Upon Discharge To Home: A Case Study

This work has significance because staff and patient education can help prevent falls. Specific interventions decrease falls. Nurses have a responsibility to their patients and their facility to be competent and confident in their abilities to do all that they can to prevent falls. Facilities have the responsibility to provide the tools and the training that is required to carry out fall prevention

• Client will transfer from the bed to bathroom with minimal assist and 2 or less verbal cue for safety awareness by D/C. • Client A will use a Reacher to don and doff putting pants on with minimal assist with minimal trunk support. • Client will be able to identify and demonstrate three ways to cope with depression by D/C. • Client will perform UE stretching routine independently daily by D/C The activities that would benefit client A is balancing in parallel bars and wheelchair push-ups. The wheelchair pushes up activity is for the strengthen of the triceps and shoulder blade muscles to help client transfer from his wheelchair to his bed. The client places their hands-on top of their chair wheels, lean forward at their hips, press down through their palms and straighten their elbows, pushing their shoulder blades down at the same time and try to lift to lift their backside from their chair seat.

PO is referred to continue chemical dependence treatment at the community agency. PO will need to have a new assessment to determine appropriate level of care. PO is recommended to attend minimally of two self-help meetings per week, abstain from all mood-altering substance, and utilize positive support structure to aim and maintain substance free lifestyle.

At today’s visit she is found sitting in her room in her wheelchair. She is awake, alert and oriented. She reports that she has had multiple falls over the weekend. She denies pain, shortness of breath and chest pain. The facility staff reports that she has had multiple falls and seems to be falling more lately. The patient uses a wheelchair;

The applicant requests an upgrade of his general, under honorable conditions discharge to honorable. The applicant states, in effect that the reason for his discharge was based on a series of events that spans almost 3 years. The applicant states that in April of 2011 a future Soldier Ms. G., deliberately missing he ship date, she was considered a Delayed Entry Program (DEP) loss, and was discharged from the FS program. The applicant further states that the next day Ms. G. came into the station and told the station commander that he knew exactly where she was, he had been in contact with her the entire time, and he had petitioned her for sex and sent her a photo of his genitals. The applicant contends that an AR 15-6 investigation reached the conclusion, that there was no evidence to substantiated her claim. The applicant states that he was separated from the Army under paragraph 14-2c misconduct (serious offense) for the allegations that was

Upon evaluation of the patient outside and inside home environment I was able to identify safety concerns that can potentially provoke a fall. Home entrance was clutter with chair flower pots, and trees, impeding client direct access to main door. Even though Mrs. Cabrera lives in a 1 story home

The purpose and scope of the “RNAO Falls Prevention CPG” are: “To increase all nurses’ confidence, knowledge, skills and abilities in the identification of adults within health care facilities at risk of falling and to define interventions for the prevention of falling. It does not include interventions for prevention of falls and fall injuries in older adults living in community settings. The guideline has relevance to areas of clinical practice including acute care and long-term care,

The nursing process has been improved along the way, from Orlando’s original four step process in the late 1950’s, then, a separate step of a nursing diagnosis was added. As to the American Nurses Association Scope and Practice (2nd Edition, 2010), there was another important step of expected outcomes to identify patient goals. So, as the nursing process has been re-evaluated and improved the patient is re-evaluated and improved by the improved nursing process-problem solver. My fall prevention project has revealed to me and my readers there are vast numbers of risk factors that are involved in falls including medications, nutrition, cultures (beliefs), mental status and a history of falls. The nursing process has been and will always be used

Many patients admitted to the stroke and orthopedic rehabilitation unit have impaired physical mobility. The length of time in rehabilitation is ten to fourteen days. Many times nurses, patients and family members form bonds that last long after the discharge. I recently had the opportunity to take care of a patient I will never forget. Mrs. C was admitted to the rehabilitation unit following recent hip surgery. She is eighty years old and had fallen raking leaves in her front yard. Mrs. C has a history of hypertension, arthritis and gout. Medications include aspirin, metoprolol and allopurinol as needed. Prior to admission Mrs. C lived independently and has two children who checked on her routinely. No cognitive or mental deficits are noted. Key parts of this paper include the introduction, NANDA, NIC and NOC elements, data, information, knowledge and wisdom and the conclusion.

