Recognising Risk and Improving Patient Safety - Mildred's Story

Summary

The script revolves around Mildred Hill, a 70-year-old woman who experiences a stroke and is admitted to the hospital. George, her accommodation warden, notices her distress and calls for medical assistance. Dr. Small examines her and suspects another stroke, leading to Mildred's hospitalization. The narrative follows her through various medical assessments, including a fractured hip surgery, and highlights the challenges faced by the medical staff in managing her care, including her specific dietary needs due to a wheat allergy. The script also touches on the communication difficulties between hospital staff and Mildred's concerned daughter.

Takeaways

• 😷 Mildred, a 70-year-old resident at Magnolia Court, experiences symptoms suggesting another stroke, prompting an emergency call to the doctor.
• 🏥 Dr. Alex Small is contacted for an immediate visit due to Mildred's non-responsiveness and lack of movement on her right side.
• 💼 George, the warden at Magnolia Court, assists by calling for medical help and later prepares Mildred for hospitalization by gathering her medicines and personal items.
• 🚑 Mildred is transported to the hospital with a suspected stroke, and her medical history, including a previous mild stroke and a severe allergy to wheat, is communicated to the hospital staff.
• 🏥 At the hospital, Mildred undergoes a series of tests and is admitted under the care of Dr. Small, who notes her right-sided hemiparesis and expressive dysphasia.
• 📝 Communication between healthcare providers is crucial, as seen when Dr. Small informs the hospital staff about Mildred's condition and her need for a gluten-free diet due to her wheat allergy.
• 🤝 The importance of a coordinated care approach is highlighted as different healthcare professionals, including nurses, doctors, and wardens, work together to manage Mildred's condition.
• 📞 The script illustrates the challenges in communication between healthcare providers and family members, as Mildred's daughter seeks information about her mother's condition and care.
• 🛑 A fall results in Mildred suffering a fractured hip, which requires immediate surgery, demonstrating the need for prompt medical intervention and care in elderly care.
• 🩺 The hospital staff must navigate procedural challenges, such as ensuring all necessary pre-surgery preparations are completed, including marking the correct side for surgery and managing post-operative care.
• 💊 The script underscores the complexity of medication management in elderly care, with attention to allergies and the administration of appropriate medications post-surgery.

Q & A

What is the initial concern George expresses about Mildred?

George is concerned that Mildred may have had another stroke because she activated her panic button, is not responding, and shows no movement on her right-hand side.

What action does George take after suspecting Mildred has had a stroke?

George contacts Dr. Alex Small to inform him about Mildred's condition and requests that he come to see her.

What is Mildred's medical history according to the script?

Mildred had a mild stroke about two years ago, mild angina, and a little bit of asthma. She also had an anaphylactic reaction to some pills containing wheat.

What steps does Dr. Small take when he arrives to examine Mildred?

Dr. Small checks Mildred's responsiveness by asking her to close her eyes, show her teeth, lift her arms, squeeze his fingers, and identify an object.

Why does Dr. Small decide Mildred needs to go to the hospital?

Dr. Small decides Mildred needs to go to the hospital because she has a right-sided hemiparesis with facial palsy, expressive dysphasia, and lives alone.

What items does George gather for Mildred before she goes to the hospital?

George gathers Mildred's medicines, a Medi-alert bracelet, and an adrenaline pen, and puts them in her bag along with some clothes and toiletries.

What complication does Mildred experience while in the hospital?

Mildred experiences a fall, which results in a fractured leg, requiring surgery.

What is the confusion regarding Mildred's condition when her daughter, Jean, calls the hospital?

The confusion arises because the nurse on the phone is not fully informed about Mildred's condition and is unable to provide specific details about her care or consultant.

What special dietary needs does Mildred have, and why?

Mildred has a wheat allergy and requires a wheat-free diet due to a previous life-threatening anaphylactic reaction.

What preparations are needed for Mildred's surgery, and who is responsible for them?

Preparations for Mildred's surgery include marking the affected side, ensuring she is fasting, dressed in a theater gown, catheterized, and has a consent form signed. The nursing staff and anesthetist are responsible for these preparations.