The Nurses ' Decision And The Factors That Go Into Ambulating Older Clients During Hospitalization

By definition the term progressive mobility means a “series of planned movements in a sequential manner beginning at a patient’s current mobility status with a goal of returning to his/her baseline” (Vollman, 2010). Much simpler explained it means for us nurses to get our patients moving. Challenging nurses to use the patient’s current musculoskeletal abilities and help them progress towards their old or new individual baseline has many benefits other than the building of physical strength. This brief summary will explore the purpose, benefits, costs and target population involved in a progressive mobility project in the Intensive Care Unit including the basis upon which the program will be evaluated. Progressive Mobility benefits the

The majority of the meting was focused on the care transitions program presentation and discussion. The presenters lay out was familiar as it was a community nursing care plan that included identifying, assessing, diagnosing, implementing, and evaluating the project she presented. The other members had a lot of questions about the process and a lot of time was spent on the social determinants of health. The presentation relied heavily on the in home part of the process and a nurse present on the board or for the presentation would have helped to connect the story for these patients in both settings. It was discussed that the elderly are a particularly vulnerable population during times of transition and that this program might help to bridge the vulnerabilities.

The nurse is challenged with the care of patients over a lifespan. Each stage of life brings its own physical and emotional changes which directs the care needs. The care needs of the pediatric patient will be much different from the needs of the geriatric population. The geriatric population has very specific needs which has prompted the government to establish the Quality Assurance & Performance Improvement (QAPI) program. The QAPI provides the framework for nursing facilities to develop and implement changes which address deficiencies the facility was found to have. Also, the QAPI program requires practices and policy be put in place to monitor care of the residents. The purpose of this paper is to list some of the changes the elderly go through as they age, and demonstrate these changes in a quality improvement project. After review of literature, I will discuss the challenges, barriers, and solutions as related to quality improvement. Lastly, I will discuss the quality of care for the geriatric in the future.

The purpose of this essay is to discuss the care given to a stroke patient with complex care needs in a community setting. A critical analysis of the nurse’s role in care delivery will be explored. This essay will focus on three key aspects of care, which are mobility, nutrition, and cognitive impairment and a rationale for the chosen needs will be given. The author will evaluate and analyse the chosen nursing care approach utilised and its effectiveness in facilitating the care given. A discussion of the psychological, physiological, and social factors influencing the patients’ needs will follow. Furthermore, the author will identify and explore on health promotion needs relating to the patient. Issues related to Inter-professional working

An elder lives a healthier, active, and stable life when provided proper care. There are many physical and psychological changes occur during the process of aging. Sally Mae Fischer is an elderly individual, living alone and has chronic and acute health issues. This paper will identify, prioritize, and describe four problems, provide assessment data, nursing interventions, and rationale for the interventions. A nurse to patient script will also be provided detailing patient teaching and follow up.

The purpose of this paper is to discuss the challenges in providing quality care to the elderly. I will conduct an evidenced-based literature review addressing quality improvement initiatives and programs for older adults. Following the literature review, I will describe barriers and solutions of quality programs and initiatives for older adults. Lastly, I will identify the future impact on nursing care of older adults resulting from this experience.

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

There are many issues to be considered carefully when planning the nursing care for the older population especially due to changes over time in beliefs, principles and values. This is why it is essential to treat each and every patient individually to provide them with the best care possible and to offer them every support in improving their quality of life.

The population for the research was two postoperative orthopedic units with 29 beds each (Tucker et al., 2012). Nursing staff provided care for the patient with total joint replacement, adult reconstructive surgery, and orthopedic oncology (Tucker et al., 2012). Patient care was directed, planned, delivered, and evaluated by registered nurses only. Data collection was through nurse’s documentation. The SNRI interventions included offering toileting assistance, assessing and addressing patient comfort and position, placing call light Kleenex, water, remote, and garbage can within patient reach. Prior leaving, they would ask the patient if they needed any help, inform the patient that nursing staff will be back, and emphasized the willingness of the staff to respond rather than the patient try to ambulate unassisted (Tucker et al., 2012). To determine the effectiveness of SNRIs there were variables that were examined patient fall rates, patient fall risk, and nursing SNRIs fidelity. The research was approved by the Institutional Review Board for the protection of human subjects. Nurses were allowed to review medical record for fall-related data, participate in the SNRI implementation, and attend focus groups with the study nurses (Tucker et al., 2012).