Elimination of patient falls is not an easy task otherwise they would have been eliminated by now. Patient falls unfortunately continue to be a challenge and occur within the hospital and nursing home settings at alarming and sometimes deadly rates. The Center for Disease Control estimates that 1,800 older adults living in nursing homes die each year from fall-related injuries. Survivors frequently sustain injuries resulting in permanent disability and reduced quality of life. Annually, a typical nursing home with 100 beds reports 100 to 200 falls and many falls go unreported (CDC, 2015). Falls occur more often in nursing homes because patients are generally weaker, have more chronic illnesses, have difficulty ambulating, memory issues, and difficulty with activities of daily living all of which are factors linked to falling. Contributing causes of nursing home falls include walking or gait issues, environmental hazards such as wet

As a community social services assistant, I work directly with pediatric patients that have been discharged from St. Vincent Hospital. When meeting with patients post discharge, I have noticed that they are often confused about the types of services they require. I have considered various options to address this issue and have come up with a potential solution. Hospital admissions can be overwhelming for young children; I am suggesting we trial providing homecare information in a more fun and less intimidating manner. I am suggesting we hire a popular local clown named Claris who performs at children’s parties .Claris is passionate about helping children, and would be able to explain homecare information in a fun and interactive way that would be easier for children to understand.

There are many steps to the discharge process and while it is important to think big one should focus on starting small to achieve short-term wins. Demonstrating quick wins will help foster increased engagement. One area to gain a quick win is to partner with community physicians by arranging follow-up appointments prior to discharge. In a recent study Bradley et al. (2014) data indicates that this effort contributed to a 0.52 percentage point reduction in readmissions (Bradley et al., 2013, para. 2). Another area to introduce new practice is in increasing the number of at-risk patients who receive referrals to home health care and post-discharge phone calls. “The effect of home visits reported that with continuous post-discharge home care,

The increase in patients falls and the number of patients that are fall risks has greatly increase. Part of this is due to the aging population. While there are many prevention methods in place, patients are continuing to experience falls. “Problem solving relies on decision-making, critical thinking, and/or clinical judgement” (Chamberlain College of Nursing, 2015). I recently had a patient that had two falls during his admission. I placed the patient on 1:1 observation. He was a fall risk due to his history, mental status, and medications (narcotic pain meds and antipsychotics). The patient did not fall again while I was at work. However, after my days off I came back and got report that the patient fell again. The patient had been taken

Current nursing practices are based on strict standards and requirements issued by The Center for Medicare and Medicaid Services (CMC) and The Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The CMS requires facilities to provide a safe environment for care and failure to do so risks losing Medicare Medicaid funding. In fact, facilities no longer receive payments for treating injuries caused by in-hospital falls. The JCAHO National Patient Safety Goal (NPSG) requires nursing home to reduce the risk of patient harm resulting from falls and to implement a falls-reduction program. The NPSG has been upgraded to a standard that requires facilities to assess and manage the patient’s risks for falls and implement interventions to reduce falls based on this assessment. The current nursing practice for fall interventions begins with assessment. Patients are assessed and reassessed to identify and address any risks factors including underlying medical or medication conditions. Risk Assessment Tools for predicting falls score each category identified as a potential risk. For example, categories include Medication, Activity/Mobility, Elimination, Previous Falls, Length of Stay, Mental Status, and Age all can influence the

The procedures were conducted using the format of questionnaires. The questions on the questionnaire were based on these four main areas: cause of falls, nursing staffs intervention in fall prevention, routines of documentation and report, and experiences and reactions of nursing staff related to fall incidents. The 64 questions were distributed into four different categories of people. The four different categories are registered nurse, enrolled nurses, unskilled nurses’ aid and other professions (Struksness et al., 2011, p.3 ). Out of the 64 questions, 7 were background questions. The other 57 questions were distributed among the four main areas of fall. 28