SIMULATION FOR CLINICAL EXCELLENCE IN NURSING SERVICES

1. Welcome To
Simulations for Clinical Excellence
in Nursing Services
SCENS

2. SCENS

3. Learning Objectives
1. Demonstrate appropriate infection control measures when caring for the
patient with hepatitis C
2. Perform a focused abdominal assessment
3. Demonstrate appropriate steps required to obtain and handle lab
specimens
4. Communicate effectively when performing an abdominal assessment and
obtaining lab specimens for the patient with hepatitis C
SCENS

4. Why?
• Overall statistics
• Statistics for Veterans
• VHA Directive 1300.01
–VHA Viral Hepatitis Program
–https://www.hepatitis.va.gov
• National Patient Safety Goals
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5. Hepatitis C
• Most common bloodborne infection in the United States
• Transmission
• Infection control practices
• Centers for Disease Control and Prevention (CDC)
• Standard Precautions
–Hand hygiene
–Personal protective equipment
–Safe injection practices
–Appropriate aseptic techniques
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6. Complication of Hepatitis C
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• Cirrhosis
–Ascites
•Albumin production
•Drop in hydrostatic pressure
• Assessment
–Respiratory status
–Fluid wave
–Abdominal girth
–Daily weights

7. Abdominal Assessment
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• Inspection
• Auscultation
• Palpation
• Percussion

8. Specimen Collection
• Orders
• Scope of practice
• Patient identification
• Equipment
• Hand hygiene
• PPE
• Joint Commission
requirements
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• Labeling of the specimen
• Packaging
• Delivery of the specimen
• Follow-up to ensure the
specimen was received
• Who is ultimately
responsible?
• Safety measures

9. Potential Issues
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• Psychosocial
• Equipment or supplies
• Positioning of the patient
• Difficulty obtaining the
specimen

10. Summary
1. Reviewed appropriate infection control measures when caring for the
patient with hepatitis C
2. Performed a focused abdominal assessment
3. Demonstrated appropriate steps required to obtain and handle lab
specimens
4. Discussed communication when performing an abdominal assessment and
obtaining lab specimens for the patient with hepatitis C
SCENS

11. SCENS

12. Kenneth Green
Sixty five (65) year-old male with a history of Hepatitis C presents with
complaints of abdominal discomfort (3/10 scale) for three (3) days and
unintentional twenty (20) pound weight loss. He has a history of alcohol (ETOH)
abuse and has been refusing to take his medication. He was admitted with
ascites, weight loss, and malnutrition.
Gastrointestinal: Abdominal
Assessment and Labs
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Past Medical History:
• Hepatitis C, alcohol (ETOH) abuse, and benign
prostatic hypertrophy (BPH)
Past Surgical History:
• Transurethral Resection of the prostate (TURP)
Medications:
• Ledispavir 90mg/Sofosbuvir
400mg daily
Allergies:
• Penicillin