospital for blood transfusion was given but the patient refused. The doctor advised the patient to go for an electrophoresis to see whether the patient has thalassemia or sickle cell trait.
Problem Analysis:
According to American guidelines the threshold for blood transfusion in anemia is a hemoglobin level of 7. This patient has a hg of 6.6. she therefore is a candidate for blood transfusion.
What are the adverse effects that can result from her low hg if it persists without medical treatment?
• Palpitations, angina
• Intermittent claudication of the legs
• Symptoms of heart
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Although it is the patient’s right to refuse treatment, it is our duty as doctors to educate the patient about her condition, the possible complications, and the benefits of treatment if she agrees to receive any. The doctor should also exlain different management options, blood transfusion or iron supplements. The patient should also understand the risks of her condition in case she decides to get pregnant. Counselling should also be done by asking the patient why she refuses receiv9ing blood transfu=on. The patient for eg may have had a negative experience at a hospital admission and is therefore afraid of the same experience. Reassurance is beneficial when
What are some factors that could have contributed to her neglected treatment?
The patient neglected the fact that her Hg is low. Also, she admitted that she was prescribed iron tablets but stopped taking them after a few days due to the constipation and nausea she experienced.
The patient may also be unaware of the severity iof her condition. It is also obvious from her history that follow up was not recommended by her other dr or was ignored by the patient as her Hemoglobin further detreated since her last blood

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