Early Ambulation Accelerate Recovery Essay

The aim of this assignment is to critically discuss the nursing assessment individualised care and nursing interventions of the acutely ill patient. The patient discussed developed severe sepsis due to a urinary tract infection and her condition deteriorated during the recovery process in the nurse’s care. Lovick (2009) defines sepsis ‘as a known or suspected infection accompanied by evidence of two or more of the SIRS criteria’. SIRS is outlined as a ‘systemic inflammatory response’ consisting of two or more of the following symptoms ‘temperature >38 degrees Celsius or 90 beats per minute, respiratory rates greater than 20 breaths per minute and white blood count higher than 12,000 cells per microliter or lower than 4000 cells per

Jones has set, he is having trouble with his own health management as he recovers post-surgery. The Occupational Therapy Practice Framework defines health management as “developing, managing, and maintaining routines for health and wellness promotion” (AOTA, 2014, p. S19). Maintaining proper health management is a crucial occupation as Mr. Jones recovers from his surgery. To improve his health post-surgery, the surgeon has required Mr. Jones to abide by his hip precautions and avoid putting any weight on his right leg. Mr. Jones seems to have trouble understanding the importance of the hip precautions because he is so eager to return to full function. The use of a health-related quality of life assessment tool, the SF-36, will evaluate his quality of life despite his operation (Smith, Johnson, Ballantyne, Dunstan, & Brenkel, 2012). SF-36 will provide insight to how Mr. Jones feels regarding his health and further explore how I can help him understand and apply his hip precautions. Per Smith, et al., (2012), The SF-36 is a “36-item questionnaire that produces scores in eight domains relating to health-related quality of life” (p. 2). The eight domains include physical function, physical role, body pain, general health, emotional vitality, social functioning, emotional role, and mental health. (Smith, et al., 2012). By interpreting Mr. Jones health-related quality of life based on these eight domains, I can better understand how he rates his current condition and how his total hip replacement has affected his health and health management qualities. I can then develop strategies prioritizing health management. Including methods to secure compliance with his hip precautions to assure he has a full recovery and can quickly return to his

Mrs. Pink, aged 75 was admitted to the orthopaedic ward after suffering a fall at home, resulting in an intracapsular fracture of the hip at the femoral neck. Mrs. Pink has a history of cancer and cardiac diseases and has severe rheumatoid arthritis. Due to ageing patients putting a great deal of strain on the health care system, the incidences of hip fractures in the elderly are a major concern and requires careful consideration regarding treatment. Known as a major cause of disability in the elderly, hip fractures and their subsequent need for surgery result in chronic pain and an altered quality of life (Strike, Sieber, Gottschalk & Mears, 2013). Although important to improve a patient’s quality of life and physical independence, pain related to a total hip replacement (THR), also known as hip arthroplasty (HA) can lead to delays in ambulation, longer hospital stays, poor functional outcomes and quality of life. The purpose of this essay is to identify the rationale behind nursing interventions provided to post-operative THR patients as well as the pathology of a femoral neck hip fracture and their procedure for assessment and diagnosis.

Bachelor’s prepared nurses are better equipped to make clinical decision more effectively and efficiently.  Nurses have to make clinical decisions all the time to improve a client’s health and to maintain wellness. For example, it is the nurse who usually takes immediate action when a client's clinical condition deteriorates, who decides if a client is experiencing complications that warrant notification of the physician.   A nurse must be able to think critically, solve problems and find the best solution for client's need to assist clients in maintaining or improving their health. For instance, if an elderly patient status post hip replacement, bed-bound complains of pain in the affected leg and swelling, an ADN prepared nurse might carry out the order for pain management and will elevate the leg to subside swelling. On the other hand, a baccalaureate prepared nurse will critically think about the potential complication status post hip replacement surgery and will take the clinical manifestation of swelling of the leg might be secondary to DVT and will notify the Medical Provider immediately in order to prevent complication.  “Research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels” Rosseter (2012)

The agenda was quite clear that during their observations the recovery showed needs were decreased according to age and BMI. They stated older patients were in need of more assistance and longer stay in the hospital as opposed to younger adults. I found it interesting that they saw patients with bilateral knees had decreased needs and that unilateral were in need of more assistance before discharge. Managing pain was their first priority during research and rehabilitation, followed by instructing care of their own surgical wound. The aim of this study was to actively reinforce assessment and management after this procedure and giving guidance to those in health care.

