Hospitalized Patient

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

Nearing the end of my shift in the Emergency Department, I was requested to accompany a patient while the nurse readied the discharge papers. Upon entering the bay, I met a very small and fragile patient who was anxious to go home. Conflicted between my primary duties and responsibilities to complete training for two inexperienced volunteers, I decided to put forth my interests in teaching by demonstrating compassionate care to my trainees. Although the patient repeatedly refused my assistance, I gave my best effort to calm her as I cloaked a warm blanket around her. As I listened to her confide in me of all of her hospital anxieties, I was shocked from the lack of quality care she had received which made her feel more sick after the first

Every one of us has relied on a medical professional at least a few times in our lives. When we get seriously ill, or suffer a serious injury, we put our health in the hands of doctors, nurses, and pharmacists, fully expecting to be treated with a certain degree of professionalism and safety. Unfortunately, sometimes the expected care is not given, or not given to the extent which the ailment requires. In these situations, we can feel blindsided, confused, even taken advantage of.

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

We know that he had sustained an at home fall. We learn that he has a history of pain and a prescription for oxycodone for back pain. We know that his vital signs on admission appear stable; he was not showing any signs of respiratory distress. As we look at the staff that was listed that day we do get the sense the hospital may have been short staffed. Staffing report shows there was one MD, one RN and one LPN managing at least 4 patients including- one patient was a child. Evidence based research has proven that the nurse to patient ratio is directly related to the patient outcomes (Stanton, 2004). It is important that we consider the staffing level that this rural ED as we know short staffing can be blamed for not being able to take the full amount of time needed to do a proper health history. A detailed health history is an imperative part of the care process; it is used by the staff to accurately assess any acute changes that may take place in the patient throughout their stay.

Ineffective discharge teaching often leads to unnecessary admissions to the hospital resulting in negative patient outcomes and decreased patient satisfaction. This negatively impacts the well-being of the patient and creates a financial burden on institutions. As a result, this universal practice issue requires a call to action on the part of the nursing profession. Nurses can proactively assist in assuring incidents of readmission do not occur. Nurses as educators play a critical role in the successful transition of patients from hospital to home. The overall goal of discharge education is to ensure there is an exchange of critical information between the patient and nurse in which plans of care are understood and followed. The research

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.

Within this case study I am going to use two of the Chapelhow et al. (2005) enablers to discuss and reflect on the care of a patient I have been involved with on placement over a period of 5 weeks. ‘Enablers are the essential and underpinning skills that come together to provide expert professional practice’ (Chapelhow, C et al. 2005, p.2). These include; assessment, communication, documentation, risk, professional decision making and managing uncertainty. The enablers work together to provide a holistic approach to the care of patients in health care settings. I am going to focus on and discuss two of the enablers, linking them both together, which will be assessment and communication as I believe these two enablers can be related most to my patient.

Meanwhile, elsewhere in Habersham County, Tom was feeling slightly nervous as he exited the staff lounge and entered the hustle and bustle of County Hospital’s ER to begin his first shift as an RN. The first few hours of his shift passed slowly as Tom mostly checked vital signs and listened to patients complain about various aches, pains, coughs, and sniffles. He realized that the attending physician, Dr. Greene, who was rather “old school” in general about how he interacted with nursing staff, wanted to start him out slowly. Tom knew, though, that the paramedics could bring in a trauma patient at any time.

Fairley (2005) gives a consultant nurse’ perspective of a clinical role in critical care unit that has evolved as a central feature of all surgical high dependency units (SDHU) in large teaching hospital trusts. Advanced nursing practice is perceived not as the acquisition and application of technical procedures which are usually undertaken by doctors, but also an integration of medicine and nursing where holistic nursing assessment and symptom focused physical examination go hand in hand. Fairley presents a reflective account of practical problems encountered relating to role integration, professional autonomy, legal and consent issues, non-medical prescribing, and role evaluation (Fairley, 2005). The paper successfully describes a model of nursing applied to high dependency units integrating the role of the advanced nurse practitioner within the medical and clinical team an reflective practice plays an important role by being the main method of evaluation of a consultant nurse’ perspective. In a

African American male that is seen today for followup post hospital discharge. He is a 48-year-old gentleman with complicated cardiac history as well as neurological history including congestive heart failure. History of strokes 01/2017, possible sick sinus syndrome. He has an implanted pacemaker that was placed in 06/2017, as well as hypertension. He was taken to the Central Hospital on 09/01 with presentation of chest pain, noted to be around his pacemaker site. He identified being in seizure and suddenly felt chest pain with shortness of breath, and was offered nitro, he developed headaches and dyspnea post nitro treatment, of note is that the EKG that was obtained during that process, did not identify any pacemaker spike despite having a

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 goal of this assignment is to define the diverse forms of integrated care and to provide evidence on their impact both on the patient and also the future of the registered nurse. An integrated care pathway contains many elements in order to make it function. There must be a clear declaration of the aims, objectives and key elements of care founded by evidence, the best practice available and a consideration of patient expectations. The records, 24-hour care and assessment of changes and outcomes must be monitored. The assistance of communication, good organisation of people’s roles and sequencing the actions of the relatives, multidisciplinary team, and most importantly the patients. For an integrated care pathway to be truly multidisciplinary, it should never be developed by one staff group. At the outset, all staff groups involved in the patient journey should be identified. A typical working group should include doctors, nurses and allied health professionals, with input from administrative and managerial staff where it is necessary. If the pathway exceeds boundaries of care, such as, discharging patients to services outside the hospital or healthcare setting, reps of these groups should be involved with their integrated care plan. It is the integration of health care, social care, and other external agencies such as voluntary groups and private sectors that impact on the patients care and health professional’s quality of care giving. It does not need all

Analyzing the journey of a hospitalized patient is imperative in nursing practice in order to produce holistic, strengths based care (Gottlieb, 2014). When examining the patient and his or her journey, it is crucial for the nurse to explore many factors including the patient’s personal history leading up to admission, the unique and individualized care plan, impacting strengths and gaps within the healthcare system, as well as the factors affecting discharge care and planning. For the purpose of this paper, a patient by the name of Anna will be explored in order to highlight essential aspects associated with providing holistic care.

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