BRIEF HISTORY: This 40-year-old Latin female was admitted for low back and right lower extremity symptoms. She had been suffering from intermittent low back pain dating back to an MVA several years ago. In December of last year she started a job where she was doing a lot of heavy lifting. Shortly after that she began experiencing pain in her back and right leg. CT scan was done that showed questionable disk bulging. This was followed by a myelogram that showed no definite defect. However, repeat CT showed marked compression at the L4-5 level. Some ligamentum flavum prominence and low-grade disk bulging. On May 27, the patient underwent a lumbar diskectomy at L5-S1 on the right side and a disk herniation was identified at the time of surgery. Postoperatively the patient had resolution of her low back pain and right leg symptoms and was doing reasonably well at the time of discharge. She remained afebrile throughout her hospital course. Her incision was healing nicely and she was ambulating without difficulty.…
The patient’s discharge plan was determined before she was even admitted to the hospital for this most recent surgery, since she came directly from LTACH. Those involved in deciding her plan of care upon discharge included the LTACH Liaison, Kathleen Diehl, as well as her physician Dr. Miller, her surgeon, Dr. Knoll, the wound nurses and the floor nurses. The medical team is coordinated by the Case Manager on the Surg-Ortho unit and the LTACH Liaison. According to Kim Cruz, the Admissions Coordinator at LTACH, typically the patient’s nurse or doctor will refer the patient to the LTACH Liaison, who will then interview the patient and review their records to determine if they meet the criteria for admission to LTACH, which is…
The purpose of this assignment is to outline a plan of care for three residents, who, for the purpose of confidentiality within this report, will be referred to as L, J, and F, from the start of my shift at 0645 hours until lunch is served at 1200 hours. The time line will also include all work breaks taken, so as to be as accurate as possible. The work plan will include descriptions of how the comfort and dignity of each resident was upheld while care was provided as well as the safety practices associated with each activity. In addition, before the order of care for L, J, and F is described, I will include a brief overview of each client's significant individual care requirements.…
The term constructive discharge is by definition when an employee feels they are forced to resign their job because the employer has made working conditions unbearable (Doyle,2013). In the circumstance presented, the employee felt compelled to resign because the work schedule was changed and would require him to work on his religious holy day. The business changed the production team schedule to accommodate growth and expansion, changing the schedule from 8:00am-5:00pm, Monday thru Friday, to four twelve hour shifts. The employees would rotate four days on and four…
In case management, there is always a point of time where the case should be evaluated for termination. The case manager should make that determination properly based on the standards and rules of case closure. The guidelines are not always the same. They are determined by the type of case and the circumstance at hand. They are also determined by the settings of the case management and others who are a part of the situation to make the most of an optimistic client outcome.…
the client and his counselor met for his 1x1 session to discuss the six components of his treatment plan and to dress any issues with client reaching his treatment goals. The client at this time has been in compliance with this treatment goals. (legal)The client is working towards getting his license back, being a support to his mother while she goes to court to custody of his daughter. The client reported that he will seek custody of his daughter in future when he is stable enough to take care of her. Client reported that he still has plans on going to sober living . The client at this time appears to serious about getting clean and sober. The counselor will meet with client next week to complete his discharge planning…
visit. Patients need to be instructed when to call their provider after being discharged from the…
Discuss strategies to support and empower the patient living with a long term condition (LTC) and their significant others when planning their discharge from hospital.…
A discharge teaching plan is classified as a tool created for the patient’s specific discharge needs when looking at both their strengths and deficits holistically (Berman & Snyder, 2012). Specifically, it incorporates education and instruction in terms of levels of wellness, decreasing risk factors, and overall participating in preventative measures.…
The process of ACP is a reflection of society’s desire to respect personal autonomy. The content of any discussion should be determined by the individual concerned. The individual may not wish to confront future issues; this should be respected…
Discharge from the hospital is the point at which a patient leaves the hospital and returns home or is transferred to a rehabilitation facility or a nursing home. The discharge process typically centers on the specific medical instructions which will encourage the healing process necessary for a full recovery by the patient. The planning process or discharge planning is also a service which fully integrates the recovering patient’s needs just after the hospital stay. In many instances, the discharge plan may includes ancillary services such as visiting nursing care, out patient physical therapy, home blood drawing, or even neuropathy observation. (Forster, 2003)…
(Maramba et al., 2004). However, current trends in healthcare indicate higher acuity patients in hospitals for shorter amounts of time and being released to home or community care sooner than ever before. Inadequate discharge planning is contributing to readmissions, inadequate follow up after discharge and lack of preparation for self-care after discharge because of insufficient patient education. (Maramba et al., 2004). Jack (2009), found that patients who have a clear understanding of their after-hospital care instructions are 30% less likely to be readmitted or visit the emergency department. Interceding to thwart preventable readmissions will aide to ease the stress on an already overburdened healthcare system as well as to reduce and save health care expenditures. Maloney found that “patients discharged with unmet needs are at a higher risk for posthospital complications, readmissions, and decreased satisfaction with care.” (Maloney et al.,…
Failure to safely and appropriately discharge patients from the hospital is placing patients at risk, not to mention the increase costs to hospitals, providers, and insurers. Many acknowledge that the hospital discharge is non-standardized, unsystematic, and fragmented process (Anthony, Chetty, Kartha, McKenna, DePaoli, & Jack, 2005; Minott, 2008). Furthermore, the inefficiencies in the discharge planning process have also shown to have life-threatening implications, especially in association with Adverse Drug Events (ADEs) (Forster, Murff, Peterson, et al., 2003). It has also been recognized that ADEs are also a result of medication non adherence (----) and medication non adherence may be correlated to a harried discharge process…
Mrs Singh has recently had major surgery and the meeting is aimed at organising a discharge package for Mrs Singh.…
It is essential to ascertain the guesstimate length of stay required. An uncomplicated surgery will obviously require a shorter term residency than more complex medical matters. Understanding assists in the decision making, consideration that facilities are different in the fact that some offer both types of care, whereas others specialize in exclusive care. Intermittently family members do not have the time, nor feel comfortable venturing out, for an official visit to one or more rehabilitation centers before the patient is released from the hospital. It is appropriate to ask to see the patient rooms, common living spaces and privacy that the residents have. Does the patient prefer to be in a private room, or more social feeling additional comfort appreciating the companionship of sharing a room is influential during their recovery? Social functions such as access to religious services and entertainment help make their time away from home easier to adapt Many times, family is troubled about their loved one’s health, forgetting that nutrition is critical as well. Asking to see the menus and dining options along with the types of foods served will assist in reassuring that the patient will be provided with food choices they are accustomed, and will eat. The concept of short term care is to have the patient return home;…