The patient may need assistance caring for himself following discharge from the hospital. The daughter lives too far to assist her father on a daily basis. The case worker needs to determine how much the daughter is willing to assist her father during the transition. The daughter may be willing to become her father’s caregiver during the initial recovery period. She would also be a good support system by providing medication reminders, encouraging medication compliance, dietary restriction compliance and promoting positive health behaviors. Another barrier is the client’s willingness to make the changes that will have a positive effect on his health outcome. The nurses and community case workers can provide all the necessary information, but the client has to be willing to accept the assistance. The best way to affect a positive lifestyle change is to encourage the client to take small steps toward the desired change. For example, the client needs to weigh himself daily and record the information, so a scale is provided and he agrees to record his weight twice a week. As this positive behavior change becomes a habit, them it could evolve into recording this information daily. Question # 3- Care Coordination Care coordination will be essential to help maintain the health of the client. Care coordination is the process that transpires between …show more content…
A transitional care nurse or nurse navigator could be utilized to assure a smooth transition from the hospital into the community. The nurse navigator bridges the gap between the hospital care and post-acute care, while working closely with hospital staff, primary care doctors, specialists and community resources (Lamb, 2014, p. 191). Following the client’s discharge, a home health nurse would assume care and begin coordinating services. This nurse would be responsible to assure that all the care services are in place and there is a smooth
Weighing the situation outcomes, it would be best of Reba put her father in a nursing home. It goes against her beliefs, but it saves a lot of time and commitment she is not capable of taking on. She would not have to remodel her home, quit her job, or go against her husband’s wishes. It would allow her father to receive the proper he deserves. She could visit as often as she wanted and would not have to stress about her capability to take care of him. After all, it is also what the physician recommended.
setting and as the patient returns to their home and community. The goal by all involved is to move the patient towards
This section discusses health psychology and behavioral medicine, making positive life changes, resources for effective life change, controlling stress, behaving, and your good life. Health psychology emphasizes psychology’s role in establishing and maintaining health and preventing and treating illness. It reflects the belief that lifestyle choices, behaviors, and psychological characteristics can play important roles in health. The mind is responsible for much of what happens in the body, it is not the only factor, the body may influence the mind as well. Making positive life changes include health behaviors- practices that have an impact on physical well being. The stages of change model describes the process by which individuals give up bad habits and adopt healthier lifestyles. The model has five stages: precontemplation, contemplation, preparation/ determination, action/ willpower, and
Discharge planning nurses achieve this move through the collection and organisation of patient data from various health professionals who treated the patient prior to and during the hospital stay. This data is used to establish the patient’s ‘baseline’ or personal average health level, and which services are needed after discharge to return the patient to this level (Holand, 2016). This could be a transition into a nursing home or rehabilitation facility, the establishment of home nursing or carer services or physiotherapy, social work, dietetics and occupational therapy professionals through
In this event, the matter that is unusual can be the fact that I have experienced and witnessed the process for interprofessional collaboration between the community nurse and other professionals that I have never knew about before. This event made me realize that there are many aspects of community nursing that I have knew about before where in this situation it is the importance and accountability of interprofessional collaboration. From my nursing theory course I have learned that interprofessional collaboration is when the nurse forms relationships with other professionals that enable them to achieve a common goal to deliver care and strengthen the health system and clients involved in it. (Betker & Bewich, 2012, p.30) In this event, our mutual goal is to provide the appropriate care for the patients/residents so they can restore their health after their hip or knee surgery. In the nursing leadership and management textbook it stated “interprofessional practice removes the gatekeeper and allows client access to all caregivers based on expertise needed.” (Kelly & Crawford, 2013, p.35) In this event, my preceptor and I gained knowledge about Revera and will pass on this information to patients who are interested in staying at a retirement home after they discharge from the hospital. One literature talked about how according to the Institute of Medicine, it is critical to have the capacity to work together as part of the interdisciplinary team to assist in delivering high quality, patient-centered care. In addition, effective collaboration among health care professionals results in improved patient care and outcomes. (Wellmon, Gilin, Knauss & Linn, 2012) This indicates the importance of interprofessional collaboration to provide...
This definition provides a goal for teams to strive for and outlines the important outcomes of high quality interprofessional collaboration. Highlighted in this definition is the need for participation and on-going collaboration and communication among caregivers who are focused on provision of seamless care. According to the WHO Study Group on Interprofessional Education and Collaborative Practice, (2008), collaboration is “an active and on-going partnership, often between people from diverse backgrounds, who work together
This section discusses the results identified within the literature in relation nurses’ shift to shift clinical handover. It should be noted that this section is rather presenting themes that were identified in the literature either explicitly as evidence emerging directions for future activity and/or research. The section begins with an introduction of major contents, followed by a presentation of key issues and results reported in the reviewed literatures relating to each of these elements. The section ends with a recommendation that presents a structured and constructive gaps to be exploited in the future research as well elements to be implanted to better the nursing practice with regard to shift handovers.
Consulting for the Caring Angel Hospital Working in the health care industry takes a lot of courage and patience in order to deal with different individual’s personalities and to be equipped to handle stressful situations according to the issues at hand. As a senior consultant at the Practical Health Care Consulting firm, my supervisor has instructed me to spend three months at the Caring Angel Hospital. While at the hospital there are a few tasks for improving the quality of care, adding value to the organization, improving employee morale, etc. Although these obstacles will be a challenge, there is an opportunity for improvement. This will allow the Caring Angel Hospital to increase revenue and accomplish the goals that are established.
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
The health care provider should ensure that they communicate effectively with the patient/client.
In my current position as the Senior Social Worker / Acting Caregiver Support Coordinator, I am tasked with completing initial assessments that determine whether or not Veterans and their identified Caregivers meet criteria for the stipend program. For those Veterans already in our program with Caregivers who receive stipends, I focus on determining whether or not they continue to meet criteria for the program and if the level of care provided by the Caregiver has changed or remains the same. Each assessment requires me to engage the Veteran, Caregiver, treatment team members, and reviewing the medical record before finalizing a decision. These Veterans have a variety of service connected disabilities and diagnoses requiring them to be assisted
Doctors who work at physical therapy clinics consistently encourage their patients to complete their therapy so that they can heal—although physicians may push their patient to move towards a healthier life, it does not mean that the patient will be open to suggestion; it would be up to the patient to truly decide to motivate themselves towards a healthier lifestyle—and until that happens the main service that a physical therapist can provide includes: education on lifestyle choices, and the consequence for each choice—how therapy can help the patient/how the therapy suits their needs, and how to set up a cost effective way to complete therapy.
1. Studies have shown that “individuals who have fallen have three times the risk of
A nurse who is advocating for their client needs to plan for or take into consideration assistive and transportation options available to the client. This is also information that is needed to be provided not only to the client but also to family members of concern. The information obtained through this experience can be used to better understand the great bounds the elderly have to take just to continue everyday
In conclusion, community resources are a valuable asset to any town. The family nurse is an extremely essential liaison between the community, family, and medical providers. It is important to educate the population on services available to them. A nurse can help by participating in local screenings, educating the municipality, and making appropriate referrals. Being involved in the community will strengthen the nurse’s knowledge, and give an understanding to their patient’s needs.