Read the following article Stevens S 2015 Preventing 30day R

Read the following article: Stevens, S. (2015). Preventing 30-day Readmissions. Nursing Clinics of North America, 50 (Transformational Tool Kit for Front Line Nurses), 123-137. doi:10.1016/j.cnur.2014.10.010

Initial Discussion Post: 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

Health literacy:

I choose health literacy because it seems that this area might need work. It seems like the patient did not fully understand the instructions or the package that was given to him. Since he is a older male, He might have faced difficulty in reading or understanding the printed material or the charts that they need to fill also to perform the calculations.

Since the patient was readmitted to the hospital just within 2 weeks, it seems like he did not follow up on the discharge planning and did not fully understand it. the patient is elderly and lives alone it would be good if we intervened and communicated with him directly to make sure he understands the directions and diet chart this time, This could take a number of sessions depending on the level of understanding of the patient.

we could make him understand by the use of some charts or contact some of the family members or friends who can come and help him understand or try some other method based on what we feel was needed after communicating with him.

the main goal of all the activities is to not let the patient leave without a clear understanding of what steps he has to take in terms of daily medicines, diet and exercise. We would also share the chart with the patient or his caregiver that lists all the symptoms patient showed initially and how he could manage them.