Discharge Plan for Patient before Vacating from the Hospital - Essay Example

DISCHARGE AND PLANNING due: This essay will discuss and create a personal discharge plan forMr. Brown before vacating from the hospital. The objective is to attain enhanced patient health outcome at minimal costs (Mclaughlin & Bulla 2010, P.140). The discharge and planning will comprise of care management appropriate for this particular patient and his caregivers. In addition, the members of the nursing team that will give care to Mr. Brown while at after discharge will be included. Definition of key terms used in the essay: Hypertension refers to a chronic illness that is manifested by raised blood pressure level. Ischemic heart disease means deficient in blood. Discharge planning defined as a process of change from one environment to another. Multidisciplinary team that refers to a group of professionals with various medicine background. From Mr Brown’s medical history, he suffers from ischemic heart disease and hypertension. He was admitted to the ward due to chest pain which is an indication of complete or partial disruption of arterial blood flow to the myocardium (Dowd 2007, p. 251). Mr. Brown will use an informal care package. The informal care package depends on informal care providers as the givers of important support such as personal assistance, nursing and help with daily chores (Da Roit 2010, p. 83). In this kind of a care package, the family members play the biggest role in taking care of the patient. Mr. Brown will depend on his two children living nearby for care, who will be assisted by supplementary informal assistants. The social services and paid assistants can complement the informal assistants. The ischemia heart disease package of care is the most appropriate for Mr. Brown’s case. The package of care states that efficient intervention and prevention strategies rely on the Maslow’s hierarchy of needs and basic care needs. The Maslow’s hierarchy of needs includes pain relief, social support, sleep, nutrition, hydration and oxygenation. Also, the Maslow’s needs include prevention of adverse medical response, environmental comfort and cognitive stimulation. The best management package for Mr. Brown will comprise of control of the hypertension to avoid pressure overload on the ventricle (Henein 2010, p.10). The antihypertensive medication is the correct treatment for hypertension. In addition, the chest pain and shortness of breath will be managed to minimise the occurrences of heart attacks and pain management. The patient will be given assistance to be able to participate in hobbies as a way of exercise (NHS Choices 2014, para 18). Discharge planning is the component of continuity of care procedure that is created to prepare the patient for the nest level of care. It also helps in making the significant plans for the care whether it may be care by an organised health care provider, self-care or care by family. The discharge planning is an affair involving different disciplines collaborating to make easy the change from one habitat to another (Pudner 2005, p.118).The objectives of discharge planning are as follows: Ensure accomplishment of sufficient planning for the individual’s release to the suitable care setting. Ensure that appropriate provisions are in place for continued care. Oversee correct use of hospital facilities is attained to ensure the patients remain in the hospital for medical reasons. Ensure that the client obtains the medically necessary care. The recovery goals are set with anticipated time frame for completion as part of the patient’s plan of care. The patient’s goals include maintaining stable vital signs, relaxed body posture and live painfree. On discharge, the patient is expected to present normal pulmonary and cardiac function, hemodynamic stability and no signs of uncontrolled arrhythmias. In this case, the discharge planning is complex because the client has compound needs and, therefore, requires collaboration with different professionals to assist in organising the discharge. According to the professional code of conduct, the healthcare professionals should listen and respond to the preferences and needs of patients under their care (Aldridge & Wanless 2012, p.269).Through communication, the nurse can to recognize the patient’s wants and tastes. For better results, follow-up strategies are created to assess the results of the discharge planning. There various aspects that should be put in consideration when making the discharge planning. In this particular case, factors such as the likelihood of unfavourable drug reactions and medication errors are some of the challenges faced by old people with long term conditions. In addition, unplanned hospital admission and polypharmacy also affect the old patients. For effective discharge planning, it is paramount to consider information such as transportation and financial obstacles to receiving medication. The patient should be aware of follow-up care needed and be in a position to travel to appointments. The finances are essential in enabling the patient to acquire medical supplies and drugs. In addition, the current functional, employment and marital status are essential elements in discharge planning. It is crucial to review the caregiver’s and patient’s comprehension of the illness and the care needed. In addition, the patient and the caregiver should understand the tests that were carried out and the results. Furthermore, the care providers and the patient should know the necessary steps in case of problems. On this point, they should comprehend the situations that require immediate observation. The degree of comfort, knowledge and skills of the caregiver is significant. Moreover, it is crucial to recognise the community resources available that could help the caregiver and the patient (Eliopoulos 2014, p. 306). The multidisciplinary team comprises of the occupational therapist, social worker, hospital nurse, heart failure specialist, palliative care specialist, patient, discharge planning team and family. For