Running head: CASE STUDY 1

Case Study Analysis and Write-Up

(Student)

DeVry University
CASE STUDY 2

Case Study Analysis and Write- Up

Introduction

The situation chosen is where an elderly male patient, Mr. Nathan is scheduled for a

prostatic surgery. However, prior to the surgery, he attempts to escape. First, she critically injured

a nurse who attempted to stop him but she was overcome by other hospital personnel and in the

process sustains bruises and abrasions. To his point of view, Mr. Nathan thinks that the hospital is

holding him as a prisoner and he had a right to leave. He later sued the hospital for not only false

imprisonment but also for aggravated assault.

Background Statement

The above context clearly shows that there are a series of problems involved. One most

the most critical problems relates to patient management. One of the major problems in this

scope is insufficient referral time. This entails ensuring that the patient under consideration is in

the best possible condition for surgery. This ought to start in the primary care. Prior to surgery,

physicians ought to evaluate the patient and identify whether he or she has other mental or

physical health complications and where they are identified, corrective measures should be

undertaken (Pudner, 2010).

Another issue pertaining to surgery patient management surrounds pre-operative

assessment. This is very fundamental as it helps in identifying risks, prior to any form of

operation. It ought to be performed by a competent and trained assessor, who has the ability to

order to perform investigations, and thereby making referrals in accordance with the local

guidelines. Following the gathering of the necessary information and ordering of tests, there is

need to examine the results prior to organizing admissions (Pudner, 2010). The process should

involve direct access to consultant anesthetics or other professionals, who are in a position to
CASE STUDY 3

examine the findings and decide the management plans necessary to optimize the patient’s

conditions.

However, other minor issues maybe involved in the case. For instance, the patient may be

in fear of being operated on. Even in cases where patients are in critical need of help, Buchbinder

and Shanks (2011) stated that he or she maybe inclined to escape due to the fear of the operation.

Besides this, before undergoing an operation, a person to be operated must give consent.

However, this depends on the state or the age of the patient. Where the patient is in critical

condition or is old, the family members may give consent on behalf.

Major Problem and Secondary Issues

Inferring from the context above, the major issues are centered on management of a

surgery patient prior to the surgery. There is a high possibility that the hospital failed to provide

Mr. Nathan with adequate referral time. Clearly, the patient had a mental problem considering

his behaviors before the surgery. He shoved the nurse away and when overpowered, he started

indicating that he was being imprisoned. If the hospital had provided a referral time, they would

have been able to identify the mental problem that Mr. Nathan had and undertake corrective

measures. The second major issue is that the hospital failed entirely in its pre-operative

assessment of Mr. Nathan. The hospital failed to conduct a pre-surgery care management on Mr.

Nathan in order to determine whether he was in a position to undergo the surgery. If this was

carried out, the risk of mental explosion could have been detected and thus provide more referral

time. Combined, the two patient-care management issues are the likely causes of the patient

developing a mental lapse.

The minor issues revealed include the fear of undergoing the surgery and consent. With

regard to the fear, the hospital would have taken the responsibility of preparing Mr. Nathan, both
CASE STUDY 4

psychologically and physically. The hospital would have made it a duty to relate to the patient

about the necessity of the operations. However, it did not do this sufficiently. The patient

attempting to escape might be because of psychological and physical unpreparedness. For issues

with consent form, it seems that the hospital failed to examine deep enough to determine whether

surgery consent would be drawn from the patient himself or from his family members.

Seemingly, Mr. Nathan was not too old to know what was going on. In this regard, the patient

had to believe that he was being held there without his will.

Your Role

To address the above problems, I would take the role of the hospital’s manager. The

manager provides the strategic direction of the hospital. In this regard, his or her decisions are

reflected in the operations of an institution. I would thereby conduct an overhaul of the hospital’s

strategy and instead implement one, which is detailed and directional. The chief advantage of

this role is that a person is able to overlook the operations of an institution and come up with a

change where things seem inappropriate. However, where such instances as suing as Mr. Nathan

is seeking occur, the manager is always sought for questioning. For instance, given the fact that

the hospital may be at fault and that Mr. Nathan’s claims may hold up in court, penalties will

probably be subjected to the manager.

Organizational Strengths and Weakness

The clear strength of the hospital is that it has the capacity to offer major surgical

operations. Additionally, the manner in which Mr. Nathan’s case was responded to, especially

with the physician giving the patient a sedative and ordering physical restraints, shows how the

hospital is prepared for contingencies. This was necessary as, according to Lubin, et al. (2001), it

treats mental and physical states of patients. However, looking it in a departmental perspective, it
CASE STUDY 5

follows that things are not right in the surgical department. The appropriate process and the most

essential and core operations are not prioritized. There seem not to be a clear direction on how

things should be carried out.

Alternatives and Recommended Solutions

For the primary issues, there is a need to harness adopt the acceptable surgical practices. As

identified, the operations at this department are unacceptable considering the normal surgical

patient care practice. If the right order of events prior and after surgery is followed, there is a

possibility of completing the surgery successfully. If nor followed, issues such as the one brought

about by Mr. Nathan are likely to arise and this is detrimental to the hospital.

For the secondary issues, as identified earlier, the hospital should be cultivate a culture of

preparing the surgery patients both mentally and physically. This should involve telling them of

the benefits of a successful operation. However, this depends with the condition of the patient.

For instance, for an unconscious person, there is no way that he or she could be prepared.

Evaluation and Conclusion

For the first solution, to know if the hospital has achieved the necessary outcomes, it

should identify another hospital undertaking similar operations and regard it as a benchmark. The

hospital should compare itself with that benchmark and identify if its operations are in line with

those of the other hospital. Where they are, then the solution would have been achieved. Where

there are still some deficiencies, then the solution would not have bore the expected outcomes.

For the second alternative, a patient accepting willingly to be operated on should be enough

to signify the achievement of the expected outcomes. By accepting surgery, a patient must have
CASE STUDY 6

been convinced that everything is being conducted with good will and for the best his or her best

interests.
CASE STUDY 7

References

Buchbinder, S. B. & Shanks, N. H. (2011). Introduction to Health Care Management. Sudbury,

MA: Jones & Bartlett Publishers.

Lubin, M. F. et al. (2001). Medical Management of the Surgical Patient: A Textbook of

Perioperative Medicine. Cambridge, UK: Cambridge University Press.

Pudner, R. (2010). Nursing the Surgical Patient. Amsterdam: Elsevier Health Sciences.