The Medical History of Mr Brown - Essay Example

Discharge Plan Affiliation Introduction The period after hospitalization presents several challenges to the patient in terms of coping with the home environment, relating with significant others and adhering to medical requirements. The patient can experience difficulties in complying with medication and relating with family members, it is also easy for the patient to forget the health messages and instructions given during discharge from the hospital. It is therefore important for significant others and medical practitioners to be included in the discharge plan so as to ensure continuity of care after learning that Mr. Brown has been leaving a lonely life and in isolation. Supporting Mr. Brown to resume the normal physiological and mental functioning states requires that several people take part in maintaining, promoting and evaluating health care. The significance of health care practitioners is to ensure that quality and continuous health care is accorded to the patient regardless of the environment. The medical history of Mr. Brown reveals that he has had several cardiac diseases some which required surgical treatment. He suffered from hypertension which is basically a condition in which there is sustained high blood pressure in the arteries due to increased heart rate and cardiac stimulation. Ischemia heart disease is the occlusion of the coronary arteries due to fatty deposits limiting oxygen supply to the cardiac muscles and cells while coronary bypass is surgery performed to create a new path for blood flow to the heart muscles. Chronic heart failure is also cardiovascular condition whereby the cardiac function reduces significantly, the heart muscles weaken and there is reduced cardiac output. This is seen to be the complication of other cardiovascular diseases such as coronary artery disease and hypertension that form the medical history of Mr. Brown. Discharge planning; this is a usual feature in health care service provision system whereby patient needs are determined for an effective hospital-home transition with the aim of shortening hospitalization, preventing hospital readmissions and stepping up the coordination of home based health care services. A discharge plan also acts as a link between the hospital and the place of patient discharge unified by the common interest of providing quality continuous care. During discharge a number of people are involved, the doctor, nurse, social worker, patients significant others and the patient himself take an active part. In this group of people each individual plays a specific part in promoting care. Any discharge plan must meet the basic criteria used; evaluation of the patient is done to ascertain the health status after which the findings must be discussed. Planning is done to prepare the patient for the home environment as other areas of need in terms of care are determined. Referral and follow up strategies are made clear (O’Leary et al. 2009). For Mr. Brown, the discharge plan must be well elaborate and holistic. There is need to provide proper home based health care services since he is found to have various health concerns ranging from chronic heart disease, loss of appetite ,inability to perform activities of daily living and social isolation which is a risk for mental illness such as depression. Factors to consider in Mr. Brown’s discharge plan It requires the consulted efforts of the doctor, the nurse and the social worker to draw an effective discharge summary for Mr. Brown after a full physical assessment and home environment evaluation. Mr. Brown must be helped to understand that his energy level will gradually normalize and that it is important to have somebody take care of him at home, the feeling of sadness and loss of interest are common during the first few days of home stay after which he should function normally. Compliance to medication; all the prescribed drugs treating chronic heart failure must be taken as indicted,Mr.Brown is helped to understand the importance of drug compliance and the consequences of defaulting (Hall et al. 2010). Adverse drug reactions are also mentioned here with to further the patients understanding of drug interaction and functioning. At this point the patient is also helped to know the effects of mixing drugs and proper storage. Physical exercise; since chronic heart failure interferes with normal blood supply and oxygenation, strenuous physical exercise is limited. Mr. Brown will be encouraged to move around taking walking as a good exercise to begin with. He is also educated on the danger signs of chronic heart failure relapse like breathlessness and fatigue (Duffy et al. 2011). Diet and fluids; fluid levels play a significant level in managing chronic heart failure especially if it is as a result of long standing hypertension. Mr. Brown is advised to reduce sodium intake since a lot of sodium expands blood volume that in turn overwork the already weakened heart. Dietary fat must be avoided to prevent complication of coronary artery disease; avoiding alcohol and smoking is part of strengthening cardiac muscles. The patient is to avoid taking frozen and fast restaurant