Discharge planning is a type of assessment which determines what a patients needs are in terms of a recovery plan once a patient has been discharged home or to another facility depending on the plans that have been made with the patient or their family (Lin et al 2012, p. 237). Discharge planning also known as transitional care should start from the admission phase of healthcare delivery but this does not always happen as sometimes the patient information cannot always be obtained (Wepfer 2014, p. 13).
This paper will focus on the patient of Mrs. Green who is returning home from hospital. The aim of this paper is to identify any information within the case that will act as a barrier or limitation which will affect her transitional care which
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Green is a 78 year old female who lives on her own in a single story home in South Australia, (School of Nursing & Midwifery 2014). She is retired and is a widow, she has two children and five grandchildren, who whilst they are supportive, live quite a distance so can only visit on the weekends and she has a pet dog called Matilda which keeps her company (School of Nursing & Midwifery 2014). She does not drive and relies on her children or taxi services; she has a private cleaner once a week and utilizes a Webster pack for her medication needs (School of Nursing & Midwifery 2014). Her medical history include gastrointestinal reflux disease (GORD), osteoarthritis (OA), type 2 diabetes mellitus (T2DM) which is diet controlled, hypertension, high body mass index (BMI), hypercholesterolemia and was a former smoker (School of Nursing & Midwifery 2014).
Mrs. Green was admitted to hospital as she was experiencing chest pain that was continuous for around 10 minutes. During her admission in the emergency department she had a 12 lead Electro-cardiogram (ECG) which indicated that she was having a ST Elevation myocardial infarction (STEMI) (School of Nursing & Midwifery 2014). Mrs. Green was then taken to have a percutaneous transluminal angioplasty which stents were placed, that was completed using a femoral approach and then was transferred to the cardiac care ward and is planned to be discharged the next day (School of Nursing & Midwifery
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Green’s day of discharge she had visits from various healthcare professionals to see how she is going post her percutaneous coronary angiogram, she was seen by the cardiac care team, the cardiologist, the cardiac rehabilitation nurse and also the physiotherapist (School of Nursing and Midwifery 2014). Prior to Mrs. Green being discharged she was educated on the cardiac rehabilitation program and was given follow up appointments with the multidisciplinary team and was given a referral to her general practitioner to monitor her medications and review her recovery, she was then due to be discharged at 1100hrs (School of Nursing and Midwifery 2014). When looking into Mrs. Greens case world there were no other further referrals made for her, she would have benefited from having a referral for the physiotherapist or the occupational therapist as she is living independently at home alone. One of the main roles of the occupational therapist is to help with mobility aids which will assist in her decreased mobility function (Gonda & Hales 2012, p. 116). Not referring to the occupational therapist could have come down to not having the time as she was only in hospital for 24 hours or that the healthcare professional; did not feel that Mrs. Green needed to be seen by the occupational
Cynthia Adae was taken to Clinton Memorial Hospital on June 28, 2006. She was taken to the hospital with back and chest pain. A doctor concluded that she was at high risk for acute coronary syndrome. She was transferred to the Clinton Memorial hospital emergency room. She reported to have pain for two or three weeks and that the pain started in her back or her chest. The pain sometimes increased with heavy breathing and sometimes radiated down her left arm. Cynthia said she had a high fever of 103 to 104 degrees. When she was in the emergency room her temperature was 99.3, she had a heart rate of 140, but her blood
At the multidisciplinary meeting, the nurse will collect and assess the information provided by the other disciplines and family members stating that the patient is not at her prior level of functioning and then analyze the information to develop a diagnosis of deconditioning. Next, the nurse identifies outcomes for the patient to get stronger, achieve prior level of function, have activities of daily living (ADL’s) met in a safe environment by planning for home health, equipment, and 24/7 supervision through family or placement in a facility. This will be implemented by coordinating delivery of a walker and a 3 in 1 chair prior to discharge to daughter’s home with the home health agency nurse, physical therapist, and aide scheduled to start that day. In a week, the nurse evaluates that outcomes are being met by following up with patient, daughter, and home health agency evaluating that the patient is getting stronger, ADL’s are being met, and will soon be able to return to living independently. To achieve these standards of practice, every nurse should be aware of her own nurse practice act to ensure to be functioning with in the laws of the nurse’s state and to ensure the best outcomes and safety of the patients. In closing, it is every nurses duty to be the best nurse they are capable of being by looking at the scope of nursing practice which gives us the framework to achieve
Carole noticed while in the tertiary care how the staff seemed to be overworked. She also felt that they did not talk to each other and when they did, she felt left out and her opinions were not considered. Her primary care physician was not informed of Carol’s progress, neither did she know about any post-stroke support. Physiotherapy waiting list was extremely long. On multiple occasions she could not tell her care providers about each other for fear of repercussions. This eventually led to two uncoordinated treatment plans, as they “were not funded” to talk to each other.
