Question

Review Comples As a member of your unit's practice counsel, you are asked to work on strategies to reduce the hospital's 30-day readmission rate for heart failure. Using the material in the required reading, address the following: 1. List the most important topics to cover during discharge teaching. 2. Compare the options for transitional care - home care referral, referral to a heart failure clinic. and telemonitoring. How would you help the client and family decide which option is best for them? # The most important topics to be covered during discharge teaching are :- - importance of compliance to medicines

Answer 1

Discharge Advices or Teaching 0 while Hospitalisation is an pleasantful experience to patients, discharge would be the same because of fear to regarding recovery and getting back to normal while dixchanging the patient we need to educate him ther and their family regarding also would be the s Home care. harge education should start from the ime patient is planned for disharge. for eg: If patient is planned for dincharge after a days, dixchange reaching should start today itself. - It includes → Home Care educate about following Importance of safety at home. Availability of care taken Hiring a home care staff if needed and if they can afford changes to be made at home if any for eg: shifting his ther room from upstairs to down stairs

3 Medication: This is the most important one. educate the client regarding done, tining, of medication and also probable side effects of it. - If possible ask them Medicine bon to get available in the market, which in divided into 7 days and 3 kinen. divide the discharge medicine, fill the bove, educate patient & family - about the drug usage. > or keep all the medicines separately in the paper bags, mention tinings on it on give it to patient and explain. s make sure entra drugs are not kept in it for examples antibiotics if prescribed for 5 days BO, then give only 10 tablets to patient. Ask them to repeat what all you have educated, clear any doubts if they have → Involve patient's Care taken in all the aspects. → Educate them when to come to Hospital & Cf any problem arises with medication)

Follow-up Give follow Euplain the up date procedene to og the procedure of I how abouts of them about the and how a where follow-up when procedence of follow-up reports to be carried Inform them about the . them a leaflet which best deperibes the for follow -up. Getary Changes - Give them a leaflet diet to be followed - Educate them ab For eq: For cardiac them about for cardiac t, simple importance of dietary changes patient - low salt diet, diet, Ariding spicy food - Approach them about dietary pati low fat diet, simple diet, Avi are to be recommended ach them in a soft way while teaching dietary changes, let them gain knowledge about its importance have dietician of Hospital, plan meals Imenu for the patient before discharge ittelf. - Personal care suplain about a personal Hygiene - Importance of exerine - Relaxation techniques - Spiritual needs et. a stress on importance of encrcise - Educate. about type of exercise they can do the cuencite which should be avoided , duration of enucine et

-> Equipment - t Arrange them with any equipment of need - for example. A bed ridden patient may need our bed Iwater bed at home, a Hypertensive patient may need Bp apparatus en. - Arrange it from Hospital if patient is willine or else ask them to buy onth and educate the regarding the equipment's usage. → Continuing the previoun work - Advice them regarding any changes to be made regarding work place. - For enample A person who has Back injury cannot sit for larger hours & hance advice them to shift to other department in the company (if possible) which would to suit them - For Cardiac patients a stressful job might not suit & hence required charges are to be sugguted. - educate about ourones: - provide prychological support and tell patient that he would be fine in few days - Dont give fake promises or imaginative promises - This appect of discharge should be better given by treating doctors.

Transitional care: dus in the process having continuity of care while from one situation to another eg: one Hospital to other a one co-ordination patient having from and shift ? to hone. - main aim for from Hospital ain aim and and adve advantage of is transitional to reduce readmission But disadvantage in it is considered to be stly, there are chances of gaps in quality and safety of care I strong colloboration between patient, family & health team is needed and multidisciplinary approach is needed Home care Referral: If physician agrees that patient will be I benefited from home health, then patient can I be directed towards home care - Home health agency details are provided to patent or family. - A team of health professionals will visit patient at regular interwalls, and patent will be treated at home for any new complaints

& Advantage comfort (because of familiarity. Quality of care because trained to Personnel are involved safe Reduces unwanted expenses like transportation Reduces physical strain to patient. Duadvantage → patients may feel isolated from family → poor quality care if care givers are not worthy or efficient e → Improper Insufficient facility. A home may not suit to provide care in many setting → Lack of energency Resources. Heart failure clinic At heart failure clinic , a specialet provides care to patient All his reeds like nedication, diet, physical changes, any new Symptons et re assessed and necessary changes are made. Adiantart - Specialist consultatim, - Problem oriented solution - prompt care & Advices, improved outcomes - All asputs of care traded are - Strong health education Included.

Dualaren - patent may feel afraid of new netting patients who are willing to vinil the cline are only enrolled and there are many patients who donot o viniH HE clinics - once patient discontinues from active consultation, he is again at rikk for HF. TELE MONITORING It is uning elettronic media to enchtange indation - some health care professionals have this system. It collect an information. This info in sent to other health care settings I doctor for interpretation. Adiantes - patients can get their latest data Over to doctor with in notine -It acts as a good support system, - patient can get advice from doctor directly eq. consultation over phone by video call - saves norey.

Daduonteger corstly for the provider to set up all the -personal face-to-face relationship is not possible may not be useful for all kind of disease → Explain all the options available multidisciplinary approach is needed explain advantages and disadvantages of all the options Consider financial situation of family → Include family in the decinion-making. → Referring to the clinic would be better because he would be in hands of a specialist care who would care him in all the aspects. But if patient or family is not willing, them to adopt a particular option would not be a good option.