efficient heart failure management, good communication and collaboration of the team members is necessary. The figure below illustrates a model of integrated heart failure service: Fig 1: Integrated heart failure service model Source: MCDONAGH, T. A. (2011). Oxford textbook of heart failure. Oxford, Oxford University Press. The heart failure specialist plays the role of a consultant in rehabilitation (Mcdonagh 2011, p.565). The nurses in the community and ward act as the receivers and finishers of the discharge checklist. In addition, the nurses make sure various services are in place before the patient leave the hospital. The commitment of the occupational therapist is to examine the patient’s capability to survive his home environment after discharge from hospital. Putting into consideration the fact that Mr. Brown has lost weight in the last few months; a dietician will form part of the medical team. The function of the dietician is to give information and advice on diet modification to enhance the standard of life and maintain health. The palliative care specialist assists the patient with end-of-life concerns. In reference to the patient’s age, Mr. Brown is categorised as old, and his social needs are critical. The social worker is liable for assessing the patient’s social needs because he lives alone. The hospital nurse is in charge of educating the patient as well as the family on the best way to provide care. It is important in the management of chronic heart failure where oxygen should be administered early through mask. Moreover, the patient and the family should know the preventive approaches that can minimise symptoms and risk of death, for instance, operations that result in cardiac decompensation. These activities include certain drugs, excessive alcohol intake and dietary information about salt. It is vital to avoid readmission to the hospital because if cardiac decompensation occurs, it can only be managed in a health facility setting. The patient together with the caregiver is given information about how to use weight and blood measuring devices (Shils 2005, p.1110). In addition, the hospital nurse educates the individual according to the information contained in the discharge plan during his stay in hospital. Moreover, the nurse reviews the learning given, provides prescriptions and advices the patient to follow-up the appointment made by the doctor (Timby 2009, p.169).Moreover, the pharmacists are included as part of the care providers. The pharmacist task is to review the present symptoms and medical regimen. It enables the pharmacist to recommend alterations in pharmacotherapy to the cardiologist in-charge. In addition, the pharmacist can give patient education and follow-up the patient through telephone to pinpoint new signs. Likewise, the pharmacist recognises the side effects and boost education fundamentals. The pharmacist makes sure the medicines are given the correct dosages through accounting for comorbid conditions. Furthermore, the pharmacist assesses the patient’s reaction to treatment and concomitant drugs. The pharmacist checks the pharmacodynamics interactions since the patients suffering from heart failure are treated using many drugs with homogenous pharmacodynamics impacts(OConnor, Stough, Gheorghiad & Adams 2005. p.529). There is proof that multidisciplinary team minimises anguish triggered by under-coordination, therefore, is the best approach to managing Mr. Brown’s case. The strongest evidence available shows that team-based models give greater value enhancement compared to nurse-based models. In addition, multidisciplinary teams for patients suffering from heart failure, patient caregiver education and providing follow-up with heart failure specialist nurses give better results. Moreover, it is successful in some discharge planning schedules with aid for older patients suffering from congestive heart failure. In addition, in the case of transitional care model for older patients having complex needs being discharged from the hospital promotes health and fewer hospital admissions (Øvretveit 2009, p.7). The creation of individualised discharge plan for Mr. Brown three days before leaving the hospital for home consists of the following steps: The findings upon admission. Pre-admission examination. Inpatient examination and arrangement of discharge strategy grounded on the patient’s needs. Execution of the discharge plan that is in accordance with the assessment. It needs documentation of the discharge procedure and monitoring (Lees 2011, p.114). The table 2 below shows the needs of Mr. Brown, who suffers from ischemic heart disease. Ischemic heart disease Evaluation Intervention Patient assessment Medical history Ischemia heart disease Hypertension Coronary artery bypass Physical examination Fatigue Shortness of breath Chest pain Nutrition counselling Examine eating habits Receive an estimate of daily food intake Recommend diet adjustments. Counsel and educate family and the patient. Make an individualised plan. Weight Management Measure height, circumference and weight to get the body mass index. If the patient has MBI >25, there is a need for long-term and short-term weight goals. The creation of integrated behavioural, diet and exercise plan. Exercise training Get an exercise test Creation of a documented personal exercise measures for aerobic resistant training. Psychological management Employ interview measurement devices to recognize psychological anguish. Create supportive rehabilitation surrounding to promote social support. Give personal counselling and education. Collaborate with suitable mental health professional. Discharge therapy Examine the necessary long-term treatment using ACE inhibitors, aspirin and beta blockers. Observe dosage adjustments and contraindications for example kidney function. Lipid management Acquire fasting quantity of total cholesterol TG, HDL and LDL. The lipid profile should be repeated 4-6 weeks after admission and two months after a change in treatment. Add drug therapy until: TG35mg/dl (1.0mmol/l) LDL Read More