This case study was made available to MIEC through our partnership with CRICO. It was written by Melissa DeMayo, CRICO Description Six days after his initial visit to Urgent Care for ear pain and facial paralysis—and after three CT scans—a 28-year-old man was diagnosed with bacterial meningitis. Key Lessons A patient’s return for care with worsening symptoms should trigger a diagnostic questioning protocol Fragmented patient care increases the need for concurrent communication among providers Clinical Sequence A 28-year-old man presented to Urgent Care with complaints of right ear pain and right-sided facial paralysis. At this visit, impacted ear wax was...
This case study was made available to MIEC through our partnership with CRICO. It was written by Lisa Heard, CRICO Description A patient suffers an infection when a biliary stent that should have been removed after three months is discovered still in place after 12 months. Key Lessons Determination among providers regarding accountability for patient follow-up is essential to prevent gaps in care. The discharging provider must have systems in place to confirm that the subsequent provider received information needed to accurately care for the patient. Information transfer involves physicians, nurses, care managers, office personnel, and information technology staff. Unresolved...
DEA Likely to Further Extend Flexibilities on Controlled Substances and Telehealth Prescribing Beyond 2024
During the first year of the COVID-19 pandemic, the provision of medical care through telehealth increased by 154%, and much of that increase occurred in behavioral health. This trend, combined with COVID risk mitigation strategies and temporary flexibilities in licensure and regulatory requirements, resulted in substantial growth in virtual-only medical practices. In the field of behavioral health, temporary flexibilities allowing telehealth-only prescribing of controlled substances has allowed these practices to flourish by allowing them to treat a full spectrum of conditions through remote-only care. However, as the COVID pandemic ended, an important question arose as to whether telehealth-only prescribing of...
This case study was made available to MIEC through our partnership with CRICO. It was written by Kathy Zigmont, CRICO Description A 74-year-old male undergoing a temporal artery biopsy suffered second-degree burns on his face when oxygen came into contact with the electrocautery device being used for the procedure. Key Lessons The risk of an operating room (OR) fire should be assessed in the holding area, as well as early in the time out checklist Implement standardized annual OR fire education for all team members Clinical Sequence A 74-year-old male with a history of right-sided neck pain and temporal headaches...
Fatal Injuries after Inadequate Wound Treatment and Documentation
This case study was made available to MIEC through our partnership with CRICO. It was written by Jennifer Clair MacCready, DNP, RN, AHCNS-BC, CRICO Description Poor documentation and inadequate wound treatment at a skilled nursing facility (SNF) contributed to an elderly patient’s death. Clinical Events A 75-year-old female with a medical history of peripheral vascular disease, hypertension, diabetes, and deep vein thrombosis was admitted to the hospital with an acute exacerbation of her chronic heart failure. Upon admission, the initial documentation stated the patient had a pressure ulcer on her coccyx that was later changed to “wound incontinence breakdown to...
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