· Follow the 3 x 3 rule: minimum three paragraphs per DQ, with a minimum of three sentences each paragraph.
· All answers or discussions comments submitted must be in APA format according to Publication Manual American Psychological Association (APA) (7th ed.) ISBN: 978-1-4338-3216-1
· Minimum of two references, not older than 2015.
Reply both peers
Peer #1: It is important to note that most injuries that happen to clients and staff occur when clients are being transferred. Safety is an integral component of moving clients and should receive the highest priority (“Assisting clients to transfer – Nursing assistant,” n.d.). The nurse is responsible for preparing and caring for the patient before, during, and after the surgery. For optimal recovery, nurses are involved in pain management, infection prevention, and encouraging ambulation as prescribed.
Before transferring the 87-year-old resident to the hospital, the charge nurse should address concerns such as stability of vital signs, particularly blood pressure and oxygen saturation levels. Also, management of pain and ensuring appropriate pain medication is prescribed and administered. It is important monitoring and management of congestive heart failure, considering the resident’s history and potential for exacerbation due to the fall and surgery (Association of American Medical Directors, 2020). Assessment and documentation of the resident’s cognitive status is also an important consideration since it ensures their understanding and consent for the transfer and surgery. It is imperative to make a review of medications and potential interactions or side effects, particularly considering osteoarthritis and osteoporosis and guarantee appropriate transportation equipment and transfer techniques to minimize discomfort and risk of further injury. It is primordial to maintain communication with the receiving hospital team regarding the resident’s medical history, current condition, and special needs or requirements as well as coordination of necessary supplies, equipment, and documents (e.g., x-rays, medical records) to accompany the resident, consideration of potential post-surgical rehabilitation needs, and arrangements, in addition to emotional support and reassurance for the resident and their family throughout the transfer process.
Addressing these concerns will help ensure a safe and smooth transfer, optimal care for the resident, and effective communication among healthcare providers.
During the transfer, monitoring vital signs, particularly blood pressure and oxygen saturation levels, is necessary to ensure stability. Managing pain and ensuring appropriate pain medication is administered along with maintaining safe transportation and transfer techniques to minimize discomfort and risk of further injury. During transfer we also need to provide emotional support and reassurance to the resident and their family and provide the resident with the necessary supplies, equipment, and documents (e.g., x-rays, medical records). At this point communication among healthcare providers keep being vital and we must include updates on the resident’s condition and special needs. We also need to consider potential post-surgical rehabilitation needs and arrangements, address cognitive and emotional changes that may occur due to the fall and hospitalization and manage comorbidities, such as congestive heart failure, osteoarthritis, and osteoporosis, during the transfer and hospitalization. The goal is to safeguard the resident’s dignity and respect during the transfer process.
By focusing on these concerns, the charge nurse can help warrant a safe and compassionate transfer, promote effective care, and support the resident’s well-being throughout the process.
The receiving nursing unit will need information to provide effective care, thus, it is required to have a complete medical history, including congestive heart failure, osteoarthritis, and osteoporosis, details about the fall and fracture, including type of fracture and imaging results, current medication list, including dosages and frequency, and allergies and sensitivities. Pre-fall cognitive and functional status, including ambulatory ability and cane use is helpful to understand the patient baseline level of independence and mobility. The nurse must have knowledge of the special care instructions or preferences (e.g., pain management, communication approaches) and contact information for family members in case of emergency. Relevant laboratory results (e.g., blood work, imaging studies) should also be delivered to the nurse and any other relevant medical or social information impacting care (e.g., history of pressure ulcers, hearing, or visual impairments). In this cases, documentation of advance directives or end-of-life care preferences is also recommended.
By having this information, the receiving nursing unit can anticipate potential needs, develop an individualized plan of care, and ensure a smooth transition for the resident (Hudak, C. M., Gallo, B. M., & Lauer, P. C., 2020).
References:
American Medical Directors Association. (2020). Transitions of Care in the Long-Term Care Continuum Clinical Practice Guideline. Retrieved from https://paltc.org/publications/transitions-care-long-term-care-continuum-clinical-practice-guideline
Assisting clients to transfer – Nursing assistant. (n.d.). WI Technical Colleges Open Press – Publishing open resources for students. https://wtcs.pressbooks.pub/nurseassist/chapter/8-4-assisting-clients-to-transfer/
Hudak, C. M., Gallo, B. M., & Lauer, P. C. (2020). Care of the older adult. In Clinical Nursing Skills & Techniques (9th ed., pp. 202-218). Elsevier Health Sciences.
Peer #2: When planning the hospital transfer of an 87-year-old resident from a nursing home following a hip fracture, the charge nurse must meticulously prepare for multiple concerns due to the resident’s complex health background, including congestive heart failure, osteoarthritis, and osteoporosis. The resident’s existing health conditions can significantly impact both the transfer and the treatment protocols. For example, managing congestive heart failure involves careful monitoring to avoid fluid overload and ensuring cardiac stability during the transfer. The presence of osteoporosis demands extremely cautious handling to prevent any additional fractures. Effective pain management is also critical, as managing the resident’s pain from the hip fracture and arthritis is essential for minimizing stress on the heart and enhancing comfort (Podsiadlo, D., & Richardson, S., 1991).
The actual process of transferring the resident requires attention to several key issues to minimize risks. Proper techniques for moving and handling the resident are crucial to avoid exacerbating the hip injury. It’s vital to continuously monitor the resident for any signs of distress, particularly concerning their heart condition, throughout the transfer. Maintaining any ongoing treatments, such as oxygen or intravenous therapies, without interruption during the move is essential for the resident’s stability (Simmons, B. B., et al., 2009).
Upon arrival at the receiving facility, the nursing unit will need a comprehensive overview of the resident’s health status and care needs. This includes a full medical history highlighting the resident’s chronic conditions, details about the recent fall and hip fracture, and any initial interventions undertaken. Understanding the resident’s cognitive function and mobility level prior to the fall will assist in creating a personalized care plan. The transfer information should also cover the resident’s medication regimen, any allergies, nutritional needs, and preferences regarding advanced care planning or life-sustaining treatment options, to ensure a seamless and holistic approach to care (Hudak, C. M., Gallo, B. M., & Lauer, P. C., 2020).
References:
Podsiadlo, D., & Richardson, S. (1991). The timed “Up & Go”: A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142-148.
Simmons, B. B., et al. (2009). Clinical update: Management of patients with hip fracture. Annals of Long-Term Care, 17(10), 31-38.
Hudak, C. M., Gallo, B. M., & Lauer, P. C. (2020). Care of the older adult. In Clinical Nursing Skills & Techniques (9th ed., pp. 202-218). Elsevier Health Sciences.
