NRS 410 Discuss what resources are often necessary for nonacute care for cardiorespiratory issues

The potential demands based on the illness process, whether it be cardiac, respiratory, or both. Some patients require the use of strong medical equipment, such as a walker or oxygen at home. When using these equipment, their home need to be rearranged to make it safer, such as moving furniture or raising carpets to eliminate trip hazards. For an independent individual who is now reliant on rides to appointments and assistance with showering, several adaptations are required. Due to the high cost of medications, especially for those with insurance, medication resources are crucial. To prevent patients from running out of life-saving medications, we must ensure that they have access to these prescriptions and the means to fill them (Johnson, 2018).

Johnson, A. (2018). Cardiorespiratory complexities. In Pathophysiology clinical applications for client health. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/1

Cardiovascular and pulmonary disease are the leading cause of mortality and morbidity globally. Comorbid factors like body composition disturbances, nutritional problems, smoking cessation, psychosocial problems that accompanies chronic pulmonary or cardiovascular diseases requires multidisciplinary and comprehensive approaches. Johnson (2018) states that evidenced- based education to the patient with chronic cardiac and respiratory disease allows them a measure of control over their conditions and ultimately their lives. Resources like medication management, Durable medical equipment, modification of living conditions, availability of rehabilitations services plays a key factor in enabling them for self-management of disease conditions and health promotion.

Some of the resources that are often necessary for non-acute care for cardiorespiratory issues include community-based resources such as facilities, personnel, and funds that help in the provision of critical care and supporting patients in managing long-term conditions (Baker & Fatoye, 2019).This improves self-care by making patients independent which in turn reduces readmission rates. Healthcare facilities enable patients to access important healthcare services as well as engage with healthcare personnel such as nurses and therapists who provide necessary and adequate healthcare information and healthcare services (Baker & Fatoye, 2019).

References

Baker, E., & Fatoye, F. (2019). Patient perceived impact of nurse-led self-management interventions for COPD: A systematic review of qualitative research.

Johnson, A., R. (2018). Cardiorespiratory complexities. In Grand Canyon University (Eds.), Pathophysiology clinical applications for client health, (1st ed). https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/1

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After an acute cardiorespiratory event, the patient must safely transition back home with the resources needed to support patient independence, and decrease the likelihood of readmission (Johnson, 2018). The patient may require durable medical equipment, such as a mobility device or oxygen, as well as medication and medication assistance. At our hospital, we have a sample pharmacy where patients can get medications for free, and case managers also have coupons for getting medications for free or less expensive.

Transportation services may be required; the nurse and case manager should assess the patient’s ability to get to and from appointments and the pharmacy while the patient is still admitted. Home Health Care services can be arranged, to make sure that the patient is able to manage their medications, any device issues, and to perform safety and living conditions check, such as whether the house has ramps/accessibility. Cardiac and pulmonary rehab should be offered to these patients, to help them learn to manage them conditions, as well as providing exercise, support, health modifications, and teaching about them conditions without having to bring them to the hospital. Surprisingly, only 13.9% of patients hospitalized for an acute MI are given cardiac rehab, despite its benefits in reducing mortality (Suaya et al., 2007). Additionally, the patient may have issues returning to their lifestyle and employment, so an assessment of whether they need additional time off, a change or modification of work duties.

NRS 410 Discuss what resources are often necessary for nonacute care for cardiorespiratory issues

Reference

Suaya, J. A., Shepard, D. S., Normand, S. T., Ades, P. A., Prottas, J., & Stason, W. B. (2007). Use of cardiac

rehabilitation by Medicare beneficiaries after myocardial infarction

Decreasing hospital readmissions has been a goal of the hospital I work in, as it is for many healthcare organizations. Many factors can play a role in hospital readmissions, especially cardiorespiratory complications. This disease can jeopardize a patient’s independence. Often, many factors need to be adjusted in a person’s environment such as their living space, daily routines, employment, etc (Johnson, 2018). As nurses we have the power to help our patients gain their independence back and help to decrease hospital readmissions. As nurses we can do this by providing patient centered care. Determining the specific needs of the patient will be important in promoting health to the patient. Understanding that each patient is different and helping to personalize their care and their programs will also support the patient in taking charge of their health and make them feel involved in their care. For non-acute care, it is important for nurses to educate the patient. Knowledge is power, and when patients know about their disease, they will be more likely to comply with the regimen, increasing independence and decreasing chances for readmission. Assessing patient’s learning needs and helping them to understand how important it take their prescribed medications as schedule, adhere to dietary restrictions, and exercising a couple of days a week. A study done by Baker and Fatoye (2019) explained how patient’s education about their cardiac disease process greatly improved self-management in the day-to-day setting and decreased hospital readmissions.

Baker, E., & Fatoye, F. (2019). Patient perceived impact of nurse-led self-management interventions for COPD: A systematic review of qualitative research. International journal of nursing studies, 91, 22–34. https://doi.org/10.1016/j.ijnurstu.2018.12.004

Johnson, A. (2018). Grand Canyon University. Pathophysiology Clinical Application for Client Health. Cardiorespiratory Complexities. https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-clienthealth/v1.1/#/chapter/1

“While it’s true that a variety of measures must be taken in order to reduce or prevent hospital readmissions for cardiovascular disease, the task is far from impossible. By combining the power of consumer psychology and adaptive technology, an automated solution such as PatientBond can help healthcare organizations significantly reduce readmission rates while fostering an environment for more positive health outcomes.”