food (Kind et al. 2012). Staying healthy; Mr. Brown is advised to get preventive services against flu and throat infections to prevent other cardiovascular related diseases such as endocarditis. The nurse provides further information on available preventive methods and their importance. Utilizing outpatient heart failure clinics and follow up; enrolling in this program helps reduce hospitalization by frequent medical checkup, treating possible complications, offering health education and monitoring medication compliance as well as effectiveness. Considering Mr. Brown’s age, home visiting is an appropriate means of preventing frequent hospital visits and a lot of strenuous activities. This requires that the nurse and social worker will be visiting Mr. Brown on a regular basis to check his progress and address patient problems (Lenert et al. 2014). The significance of involving significant others Mr. Brown has been living alone alongside having long history of several cardiac diseases and this will not help him now that he has been diagnosed with chronic heart disease, he requires a cordial home emotional environment, close monitoring and help to meet activities of daily living. In addition to this, involving his children in the discharge plan greatly helps in ensuring that he stays healthy and free from depression. Significant others will also contribute to effective planning of home care for Mr. Brown; they receive health education and directives concerning the patient’s diet, medication, exercise and emotional support. Another vital role is liaising with the social worker and the nurse during home visits accounting for the patient’s progress and airing their personal views on care being provided (Key-Solle et al. 2010). Involving Mr. Brown’s family as part of discharge plan will ensure continued patient education even in the home environment. After discharge the patient is likely to forget most of the health messages given in the hospital however his relatives will help him recall and put into practice if they were actively involved. Since Mr. Brown’s discharge plan is complex, he may not recall everything and meeting all the expectation requires help. Involving significant others will help them as well to know the importance of strictly observing the plan of care at home. This will also help them understand the costs of care to be incurred. Importance of communication during discharge A comprehensive discharge plan is one that has clear instructions to both the patient and care givers. the multidisciplinary team (MDT)has to work together to ensure that all vital elements of care are included in the discharge summary, health education address all essential parts of care and the patient understands why social worker and the nurse will be conducting a regular home visit. For instance the doctor must be clear when advising the patient of drug compliance and safety. He or she must clarify that failing to adhere to the drug regimen will complicate the condition as well as the common side effects of medication so that the patient clearly differentiates them from signs and symptoms of chronic heart disease. Proper communication during discharge will help avoid duplication of roles and will help in demarcating special parts played by each member of the MDT (Lenert et al. 2014). In conclusion, cardiovascular diseases require an elaborate discharge plan involving the multidisciplinary team and the patients significant others. Factors such as diet, exercise, medication compliance, follow up services and emotional support are of absolute necessity to consider when drawing a discharge plan for a chronic heart disease patient. Involving significant others will ensure a conducive and supportive home environment for the patient to recover. Proper communication between the patient and the multidisciplinary team is very essential in ensuring a successful and conflict free period of home based care for chronic heart disease patient (Horwitz et al. 2013). References Duffy, B.L., Bost, J. & McNeil, M., 2011. What makes a perfect discharge summary: Faculty and resident consensus. Journal of General Internal Medicine, 26, p.S318. Hall, M.J. et al., 2010. National Hospital Discharge Survey: 2007 summary. National health statistics reports, pp.1–20, 24. Horwitz, L.I. et al., 2013. Comprehensive quality of discharge summaries at an academic medical center. Journal of Hospital Medicine, 8, pp.436–443. Key-Solle, M. et al., 2010. Improving the quality of discharge communication with an educational intervention. Pediatrics, 126, pp.734–739. Kind, A.J.H. et al., 2012. Provider characteristics, clinical-work processes and their relationship to discharge summary quality for sub-acute care patients. Journal of General Internal Medicine, 27, pp.78–84. Lenert, L. a, Sakaguchi, F.H. & Weir, C.R., 2014. Rethinking the discharge summary: a focus on handoff communication. Academic medicine : journal of the Association of American Medical Colleges, 89, pp.393–8. O’Leary, K.J. et al., 2009. Creating a better discharge summary: Improvement in quality and timeliness using an electronic discharge summary. Journal of Hospital Medicine, 4, pp.219–225.  Read More