Please use scholarly sources to cite/support your
Please use scholarly sources to cite/support your comments. Help me to reply to the STUDENT POST below: Discussion post by a classmate: One of the common problems I see, especially on a medical surgical unit, is older patients who get readmitted for falls. The causes of the falls are usually noncompliance with physical therapy outpatient, physical barriers and hazards at home, noncompliance with medication, and not taking care of themselves. They either come in for fractures or sprains from the fall, have positive orthostatic vital signs, and require physical therapy. It is also sad to see older patients who do not have family support or their children live in a different state, so they do not have support at home. Barriers I see are the common issue of noncompliance, not having insurance to get home health care or go to a rehab facility, hearing deficits, and misunderstandings of the care plan after discharge. For example, I’ve assessed a patient’s understanding of taking blood pressure medications and monitoring blood pressure. The patient informed me that her doctor never told her she must monitor her blood pressure at home while taking a medication like metoprolol or what symptoms are expected of it. I had to sit down and thoroughly explain the importance of taking blood pressure readings and even showed her that amazon sells blood pressure machines for home use. I told her she should be monitoring her blood pressure and documenting it. Interventions that can be created to address these issues is creating short-term goals that can lead to long-term goals for our patients. It is also important to take into consideration a patient’s reading level and the best way they learn. It is very important to consider the patient’s home life to prevent recurrent falls. Is it safe to discharge them back home independently? Can they have a friend or family member at home to help? Would they benefit from going to rehab or even an independent ALF? An intervention for nurses to assist in is collaborating with physical therapists in hospitals to assess a patient’s physical barriers and abilities, what their home is like if they have any stairs, railings in the bathrooms to prevent falls, rugs, etc. Another intervention is related to health and wellness. Are they able to eat enough meals throughout the day? Is it healthy meal choices, do they drink enough water and are hydrated, exercise, and are they compliant with medications? Interventions to address this issue is to determine if they even know what the medication does and what they need to monitor. An example to address unintentional nonadherence could be to use pillboxes or blister packs to better organize medications (Neiman et al, 2017). For water intake, there are phone apps or journaling. It would be nice if there was a way to collaborate with a patient’s primary care provider to recommend certain interventions long term. A first step to help busy families adopt healthy lifestyle behaviors is to create SMART goals that are simple and as time goes on, can add more interventions. For example, a smart goal could relate to planning and making healthy meals every week. It could start as 1 meal and, over time, add more meals throughout the week. They can document what they do and monitor it. There’s the example that a goal should not just eliminate all unhealthy foods from your diet. A positive goal that is more effective could be to add a fruit or vegetable to dinner or lunch instead of the negative goal of eliminating all unhealthy foods. References Neiman, A., Ruppar, T., Ho, M., Garber, L., Weidle, P., Hong, Y., George, M., Thorpe, P.(2017). CDC grand rounds: Improving medication adherence for chronic disease management- innovations and opportunities. MMWR Morb Mortal Wkly, 66(45). DOI: http://dx.doi.org/10.15585/mmwr.mm6645a2
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