Patient Handover and Instructions
Dylan Reeves is 45 years old. Dylan is a type 1 diabetic on regular insulin with periods of poor control and a history of diabetic leg ulcers. Dylan has had a couple of episodes of DKA but no other medical history and has no allergies. Dylan has been admitted to the medical ward from his doctors medical practice after feeling unwell with a fever, rigors, fatigue, and a purulent leg ulcer, being a regular patient at the hospital with diabetes and associated complications. Dylan was admitted for IV fluids and IV Ceftriaxone for suspected sepsis from the leg ulcer. He is on the sepsis pathway. Please review Dylan’s notes from the time of his admission below.
OSCE Autofail re-assessment Dylan Reeves
In your OSCE you initiated the wrong calling criteria for Dylan Reeves. Your calling criteria (Clinical Review or Rapid Response) should be based on assessments of Dylan Reeves that you documented on the NSW Health Standard Adult Observation Chart and the instructions on the chart which come from the Clinical Excellence Commission’s Between the Flags program.
Task
There are 2 parts to this task you must address (800-1000 words):
1) Reflect on and discuss why you selected the wrong calling criteria (or did not make a call at all).
2) Outline and discuss which calling criteria is correct for Dylan Reeves and provide a rationale and discussion on reasons for the call. Your discussion and rational should identify and link Dylan Reeves signs of deterioration to his presenting problem and the Clinical Emergency Response System (CERS).