SIM440 Collaboration for Improving Outcomes Activity 4
Discharge Plan
The purpose of this assignment is to gain an understanding on what goes into a discharge plan. For assignment 3, using the case study, you will create a discharge plan for a patient using the attached Discharge Plan document. You are to complete all sections of the discharge plan: assessment, diagnosis/plan, education needs, financial worksheet, and the reflection and conclusion. You need to be as detailed as possible in filling out all the boxes. The reflection and conclusion section allows you to summarize the patient’s plan of care based on all proceeding information and to make recommendations for the plan of care for the patient. Reflect on what you learned in this activity. What do you think about using this discharge plan, did it help you to consider areas you might not have previously included in a discharge plan? Please follow the example discharge plan provided for your guidance.
You can type right into the document, save it, and submit for grading. What necessary community resources and referrals will the patient need? What, if any, special equipment, or supplies might the patient need? You may not find all the information you need for the discharge plan in the case study. So, you need to research the patient’s condition, etc. to help you complete sections of the discharge plan. You can find approximate costs for equipment/insurance, etc. on the internet. Remember this is a fictitious patient.
Case Study
Mr. Joe Jones, who is 75 years of age, is being discharged home after having a right knee replacement. “I am glad that the surgery is over. Now, I can walk without a walker and pain.” He lives in a one level home independently. His wife died last year. He has private insurance. Mr. Jones is a retired engineer and can meet his financial needs for daily living. His allergies include penicillin and seasonal allergies. The discharge orders from the orthopedic surgeon include continuous passive motion (CPM) at the current setting of 0-degree angle. Patient to use crutch extensions when walking with crutches for upper body support (non-weight-bearing post discharge day 1 and may begin weight-bearing post-discharge day 2); and home nurse visits, as needed. Physical therapy should begin the day after discharge at an orthopedic center. Dressing changes BID until stitches are removed 14 days post-op. Clean with normal saline and apply clean, dry dressing with paper tape. The prescriptions will be faxed to the center. The following medications with prescriptions attached include: Lovenox (enoxaparin) 70 mg subcutaneously once daily for 7 days, Vicodin (hydrocodone bitartrate) 10 mg every 4 hours PRN, and Colace (docusate sodium) 100 mg every day. The patient is to follow up with the orthopedic surgeon in 3 weeks. His daughter, Nancy, plans to stay with him for several weeks to assist him with meals and household chores, and take him to physical therapy and the orthopedic surgeon for follow-up. Mr. Jones has three other children, Kevin, Lucy, and John, who live in other states. He is a widower and attends a local church. He volunteers as an usher every Sunday. He has a past medical history of a colon resection related to acute diverticulitis and arthritis. Mr. Jones uses ibuprophen 200-400 mg prn for pain.
Reading and Resources
Watch Video Case Management Rubric Tips for Assignments.
Chapters 16, 20, 23, 26 , in Fundamentals of Case Management Practice.
Review clinical guidelines of the AHRQ.
*Activity must be submitted per the Discharge Plan document
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