Older adults with multiple chronic end-stage diseases and comorbidities are a population who are at high risk for suffering gaps in care when transitioning from acute care to skilled facilities and home. The typical process of care transition presents certain gaps: among them a lack of coordination of care that erects barriers to the delivery of high-quality care. Patients residing in skilled nursing facilities (SNFs) have a high risk of poor outcomes owing to changes in setting and providers. Other risk factors include age, dependency, frailty, socioeconomic challenges, and caregiver's level of education (Coleman, 2003; Coleman, Min, Chomiak, & Kramer, 2004). The transition from hospital to SNF is a journey through a revolving

Care Transition Experiences of Spousal Caregivers: From a Geriatric Rehabilitation Unit to Home is a study aimed at looking at transitions of care when an elderly couple is faced with one spouse requiring care post discharge from an acute rehabilitative care setting. “Spouses, more than any other caregiver, are likely to provide care during periods of disability and illness, and are likely to continue to do so even as their own health declines” (Polit & Beck, 2014, p. 158). In keeping with the approach of patient and family centered care, there is a need to look not just at the needs of the patient, but the needs of the family support system and the impact illness has on the entire family unit. Illness and the effect it has on the health and well-being of a patients loved one or spouse can directly impact how well they maneuver through the period post serious health event and the journey back to baseline or wellness. In persons of advanced age, this can have additional considerations such as, the health and well-being of the caregiver and their ability to care for themselves, let alone their spouses. There may also be the added burden of dealing with such comorbidities of dementia or delirium related to the effects of illness or medication, which is not uncommon with a patient over the age of 70 years. “Transitional care is

The ambulation of hospitalized patients is very pertinent to alleviating many cases of impaired mobility and also greater lengths of hospital stays for patients in Intensive and Intermediate Care settings. This study was done in attempts to understand and determine the importance of implementing a nurse based mobility protocol, to increase the percentage of patients being able to ambulate during the first 72 hours of their hospital stay. This experiment was carried out in a large community hospital, using patients from a 16-bed adult medical/surgical intensive care unit and a 26-bed adult intermediate care unit. Guided by the nursing assessment of mobility potential, a mobility order set was developed and implemented on each unit. Depending on the assessment, nurses were able to get a second opinion by consulting an occupational therapist or physical therapist. Daily reports were collected to determine each patient’s ambulatory needs and status compared to their activity levels. “The results after this 6 month study showed the importance of implementing mobility. Prior to implementation 6.2% (12 of 193) of the ICU patients and 15.5 (54 of 349) of IMCU patients, ambulated during the first 72 hours of their hospitalization. After implementation there were great improvement in mobility to 20.2% (86 of 426) and 71.8% (257 of 358), respectively” (Drolet, 2013, p.1).

Being in a hospital is strenuous on anyone and without the proper support systems in place; it could potentially worsen their condition. With enjoying the ability to be active in my life, I do yearn for those years where I could travel without the weight of my health being on my shoulders. That is why, I am delighted at the fact that physiotherapists can come in to help with muscle strengthening and getting me back to a state that perhaps I will be able to do yoga again, or sit long enough to finish a puzzle. I truly value the time that I spend meeting people in my care center, and without being able to be active, I do believe that my motivation to participate in the most basic activities would decline. Access to

As our nation’s elderly population continues to live longer, advanced practice nurses will provide primary care for many of these individuals for years to come. Chronically ill elderly patients often have multiple comorbidities that affect their quality of life. Eventually many of these patients experience a decline in their physical or cognitive functioning that requires around the clock assistance and nursing care provided by a long term care facility. When the transition to a facility occurs, the patient often experiences a loss which can have a negative effect on the patient’s psychological status. “For many people a lack of control over their lives and loss of independence are the inevitable (or perceived) consequence of ageing and of

In this essay I will discuss theoretical principals of rehabilitation of a particular patient I cared for while on clinical placement. It will focus on the role of the multidisciplinary team involved in this rehabilitation process post acute myocardial infarction and the education and support given to the patient and her family during the discharge planning process. Also I will be including statistics and evidence of pathophysiology. The National Service Framework for Older People (Department of Health, 2001) sets out eight standards including standard three about intermediate care services that promote independence and provide effective rehabilitation services. Active rehabilitation is seen to reduce the risks of hospital readmission,