Site Evaluation

For this rotation I had both a mid-rotation site evaluation and an end of rotation site evaluation. Similar to my previous site evaluations I prepared 3 H&Ps and a journal article to discuss over those two meetings. Writing the H&Ps for this rotation was a little different than writing for the emergency room. This is because I had spent much more time with these patients and was able to include more information regarding their social history, family history and past medical history.

For the first site evaluation I presented a patient who presented with classic UTI symptoms. She had malodorous urine and dysuria. Additionally, she mentioned that she’s previously had UTIs and this is how they always presented. After doing an in-office urine dip stick we saw it was a clear UTI. During the meeting I was asked why we did not do a pelvic exam being that the patient presented with urinary complaints. That is not something that the doctor thought was indicated, but it did make me think that maybe in the future that should be done. The doctor also mentioned to the patient that she should drink a lot of water to prevent recurrent UTIs. This is what influenced one of my PICO assignments for the rotation in which I found that further research should be done but increased hydration seems to be safe, effective and cheap and should be encouraged.

For my second site evaluation I prepared an H&P on a patient with bedbug bites. She was a home health aid and her client had similar itchiness to her. We visualized several bug bites on her skin in characteristic bed bug fashion- in clusters. I chose to present this patient because I thought it was interesting and different than typical topics. I also wrote about a patient with a URI with a cough, sore throat etc. I chose to discuss a journal article which discussed the efficacy of honey for URIs. We discussed how over using antibiotics can lead to resistance and harm and how honey provides some sort of antimicrobial properties without the risks that antibiotics present.