clexane



hi mario, thanks a lot that's ok bye hi there hello how are you good thank you i'm chelsea from recovery hi chelsea and this is mary murray


clexane, mary hello mary hi there your back on the ward now my name is jacinta i'm the nurse looking after you tonight ok so this is mary murray her ur number is 210


7101 and her date of birth is the twenty six of the first 1938 correct um she's had her neck of femur fixed today obs are fine she's has some pain relief neurovascular in tact everything's in the chart that you need to know i've really got to get back to recovery because it's flat out down there well hang on a moment chelsea that's not really ok i need to know as much about mary as possible as i'm looking after her tonight and i need to need to make sure that the


care i give her is safe so would you mind giving me a little more detail oh of course yeah ok so mary's been to theatre today and shes had her left neck of femur repaired she fractured it a couple of days ago she's had an internal fixation of that today she's a past history of having actual fibulation of that today she's normally on warfarin


she has type two diabetes she heads some hypotension and high cholesterol she's had a general anaesthetic today and intraoperatively she was nice and stable they gave her some paracetamol intraoperatively should got to recovery at ten o'clock this morning her observations have been stable blood pressure has been around one hundred thirty over seventy pulse has been around since eighty five and respiratory rate is sixteen she's on two litres of oxygen


her oxygen saturation has been ninety nine percent she had some pain when she woke up and she's had 80 micrograms of iv fentanol pain protocol and we followed that up we've followed that up with five milligrams of oral oxycodone when she left the recovery her pain score one to two she's got a urinary catheter insitu which is yielding good amounts of urine her estimated blood loss intraop was two hundred mills


she's gotta left hip wound there which was dry mary i'm just going to have a look at your wound yeap that's good alright good she's got a ivt insitu four percent and a fifth and that's running at eighteen mills-an-hour her bsl was six point six when we did it in recovery now post op orders are she can eat drink is tolerated weight bear as tolerated neurovascular


observations to her left foot she's to have her warfarin held and start the clexane as ordered in her drug chart and she should can have iv cefazolin one gram for three doses eight hourly now she's got


her glasses and her hearing aid she's a little bit deaf and the doctor wanted her haemoglobin checked as well so has that blood been taken yes the anaesthetist took the blood but he wants your evening ortho reg to follow it up thanks ok and her daughter jan would like to be informed of her return to the ward to ok happy with that yes thanks for that chelsea so just to confirm with you i need to let jan her daughter know that's right and also


make sure that orthopedic reg chances that haemoglobin result correct yes that’s right so i really appreciate that hand over that was really good and is going to make my job a lot easier this afternoon look after mary and making sure that she is safe good no problem ok mary i’m going back to recovery now i'm going back to recovery i've given jacinta your heading aids oh alright good thank all the best now take care thank you ok bye bye ok now mary i'm going to go and let jan know you're back but just before i go how is your pain going oh what's your pain score now


oh it's near forty ok so we'll get you some more pain relief then ok yes thank you the key principles highlighted in that scenario include making time for a thorough handover especially when workload is high is important to patient safety there was a clear transfer of accountability and responsibility in the care of the patient the hand over occurred at the ward bedside to allow for visual cues in patient observation the isbar process was supported by clinical notes to ensure important


information was not overlooked isbar standardises clinical handover it's especially helpful for junior staff who often are unable to identify the important pieces of information which needed to be handed over it's also very it also gives structure to a hand over so that everything is handed over and no vital information is missed


i think as a nurse it is important that we take the time for a good clinical handover so that important information isn't left out


clexane

we're all busy so it's really vital that as a senior nurse we show the way for the junior staff on how to give good clinical handovers um... because ultimately as unless nurse you're responsible for that patients care so it's vital


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