setting and as the patient returns to their home and community. The goal by all involved is to move the patient towards
Patient’s experience with the healthcare team to the standards of patient centered care, there are some parallels and differences. In Barry and Edgman-Levitan’s text Shared Decision making: The Pinnacle of Patient Centered Care, it explained how the patient centered care is divided into three broad areas. One of the areas discussed about information, communication and education. It stated that “Adequate information must be shared with the patients and this would include clinical management…This is very relevant in understanding the concept of self-care and individual health promotion..” Barry& Edgman-Levitan (2012). In Ms. Patient’s case, the doctor was able to explain thoroughly to the patient and her parents about her current health condition and idea of scoliosis so the patient can have a better idea about self-care while reassuring her parents. Therefore, the doctor successfully shared adequate information about the patient’s condition so she can better understand how to manage herself effectively. Another example from one of the broad areas was idea of integration and coordination of care, “patients feel vulnerable when they are faced with illnesses and they feel the need for competent and caring healthcare personnel.” Barry& Edgman-Levitan (2012). In this case, both the doctor and the nurse proved themselves as part of a caring healthcare personnel when they tried to have a casual conversation with the patient in the beginning and asking her
“We can’t turn away from a patient’s pain just because it’s difficult” (chapman, 2015, p. 88). I know the path of least resistance is taking a path of ignorance. Easy, is to ignore or neglect the true pain patients experience in times of crisis. As caregivers I believe we all want to heal others or we wouldn’t be in the field of nursing, but there are only handfuls willing to be present during the healing process because sharing one’s pain hurts. As a surgical nurse, I find being genuinely present takes hard work on my behalf, not only mentally but emotionally. On a unit where patient’s needs and conditions are changing at astonishing rates, being present requires mental strength in order slow down enough to recognize the value presence
Coronary artery bypass graft surgery is a procedure that can be life-saving for patients with heart disease, but it also carries risks after the procedure that can impact patient outcomes negatively. Because over 395,000 Americans have CABG surgery each year, and the risk-adjusted mortality rate for patients is 2%, according to Centers for Disease Control (CDC) statistics, health care professionals must find ways of reducing risks and complications to improve the outcomes for many patients (Ferguson, 2012). Heart disease is often comorbid with other conditions, like lung disease, peripheral arterial disease, hypertension, and diabetes, which can raise the risk of complications (Ferguson, 2012; Nejati-Namin, Ataie-Jafari, Amirkalali, Hosseini, Sheik Hathollahi, & Najafi, 2013). Complications that can arise following surgery include atrial fibrillation, prolonged inflammatory reactions, a build up of fluid near the heart, accelerated atherosclerosis, and nearby vein or artery blockage (Gokalp, Ilhan, Gurbuz, Cetin, Kocaman, Erdogan, & … Satiroglu, 2013; Ferguson, 2012; Scheiber-Camoretti, Mehrotra, Ling, Raman, Beshai, & Bowman, 2013; Sicaja, Starcevic, Sebetic, Raguz, & Vuksanovic, 2013). These complications can lead to increased lengths of stay, increased readmission rates, risk of further complications, failure of the bypass graft, cognitive dysfunction and memory loss, patient suffering, and even death (Ferguson, 2012; Gokalp et al., 2013; Sicaja et al., 2013). In turn, nurses, other care providers, and institutions may face negative consequences themselves, including a risk of lawsuits, increased employee workload, higher per-patient costs, reduced or withheld private insurance, Medicaid, and Medicare reimbursements, auditing...
