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18 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Define discharge planning and continuity of care.
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Discharge planning
Continuity of care |
Discharge planning is the systematic process for preparing the patient to leave the healthcare setting and maintain a continuity of care.
Continuity of care is a process by which healthcare providers give appropriate, uninterrupted care and facilitate the patient's transition to different settings and level of care. |
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Describe health care team members involved with discharge planning and define their roles.
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Patient
Patient's significant others Health Care Personnel: Physician Nurse Nutritionist PT/OT/Speech Therapists Local Agencies |
More specifically, the role of a nurse during discharge planning is essentially the nursing process:
Asses the patient's needs Identify problems Develop mutual goals, long and short term. Coordinate home services Teach |
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Identify individuals who need discharge planning.
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All patients
High risk patients |
Everyone needs discharge planning.
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Discuss clients who have the greatest need for discharge planning.
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Patients with:
Knowledge deficits Social isolation - no support New DX of a chronic disease Financial difficulties Mental instability Complex home regime Major surgery Lack of referral agencies Terminal illnesses Newborns and dependent children |
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Describe the nurses role in discharge planning.
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Asses client/family
Identify problems Develop goals Coordinate services - PT, OT, RT, etc Teaching |
Goals include both long term and short term
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Identify common nursing diagnosis related to discharge planning.
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Self care deficit
Anxiety related to Ineffective family coping Impaired home maintenance management |
Knowledge deficit
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Describe the components of teaching needed prior to discharge.
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Medication - side effects
Diet - restrictions Procedures and treatments Health promotion- smoking cessation, lifestyle changes that could effect their health. Referrals Other? - Equipment use (teach before leaving the hospital) |
Document ALL teaching!
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Identify the role of the nurse when the client is discharged against medical advice. ("AMA")
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Assess reasons
Teach client ramifications of decisions Legal Role of a nurse |
#1 reason for leaving is dissatisfaction and cost
The nurse must do the following: Notify the physician Have the patient sign the AMA form, then the nurse must do so as a witness Provide teaching to the patient. Document, document, document 20% of those that leave AMA are readmitted and usually in worse condition. |
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Explain the discharge procedure.
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See that the patient has a discharge order.
Give discharge instructions and have the patient sign them. Make sure the patient has made financial arrangements. Return valuables. |
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Identify the age groups of hospitalized children.
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Infant- Birth to 12 mos.
Toddler- 12-36 mos. Pre-school- 3-5 years School Age- 6 - approx. 12 years Adolescent- 11-20years |
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Describe the cognitive behavior related to each age group.
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Sense of self
Language Sense of time Magical Thought Concrete Thought Logical Thought Abstract Thought |
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Describe the psychological relationships specific to each age group.
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Trust
Autonomy Dependent/independent Egocentric Self Esteem Body Image Parents Friends |
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Describe the social development specific to each age group.
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Caregiver
Parent Peers |
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Describe the physical development specific to each age group.
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Gross Motor
Fine Motor Secondary sex characteristics |
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Identify common hospital stressors in regards to each age group.
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Fear of pain/injury/death
Caregiver/peer separation - major stressor for 6-30 months old Isolation Unfamiliar routine/role Loss of independence |
Separation Anxiety has 3 stages; Protest, Despair, Attachment
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Discuss behaviors related to stressor of hospitalization for each age group.
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Aggression
Regression Withdrawal Change in behavior Boredom Separation/Stranger Anxiety |
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Outline nursing interventions that minimize the common stressors for each age group.
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Caregiver
Routine Education Interaction from others Parent/family involvement |
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Define Play and describe the types and functions of it.
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Communication
Desensitization Teaching Modeling Relaxation |
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