Non-acute care is essential in my current job that is case management. This role provides a rosrponisiblity of saving a large corporation I work for money, by protecting patients health and surety by providing the patients resources like rides to and from pharmacies so they don’t miss their medication, home O2 delivery system setups, PT/OT, ect. By preventing patient readmission its part of the nurse case managers job to asses what is needed at home to prevent risk from occurring. “The cardiorespiratory patient will have a variety of needs after being discharged from an acute care facility. This includes cardiac rehabilitation,pulmonary rehabilitation,or just the need for different types of durable medical equipment.”

Brent Walker, S. V. P. M. & A. (2022, March 16). 4 Ways To Prevent Hospital Readmissions: Patientbond. Digital Healthcare Patient Engagement Platform. Retrieved July 22, 2022, from https://www.patientbond.com/blog/4-ways-to-prevent-hospital-readmissions-for-cardiovascular-disease

Pathophysiology clinical applications for Client Health. (n.d.). Retrieved July 20, 2022, from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/1

Patients that have had respiratory or cardiac conditions requiring hospitalization, whether acute or chronic will need encouragement and support. While inpatient the nurse must provide education on the condition and medications, while supporting the patient to participate in physical and occupational therapy (Johnson, 2018). This information can be overwhelming to patients as they may have several things to do when they are discharged. Patients must understand the importance of adhering to prescribed medications, doctor’s appointments, therapies, and dietary changes (Johnson, 2018). To assess the patient’s understanding of education and medications, the nurse can use the teach-back method to see if any further teaching is required.

To reduce hospital readmission rates there are several things that can be done. One thing that can be done along with education, is helping the patient schedule their specialist follow-up visit before discharge, within 2 weeks (Nair et al., 2020). Also, when transitioning from the hospital back to the patient’s place of living the nurse must be mindful of the environment in which they are living. To support the patient’s independence the nurse must assess living issues like stairs or how well the patient can perform their activities of daily living (Johnson, 2018). Addressing things like education, doctor’s appointments and living situations can help reduce hospital readmissions.

Johnson, A. (2018). Pathophysiology Clinical Applications for Client Health (Chapter 1). Grand Canyon University (Ed). https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/1

Nair, R., Lak, H., Hasan, S., Gunasekaran, D., Babar, A., & Gopalakrishna, K. (2020, March 12). Reducing All-cause 30-day Hospital Readmissions for Patients Presenting with Acute Heart Failure Exacerbations: A Quality Improvement Initiative. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186095/

Easily being a leading cause of death worldwide, cardiorespiratory issues naturally occupy a spot as one of the most pressing public health concerns. According to Alpaydin et al (2021), despite penalties, one of the most persistent problem areas that U.S. hospitals have is attempting to achieve compliance with the prevention of hospital readmissions for cardiovascular disease. While there are undoubtedly a multitude of factors that can contribute to this high rate of hospital readmissions for cardiovascular disease, patient-centered factors are most frequently cited. Hong et al (2020) discuss how numerous studies have shown that low patient participation in terms of adhering to recommended diet, exercise and medication regimens is one of the primary reasons for high readmission rates, especially among individuals with chronic conditions. It is imperative that we, as healthcare providers, ensure that our patients are leaving the hospital armed with everything they need to remain compliant outside of the hospital.

There is a wealth of information out there. In this day and age, patients that live with cardiorespiratory issues (such as Chronic Obstructive Pulmonary Disease, Cardiovascular Disease, or asthma) have a world of information right at their fingertips (via the worldwide web); for those that do not, we can step in to fill in the gaps with referrals and information for them and their caregivers. Non-acute care of the patient with cardiorespiratory issues will probably require referrals to home health agencies, medical equipment suppliers, occupational and physical therapists, medication resources, and cardiac rehab. Social workers and Case Managers are crucial players in the referral game, as they work with the patient before they’re even discharged to arrange the various services that will be required to help them manage their disease, thereby supporting their independence and decreasing their chances of being readmitted.

REFERENCES

Alpaydin, A. O., Ozuygur, S. S., Sahan, C., Tertemiz, K. C., & Russell, R. (2021). 30-day readmission after an acute exacerbation of chronic obstructive pulmonary disease is associated with cardiovascular comorbidity. Turkish Thoracic Journal, 22(5), 369–375. https://doi-org.lopes.idm.oclc.org/10.5152/TurkThoracJ.2021.0189

Hong C., Burnett, R. T., Li B., Kwong, J. C., Crouse, D. L., Lavigne, E., Goldberg, M. S., Copes, R., Benmarhnia, T., Ilango, S. D., van Donkelaar, A., Martin, R. V., & Hystad, P. (2020). Residential greenness and cardiovascular disease incidence, readmission, and mortality. Environmental Health Perspectives, 128(8), 087005-1-087005-11. https://doi-org.lopes.idm.oclc.org/10.1289/EHP6161

NRS 410 Discuss what resources are often necessary for nonacute care for cardiorespiratory issues