Morgan began to explain the roles and responsibilities of a Case Manager. There are three Case managers that work together on a unit to take care of things such as insurance issues as well as discharge planning. However, the main focus is discharge planning. Discharge planning is the action of figuring out what needs to happen for the patient to leave the hospital safely. This includes DME, or durable medical equipment, like walkers, bedside commodes, hospital beds, and suction equipment.
al., 2010, p. 103-104). In medicine, beneficence is the foundation of every encounter a clinician has with their patient, they are there to help alleviate symptoms and diseases in order to do good for them. In the case of Ms. R, respecting her decision to live alone will violate this premise of beneficence and go against all the medical advice she has been given. However, like with all decisions in medicine, a patient is presented with options and if the patient is mentally capable of making their own healthcare decisions, their decision should be respected no matter what it is. Nonetheless, just because Ms. R made a decision to live alone and accepts her potential risks, doesn’t mean that her daughter along with the medical team should let her put herself in harm 's way. There are other means of beneficence and nonmaleficence in this case that can be achieved while still respecting Ms. R’s autonomy. Firstly, Ms. R’s daughter can move in with her and be by her side everyday, or if she cannot move in, she can come visit her mom on the days the home health aid is not scheduled, that way someone will be always there to monitor her. Additionally, due to Ms. R’s increased risk of falling along with her other medical risks, the social working can help arrange for Ms. R to receive a
...ital if you have symptoms such as dizziness, fatigue, chest pain, or heartburn it is essential that you get to a hospital immediately, just to make sure that you can get the treatment that you need so you and your family do not have to experience a myocardial infraction. Even though coronary artery disease usually affects persons over age 60, the disease can still be seen in people who are much younger for various reasons. The diagnosis of coronary artery disease remains the number one cause of hospitalization and death in the adult population in the United States today, but with the proper treatments, knowing the risk factors of coronary artery disease and medical technology such as stents, coronary endocartomy, and coronary bypass grafting that we have available to us today the prognosis can be positive for many patients and will save more lives than not knowing.
When working with Mrs. Browning who is an elderly woman we need to take into account social policies that affect her welfare such as her housing, health care and support services. Whilst conducting her assessment we need to become aware if her housing situation stable, if she is aware of the health care system and what she can access and most importantly the support
influences discharge planning (Jette et al., 2014a). An adequate discharge planning improves the efficiency of care and reduces costs by transitioning patients, in a timely manner, to the next appropriate level of care (Jette et al., 2014a). According to Jette et al. (2014a), to reduce delays in discharge from the expensive
Therefore, she may find it harder than most of the population to transition into the role of the patient and rely on others to make clinical judgements to promote and protect her recovery. Moreover, she was in a lot of physical pain, with her right leg in a full cast, causing her to be at bed rest. This I believe, as well as the patient being more aware of the inner workings of the hospital compared to other patients without a medical background, may of contributed to her ill ease and need to feel in control of her nursing care, over that of her care plan set by the
At the beginning of the summer of 2014, my mother became tragically ill after a hectic emergency room visit. Afterwards, extensive testing revealed that she had several serious medical conditions including atrial fibrillation, mitral valve disease ,and congestive heart failure. After her stay in the hospital, she was sent home with new medications and assured that her conditions could be easily managed. A short amount
Finally the evaluation involved reviewing the care plan by checking if the patient’s condition has improved, goals achieved and interventions applied successfully (Alfaro-LeFevre, 2010). The issues highlighted in the previous stages made it difficult to assess the effectiveness of Jane’s nursing interventions and the achievement of goals as the criteria was unclear. Despite this, all three care needs had either shown signs of improvement and/or not deteriorated further. The patient also expressed that the care plan had working effectively for her because she felt involved in the process as the orthopaedic consultant and nurses talked to her on a daily basis and that it was addressing her needs. To support this Kitwood, (2007) states that it is ultimately the patient who will say if the care plan has met their needs effectively