CASE HISTORY
Stephanie was a bright seven-year-old girl who came to her rural Manitoba hospital for a tonsillectomy.She was a little scared,but her mother was with her and she liked the surgeon,Dr.Ryan,and his funny Winnie-the-Pooh ties.Sometimes she would even grab his tie while Dr.Ryan was examining her.However,she did not much like the IV catheter Dr.Ryan had to insert in her arm.It hurt a little,but she was brave and did not cry much.The surgery went well and Stephanie was recovering in her hospital room a few hours later.However,that night the nurse noted her temperature had risen to 102°F.By the next day,Stephanie's heart was racing and her breathing was labored.She was rushed to the pediatric intensive care unit and empiric antibiotic therapy was initiated.Despite this treatment,her blood pressure began to fall.Stephanie was diagnosed with postsurgical septic shock.To everyone's horror,Stephanie died two days later of MRSA sepsis.The organism recovered from her blood was a MRSA strain identical to one causing a wound infection in a 57-year-old man two floors down.
Discuss at least three key measures implemented in health care settings that are designed to prevent transmission of infectious diseases in health care environments,and offer a scenario that reveals how a breach in these procedures could have led to Stephanie's tragic death.
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