An older adult male is readmitted to the hospital with an ex

An older adult male is readmitted to the hospital with an exacerbation of heart failure just 2 weeks after being discharged for the same problem. He lives alone and does not drive. He presented to the emergency department reporting severe shortness of breath at rest. Physical exam shows 4+ peripheral edema of the lower extremities, abnormal breath sounds in both upper and both lower lobes with a labored breathing pattern and an extra heart sound. His weight in the emergency department is 10 pounds more than his weight on discharge 2 weeks ago. Oxygen saturation is 90% on 4 liters by nasal cannula; heart rate 110; blood pressure 140/90; respiratory rate 24. When he was discharged 2 weeks ago, he had been provided the standardized package of discharge information for heart failure patients. This information discussed medications, diet, exercise and when to seek medical help for changes in his symptoms. Address the Following: Select one of these listed variables - communication, discharge planning or health literacy. Describe why your selected variable is a priority for this patient and support your answer with a reference or references. Identify an intervention that the RN can implement that addresses your selected variable and help prevent further readmissions for this patient.

Solution

In this situation the variables that should be selected is communication as communication with the discharged patient is the key to efficient discharge planning as this process aims at attaining continuity of care (Armitage 1991). Hence the vital stats of this patient and weight could have been regulated and monitored by effective communication post discharge by an intervention that the RN could implement to help prevent further readmissions for this patient. Thus communication is the most important aspect of an effective discharge planning, Smith, (1996)