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Case Study
Mr. Olsen is a 70-year-old male, 5’ 9”, weighing approximately 160-182 lbs, is alert and oriented. He presents with slowly healing right leg amputation (BKA) post-6-months for severe peripheral vascular disease, old hx.of CABG x4, transvenous ICD (internal defibrillator/pacemaker combo), type I diabetes, chronic mesenteric ischemia, frequent angina, worsening hx CHF, ascites w/SOB. Within last month the patient began paracentesis 2x week, hence fluctuating weight levels. His provider healthcare team is contemplating changing his status to palliative care, yet the patient is “not ready”, hence ventilator standby. The patient develops a new cough and fever.
HaH Nursing Huddle
The patient meets all of the criteria for HaH. Nurse remotely monitors at-home-patient 24/7, plus 2 RN in-home visits per day.
Nurse Practitioner conducts 1 scheduled remote assessment/visit with patient per day, yet, may go up to 3 tele-visits per day if the situation is warranted (happens frequently with covid patients (labile).that button and have instant access to the Nurse Practitioner. You, as an advanced practice nurse, receive notification from the RN at the tele-hub (located at hospital), that the home-care RN reports the patient has developed a cough and fever. You order a home test for covid. The patient is tested. The result is positive. The patient is given a pre-programed i-Pad in which to communicate. The i-Pad is configured with a one-button alert system – when a need arises, the patient may push.
You need to get the word to the consult room/physician on-call, then and out to the team- re: the best way to proceed with the patient care plan.
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