As a clinical requirement for my Adult 1: Medical-Surgical course, I had the opportunity to observe a patient in the Operating Room and in the Post Anesthesia Unit of Advocate Good Samaritan Hospital. The procedure that I observed was a left total knee replacement. The patient needed this surgery because she was experiencing osteoarthritis, and this surgery could alleviate her pain and discomfort. I was with the patient from the end of her stay in the pre-operative holding area to the Operating Room, and then to the Post Anesthesia Care Unit. This paper will include background inquiry, preoperative and operative
Improving the quality of discharge planning in acute care include addressing the lack of appropriate staff and patient education about appropriate planning for discharge (4). This includes implementing proper discharge teaching regarding signs and symptoms to seek medical attention, management and care of medical equipment, and access to community resources (4, 5). Other challenges are patients with complex comorbidities too difficult to discharge as well as lack of community supports and equipment for newly discharge patients and lack of rehabilitation and nursing home beds (4). Consequently, acute care units are pressured to vacate hospital beds in response to the growing elderly population. Hospital professionals tend to focus discharge teaching and preparation on medical areas such as diet, activity, treatments, and medications (5). Community referrals to appropriate services at the time of hospital discharge does not often happen contributing to poorer patient outcomes and re-hospitalizations
To effectively manage the discharge of individuals and transfer of care between settings, the social service team at UPMC-MDU start early to anticipate problems and discuss barriers and reoccurring traumatic events, but most importantly, patients and multidisciplinary team, via daily meeting, are involved at all stages of the discharge planning and medical treatment process. Considering this process and significance to employ a person-in-environment approach, I have become more aware of the need for skillful care coordination to achieve the most successful clinical and
Standard 16 of the American Nurses Association (ANA) Scope and Standards Practice, directs nurse leaders to advocate not only for patients but for all members of our healthcare community. As a discharge planner, I am in a unique position to advocate not only for patients but for caregivers as well. As part of my responsibilities, I participate in daily multi-disciplinary team rounds. The meetings take place so that all disciplines can openly discuss patient care needs. They provide the perfect opportunity for anyone to bring to light problems or concerns.
The multidisciplinary team (MDT) meeting that the author attended was regarding Laura 's case, a 62 year old lady that lives alone and had a fall followed by knee surgery at her right leg which now needed rehabilitation. Laura also has Hypertension, arthritis and recently diagnosed with Parkinson which are managed with medication. In the MDT attended Laura and her daughter, the physiotherapist, occupational therapist, the nurse and the author as a
This case study is about a patient, T.C., who I treated while a physical therapy assistant at an acute rehabilitation hospital. T.C. had terminal spinal cancer and at the time of admission had a fair prognosis to maintain function and strength enough to be discharged to his daughter’s home with home health care and family support, and he wanted to eventually go back to his own apartment. He was using a wheelchair as he was partially paralyzed from the waist down, and was able to use a transfer board to transfer from his wheelchair to bed and back.
The team will navigate patients through the program, resources and pulmonary rehabilitation. The registered nurse will meet with the patient prior to discharge to evaluate and refer them to the appropriate services along with the social worker, which may find alternative way to pay for patients medication and other support services that may be offered. The nurse practitioner and the respiratory therapist will see the patient within 48 of hours upon admission into program. The nurse practitioner and respiratory therapist will evaluate the needs at home and enroll the patient in pulmonary rehabilitation, which will be part of the care offered to all patients. Resources for the patient will consist of a 24-hour hotline for patients who may need to seek medical advice prior to going to the emergency room. Patient will be supplied with emergency medications for home use if symptoms begin to appear. A nurse practitioner will be available to advice the patient in intervention with the emergency medications is indicated and advice if treatment may need to be continued in the emergency room. With the protocols in place for medications, the patient will be seen within 12 hours if use of the emergency medications were taken in the home. The nurse practitioner will update the electronic medical chart of the patient to document
The AICU is full and the discharge planner is under pressure from his supervisor to free up beds, which are needed for other critical patients (Belhaven University, 2015). The hospital’s business office requests if the patient can be discharged from AICU due to the cost being the responsibility of the hospital, in the amount of $9,000 per day, or if the family will agree to disconnect the ventilator. Unfortunately, “the attending physician is new on the
The Nurse Practitioners, Physican Assistants, Case Managers, and if needed Physicans involved with the insurance companies and/or prescribing alterative medications that will be covered by insurance prior to discharge.
It is always important to consider what will happen to this patient after they are discharged. Is the patient capable of attending to their own activities of daily living unassisted? Will this patient require long term care? Has the patient any family or friends willing to assist the patient at home? Will the patient require a home help service and if so can they afford it? Does
OT and OTAs will collaborate in writing a discharge plan for the client. The OT will re-evaluate and finalize the client’s treatment goals, and treatment progress to verify if the treatment goals have met. It is the OTs’ responsibility to provide an in depth evaluation of the client’s occupation status. The discharge plan will include the date and goals are expected, purpose of the referral, summary of the client’s condition, a comparison of the initial evaluations findings to the outcome findings, intervention plans, intervention implementations, and outcomes. OTAs can contribute into the discharge plan by providing the intervention outcomes about how well were the client’s performances, and the effectiveness of therapy. OTAs can also help
Mrs Smith, 5 days prior to visiting hospital tripped and fell, her injury’s prevented her from standing up. At hospital she was diagnosed with a left fractured neck of the femur (L NOF) and required an immediate left total hip replacement surgery. Mrs Smith is 85 years old, lives with her husband at home, has no children however has a strong social support network through her church. She is involved in her community and continues to teach piano. Mrs Smith only known medicine issue is urinary incontinence. 10 days’ post-surgery Mrs Smith developed a urinary tract infection increasing her length of stay in the hospital. This led to the diagnosis of delirium, worsening of her continence issues impacting negatively on her mental health. This has resulted in slow progress in mobility and delay of her rehabilitation plan. Mrs Smith’s anxiety levels are heightened as she is fearful of falling again and is concerned whether she will be able to return home as her mother passed away shortly after she broke her hip. This case study will examine if Mrs Smith will be able to return home with an effective management & discharge plan based on a multidisciplinary team using a person centred approach. The treatment plan will endeavour to assist Mrs Smith to return home. A full health, coordination and function analysis is scheduled to assess to identify any underlying medical condition and possible risk factors for further falls.
Using the seven key principles of the hospital discharge process devised by the Department of Health (DH, 2003), this case study will critically analyse the process of an elderly patient who was discharged from a local acute trust. It begins by providing a definition of discharge planning, before providing a brief biography of the patient, including a rationale of why this patient was selected, details of her past medical history, reason for current admission, any issues raised and details of any care provided. Throughout this case study, in accordance with the Nursing and Midwifery Council (NMC, 2008) and the Data Protection Act (1998), the patient shall be referred to as Mrs. Blue to maintain anonymity. Although the
Discharge Planning – Patients who require continuing care after release from the hospital are identified and the appropriate services are arranged through participating home care, medical equipment and other providers.