Multiple studies demonstrate a relationship between lower patient-to-nurse ratios and improved patient outcomes (Garrett, 2008; Penoyer, 2010; Unruh, 2008). Patient outcomes addressed in the various studies included falls, infections, length of stay, mortality, patient safety, patient satisfaction, postoperative complications, pressure ulcers, quality of care and unplanned extubation with reintubation. A 2004 report from the Agency for Healthcare Research and Quality (AHRQ) stated that adverse events can increase the cost of a total treatment by 84%, length of stay by 5.1 to 5.4 days and probability of death by 4.67% to 5.5% (Garrett, 2008).

GDT has been found to be the pillar upon which the Enhanced Recovery after Surgery (ERAS) program is built upon. The downside of this technique is that it does not work well for bedside applications and most specialists do not allow the use of this method on a day-to-day basis. In the past few years, the use of GDT policies has been suggested as an important part of the ERAS package. The main concept of this plan is to have a myriad of solutions that will automatically lead to a better result in magnitude (Trinooson & Gold, 2013). Most of the studies, however have analyzed the effect and impact of implementation of the ERAS program. With regards to this shortcoming, it can be conclusively said that the outcome of using GDT mediation cannot be seen

The National Institute of Nursing Research (NINR) has conducted a series of studies that involved several groups of individuals who suffered from chronic conditions such as diabetes, high blood pressure, cardiovascular disease, and pain, as well as behavioral issues. These studies have also included transitional care; especially post-surgical care for the elderly. A report titled “Changing Practice, Changing Lives” that was published by the NINR and the National Institute of Health (NIH) includes a list of ten landmark nursing studies (Web. ninr.nih.gov, 2016). These studies were primarily focused on educating the population on how to cope with different health issues, and especially how to manage

Hip fractures are one of the most common causes of extended hospital stay among the

On April 11, 2014, I had the privilege of direct observation of a patient’s orthopedic surgery, from the pre-operative to post-operative setting. The patient with the initials N.R, which we will call Mrs. R, arrived to the hospital just prior to 6:30a.m. As the name implies, Mrs. R was a female patient, 76 years old with an admitting diagnosis of right hip osteoarthritis. Due to arthritis in her hip, Mrs. R’s ability to perform daily activities and participate in hobbies such as dancing has been extremely compromised over the last 2 years. The overall goal of Mrs. R’s surgery

An analysis put out by The Journal of American Medical Association (JAMA) presented some overwhelming statistical results concerning patient mortality. The research subjects were post operative surgical patients. The results implicated a seven percent increased risk of patient mortality for every additional patient added to a patient load of four, which resulted in an increased risk of five deaths per 1,000 patients (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002). For the purpose of putting these hypothetical statistics into perspective, analytical statistics from another portion of the JAMA article showed a data set from results obtained in 168 different hospitals in Pennsylvania. The patient characteristics were similar to the previous results. A mean nurse to patient ratio ranged from between 4:1 to 8:1(Aiken et al., 2002). The mortality rate results were 4,535 patients out of the sample size selected of 232,342 surgical patients (Aiken et al., 2002). These patients either died during their hospital stay from preventable complications or within thirty days of their discharge. These complications would likely have been avoided with an adequate staffing level.

It is a challenge to manage pain in older adults. The course of action, effect and

Most hospitals, medical practices across the United States are transitioning to electronic health care record system to improve quality measures and manage the number of patients they can generate, retrieve, and accumulate. However, the ambulatory care providers usually don’t use EHR technology to the full extent of its power because it associates barriers that stand in the way of changing medical practices. In this case, the EHR will also examine some of the advantages and disadvantages while medical practitioners make their decision. In ambulatory care, there are many advantages of using electronic medical records, such as increasing the cyber security level and privacy safety, eliminating medical errors, and improving the quality of care.

You'll be in pain after your knee surgery, and you'll probably be sent home on pain medications to keep you comfortable. If the medications make you groggy, you may develop irregular sleeping patterns that interfere with taking other medications on schedule. If you need to take antibiotics or medications for a condition such as diabetes or high blood pressure, you need to take the drugs on time. A home health nurse or aide will make sure you take your medications on time. He or she can also supervise your medications to make sure you take the right dosage since you may have fuzzy thinking due to pain and narcotic medications.

Teaching the importance of activity and exercise has a huge significance to the patient especially she undergone surgery, left knee arthroplasty. Lack of adequate knee exercise after surgery will lead to various complications that are dangerous and life threatening such as deep vein thrombosis, stroke and pulmonary embolism. Another complication that is associated with inadequate movement of the limbs and extremities is muscle contracture (LeMone et.al, 2011 p 142). Patient has a high risk of developing these complications. We wanted to educate the patient about these so that we could lower her risk at some point. We believe that even when patient is lying down on the bed, she can do a lot of things to improved her health and prevent