INTERDISCIPLINARY PLAN OF CARE FOR THE ORTHOPEDIC PATIENT TANIA - - PowerPoint PPT Presentation

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interdisciplinary plan of care for the orthopedic patient
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INTERDISCIPLINARY PLAN OF CARE FOR THE ORTHOPEDIC PATIENT TANIA - - PowerPoint PPT Presentation

Jan 24, 2023 407 likes •588 views

INTERDISCIPLINARY PLAN OF CARE FOR THE ORTHOPEDIC PATIENT TANIA PORTILLO RN-BC, BSN ASSISTANT NURSE MANAGER WOMENS SURGICAL UNIT UNIVERSITY MEDICAL CENTER OF EL PASO OBJECTIVES - T o assist and educate patient to play an active role

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INTERDISCIPLINARY PLAN OF CARE FOR THE ORTHOPEDIC PATIENT

TANIA PORTILLO RN-BC, BSN ASSISTANT NURSE MANAGER – WOMEN’S SURGICAL UNIT UNIVERSITY MEDICAL CENTER OF EL PASO

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OBJECTIVES

  • T
  • assist and educate patient to play an active role in their

care to improve pain control and have better outcomes

  • T
  • understand the importance of daily Plan of Care to

maximize mobilization

  • T
  • collaborate with interdisciplinary team in regards to

discharge planning

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SLIDE 3

PREOPERATIVE TEACHING AND EDUCATION

SURGICAL GUIDEBOOK (DSRIP PROJECT)

*What to expect before and after your surgery? *What you will need to know during your hospital stay. *Different phases of care – Surgical/Orthopedic procedure

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PREOPERATIVE TEACHING AND EDUCATION

Hibiclens use the night before and the day of surgery.

Pain management expectations Use of IS and its importance

SCD/anticoagulat ion therapy

Early mobilization

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TEACHING PAIN MANAGEMENT

  • Scheduled VS PRN pain medication
  • Medication information folder
  • Set realistic goals for pain control
  • Coordinating physical therapy visits
  • Treating mild/moderate

VS severe pain

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PAIN MANAGEMENT (TEACH BACK METHOD)

  • https://www.youtube.com/watch?v=kBzzvsQ_B7M
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INTERDISCIPLINARY TEAM

Physician Nursing Physical Therapy Care Management T eam

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SLIDE 8

DISCHARGE PLANNING

Ready to DC

Placement Rehabilitation Skilled Nursing Facility Home DME, anticoagulation therapy + Home Health VS Outpatient Rehab + Family teaching

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Acute Inpatient Rehab

  • Nurse-patient ratio (5-6)
  • Minimum of 3 hr of

combined therapy per day

  • r 15 hrs over 7 days
  • Average LOS 12 days
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SLIDE 10

Skilled Nursing Facility

  • Nurse-patient ratio(15-20)
  • Therapy for less than 3 hr,

frequently 1-2 hrs/day

  • LOS 21-30 days or greater
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WHAT IS DELAYING OUR DISCHARGES?

Increased LOS

Insurance – Lack of rehab/SNF beds Multiple comorbidities High acuity

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DISCHARGE PLANNING STARTED ON DAY 1

  • Pain management (weaning IV pain medication)
  • Placing Social Worker/Case Management Consult
  • Anticipating use of anticoagulation medication and obtaining script (Lovenox, Arixtra,

Eliquis, etc)

  • Prescriptions for DME prior to day of discharge
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READMISSION PREVENTION

  • MPOST screening tool (Martin Postoperative Discharge Screening Tool)
  • Implemented by DSRIP program
  • Evaluates patient’s vital signs, lab results, wounds, pain control, and ambulation status to

determine whether patient is a high risk for readmission

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SLIDE 14

CONCLUSION

  • Preoperative and continuous education
  • Set realistic goals with patient
  • Pain management is vital
  • Safe discharge in order to prevent readmission/complications
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REFERENCES

Landeiro, F., Leal, J., & Gray, A. M. (2015). The impact of social isolation on delayed hospital discharges of older Majeed, M.U., Williams, D.T., & Pollock, R. (2012). Delay in discharge and its impact

  • n unnecessary hospital bed occupancy. BMC Health Services Research, 1-6

Watkins, J.R., Soto, J.R., & Bankhead-Kendall, B. (2014). What’s the hold up? Factors contributing to delays in discharge of trauma patients after medical clearance. The American Journal of Surgery, 969-973