NRS-460 Benchmark – Case Study: Timothy Smith – Discharge Planning
Directions: Read the case study below. Evaluate the information and formulate a conclusion based on your evaluation. Complete the critical thinking table and submit the completed template to the assignment dropbox.
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the complex management of disease during the discharge of a patient, and the additional aspects of communication and safety in the work environment. The purpose of this assignment is to participate in discharge planning for a patient utilizing communication and information technology, and in a scenario where patient and provider safety is a concern.
PART I: Health History and Medical Information
Evaluate the health history and medical information for Timothy Smith, presented below.
Mr. Smith is ready to be discharged from the hospital. Timothy has been weaned off of oxygen. His tube feedings have been discontinued and he is tolerating a pureed diet. To facilitate safe discharge, the hospital case manager has set up services with a transitional care manager from a Home Health agency. The goal is for Mr. Smith to attain safe recovery and rehabilitation.
1. Broken left leg status
2. Weight bearing status: non-weight bearing, stand pivot with right leg only
a. Assistive devices: wheelchair
b. PICC line present for discharge
3. Left upper leg wound care: dressing changes as needed for open reduction internal fixation (ORIF) on leg
4. Psychiatrist telehealth follow-up scheduled for a Zoom call upon discharge
5. Telehealth follow-up visit scheduled two weeks after discharge with Primary Care Physician (PCP)
Lab Tests and Vitals
1. Room air, respiratory rate 16 breaths per minute
2. Vital signs are within normal limits
PART II: Critical Thinking Activity
Use the findings from your evaluation to complete the following:
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Home
Health Care and Rehabilitation Therapy
During care coordination
and transition of care planning, it is important to consider the type and
level of care a patient might need.
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You are the transitional
care manager assigned to Mr. Smith prior to discharge. Based on Mr. Smith’s assessment findings,
develop a discharge plan that encompasses his care needs following discharge.
Your response should be a minimum of 200 words.
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Discuss three to five
interdisciplinary roles that will be essential in supporting Mr. Smith’s home
health and rehabilitative care needs. Your response should be a minimum of 150 words.
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You are the home health
nurse assigned to treat Mr. Smith.
Identify two areas of concern that you might prioritize during your
initial visit with him following discharge. Your response should be a minimum of 150 words.
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Psychosocial
and Spiritual Considerations
Providing
holistic nursing care for patients with complex conditions requires that the
nurse takes into account the patient’s psychosocial and spiritual needs.
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Given the
patient’s current situation, discuss ways in which the nurse can take into
account and address the patient’s psychosocial and spiritual needs. Your
response should be a minimum of 150 words.
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Just
Culture
The patient is due to
receive his IV antibiotic prior to discharge. As the nurse reviews the electronic
orders, she notices that the antibiotic dose seems incorrect. Upon discussion
with the provider and pharmacy, it is determined the dose entered was incorrect.
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Discuss how reporting this
near miss will help contribute to a just culture reflecting civility and
respect. Your response should be a minimum of 200 words.
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Discuss how clinical
judgement and critical thinking should be applied despite the use of
information and communication technologies. Your response should be a minimum
of 150 words.
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Levels of
Risk
As Mr. Smith is waiting
for the nurse, he becomes impatient and starts to verbally attack the patient
care technician as she obtains his vital signs.
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Identify actual and
potential levels of risk to the care team within this situation given the
patient’s history of PTSD. Your response should be a minimum of 150 words.
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What can the nurse do to
diffuse this situation? What steps can be put in place to ensure safety for both
patients and providers in the future? Your response should be a minimum of
150 words.
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Patient
Portal
The nurse is helping Mr.
Smith log in to the Patient Portal (i.e. MyChart) before discharge.
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Explain the considerations
for ensuring the patient would be able to use this resource at home. In your
discussion include considerations related to the patient’s condition and
cognitive status based on his assessment findings and history of injury
reviewed in previous topics. Your response should be a minimum of 200 words.
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Discuss the benefits for
both the patient and the care team in using information and communication
technology to support the patient-provider relationship. Your response should
be a minimum of 150 words.
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What obstacles might
hinder his use of the Patient Portal? Your response should be a minimum of
150 words.
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Telehealth
Mr. Smith is scheduled for
a telehealth appointment with the psychiatrist upon discharge.
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Discuss the information
and resources that the nurse should ensure the patient has available in
preparation for his visit. Your response should be a minimum of 150 words.
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References
(Please include working hyperlinks.)
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