https://padlet.com/meu10/BreakoutGroup4 Facilitator: Dr. Lorna Simangan en-us 2022-05-31 08:48:20 UTC 2026-01-28 18:02:39 UTC hello@padlet.com https://padlet.net/icons/png/0034.png meu10 https://padlet.com/meu10/BreakoutGroup4/wish/2208703731 A 65-year-old man diagnosed with coronary artery disease had angioplasty 3 months prior, maintained on aspirin and clopidogrel. He began to complain of worsening low back pain the past month, recently accompanied by lower extremity weakness with no loss of bowel or bladder function.
Physical examination showed a marked decrease in the patient’s reflexes, strength, and sensation in both lower extremities. Magnetic resonance imaging of the lumbosacral spine demonstrated acute disc herniation and extrusion at L4–L5 with cranial disc migration resulting in severe central canal stenosis, and a significant mass effect on the right-sided nerve roots at the L4 level.
Based on these findings, the orthopedic surgery service recommended laminectomy, and referred patient for cardio-pulmonary clearance.  Teleconsult to cardiology service was done, and patient was advised to discontinue aspirin and clopidogrel 5 days prior to the procedure. Patient was assured that he would undergo pre-operative assessment once admitted.
2 days prior to the scheduled operation, patient told his bedside nurse that he looks forward to his operation to relieve him of his severe low back pain and is grateful to his family for their financial support. Nurse assured the patient that he is under the care of the best medical team and everything has been prepared. While doing the morning rounds a few hours prior to the procedure, the bedside nurse discovered that the patient took his aspirin prescription the day prior.]]> 2022-06-02 08:31:11 UTC https://padlet.com/meu10/BreakoutGroup4/wish/2208703731 https://padlet.com/meu10/BreakoutGroup4/wish/2209726435 Probability of bleeding with ASA intake perioperatively]]> 2022-06-03 03:14:20 UTC https://padlet.com/meu10/BreakoutGroup4/wish/2209726435 https://padlet.com/meu10/BreakoutGroup4/wish/2209726465 There is the possibility the patient will bleed during the procedure]]> 2022-06-03 03:14:23 UTC https://padlet.com/meu10/BreakoutGroup4/wish/2209726465 https://padlet.com/meu10/BreakoutGroup4/wish/2209726480 complain of worsening low back pain the past month]]> 2022-06-03 03:14:24 UTC https://padlet.com/meu10/BreakoutGroup4/wish/2209726480 simanganmlf https://padlet.com/meu10/BreakoutGroup4/wish/2209731582 Dr. Claire repetitive  service 
visual cues; psychological safety to nurses


]]> 2022-06-03 03:20:17 UTC https://padlet.com/meu10/BreakoutGroup4/wish/2209731582 simanganmlf https://padlet.com/meu10/BreakoutGroup4/wish/2209733975 Dr Leah - shared work and responsibility
collaborative work force - inter-professional system]]> 2022-06-03 03:23:15 UTC https://padlet.com/meu10/BreakoutGroup4/wish/2209733975 simanganmlf https://padlet.com/meu10/BreakoutGroup4/wish/2209734598 Joy - close monitoring]]> 2022-06-03 03:24:00 UTC https://padlet.com/meu10/BreakoutGroup4/wish/2209734598 simanganmlf https://padlet.com/meu10/BreakoutGroup4/wish/2209736185 fear    
poor communication
limitation on the patient (routine)]]> 2022-06-03 03:25:53 UTC https://padlet.com/meu10/BreakoutGroup4/wish/2209736185 simanganmlf https://padlet.com/meu10/BreakoutGroup4/wish/2209740820 Joy - safety measures; strict adherence to orders
Dr. Claire - system error - multi-factorial  problem 
to prevent - nurse would have different perspective
                      work load
to prevent - doctors - need to be explicit; clear orders
for this case - this is good patient divulged, so measures can be done
current - easier, more collaborative; family conferences

Dr. Leah - good if patient divulged;  it is so unfortunate if this was not disclosed and complications may happen
regarding order of stopping aspirin - medication should not be accessible to the patient]]> 2022-06-03 03:31:40 UTC https://padlet.com/meu10/BreakoutGroup4/wish/2209740820 simanganmlf https://padlet.com/meu10/BreakoutGroup4/wish/2209742708 Dr.Caire  - open communication
                   adherence to checklists/procedures
                   if non-adherence - find out why

Dr. Leah - open mindedness


]]> 2022-06-03 03:34:07 UTC https://padlet.com/meu10/BreakoutGroup4/wish/2209742708 https://padlet.com/meu10/BreakoutGroup4/wish/2209752745 The patient being able to take ASA while in admitted in the hospital despite orders to discontinue anti-platelets]]> 2022-06-03 03:47:45 UTC https://padlet.com/meu10/BreakoutGroup4/wish/2209752745