Elizabeth Case Study - Nursing Assignment Help

Assignment Task:

Learning outcome(s):
1:Demonstrate research literacy skills in searching, critiquing and applying evidence
2:Analyse health literacy as it applies to self-management for people with chronic illness/es
3:Identify the legal and ethical issues that arise from changes to cognition, chronic and life limiting illness and the impact on chronic illness management
4:Incorporate knowledge of the social determinants of health and public policy to support people, including Aboriginal and Torres Strait Islander people and culturally and linguistically diverse population groups, to engage with health services
5:Evaluate the impact of ageing in the context of health and illness for older people in the community
6:Differentiate the roles of nurses working in interprofessional teams who care for people with chronic and/or life limiting illness in different healthcare environments
7:Utilise the health promotion, supportive and palliative approaches to care for people with chronic and life limiting illness in a range of healthcare settings
8:Apply the Evidence Base Practice Framework to nursing practice focusing on chronic illness management and ageing in primary healthcare practice
  
The importance of discharge planning and transitional care interventions for nursing and midwifery practice
Some background to the topic
Newspaper headline: Hospital threatens elderly patient with eviction after she overstays welcome in emergency      
An 89-year-old woman, Elizabeth, who spent three days in the Prince of Wales Emergency Department suffering from diarrhoea and compression fractures in her spine was forced out of hospital under the Inclosed Lands Act, despite protestations from her hostel that she needed acute care. By Harriet Alexander, Sydney Morning Herald, 2015. 
 
There is compelling evidence which highlights the association between high quality discharge and transitional care interventions for older adults such as Elizabeth and a successful discharge home (Zuckerman et al., 2016). A discharge is successful where the older adult is satisfied with their care and where they do not return to hospital for a reason that was preventable (Burgess & Hockenberry, 2014). In Elizabeth’s case, following her eviction from the Prince of Wales hospital, she returned to hospital several days later with more pain and other severe health difficulties. This was distressing for her and for her family. It also cost the health system resources. Had she been admitted and treated the first time that she presented to hospital, she would not have required as many resources to assist her to recover her health. We call ‘preventable reasons’ avoidable re-admissions.  There are many reasons for avoidable re-admissions among older adults including pressure on beds and ageist attitudes of health professionals. Avoidable re-admissions are problematic for patients, their families, nurses and for the health service because no one wishes to be in hospital and avoidable readmissions waste resources.
Whether we practice in the acute care setting or the primary care setting, we are ethically and professionally obliged to provide high quality safe and effective discharge and transitional care interventions when the patient returns home to the community. The key to providing this level of care is ensuring that our practice is based on the best evidence available.

• How can nurses identify high quality discharge and transitional care interventions to use in their practice with older adult patients? How do nurses know which nursing care and multidisciplinary care interventions are effective and helpful in reducing unwanted outcomes such as avoidable re-admissions for older adults living with chronic illness?

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