Marcia is a 63-year-old female who is being discharged from the hospital for treatment of Chronic Obstructive Pulmonary Disease (COPD). Marcia consumes canned and processed frozen foods at home and does not exercise. She smokes half a pack a day and has been doing it for the past twenty five years. In addition, Marcia does not communicate with other people outside of her immediate family.
To prevent further readmissions, the providers in the case study should focus on evidence-based practices of transitional care (TC), which is effective in reducing all-cause hospital readmissions in patients with COPD such as Marcia (Ridwan et al., 2019). In addition, Marcia’s providers need better communication strategies to conduct pre-discharge and post-discharge interventions when transferring her between different environments (Ridwan et al., 2019). To prevent Marcia from being readmitted, hospital employees should familiarize her with medication and treatment-related matters and schedule her next appointment instead of making Marcia do it herself (American Association of Colleges of Nursing, 2016). Moreover, in addition to having Marcia use nicotine gum, the medical staff needs to develop a sufficient smoke-free policy due to the patient’s long history with cigarettes (Sharpe et al., 2021). Finally, an employee should be assigned to regularly follow up with Marcia to monitor her condition and make appropriate recommendations.
Marcia’s low social interaction may be the reason for readmissions, and a solution to that issue may greatly alleviate the issue. Social determinants of health (SDH) can impact all-cause hospital readmissions (Sharpe et al., 2021). For Marcia, such factors include a lack of a university education, not having a full job, and living alone in a poorly maintained apartment complex that is located in a seemingly underprivileged neighborhood. To reduce the possibility of Marcia’s readmission, authorities should provide her with social interaction and communities that would support her case and issue. Moreover, medical professionals should implement an individual approach to Marcia, such as finding a psychologist (Cianelli et al., 2016). In addition, Marcia should stop smoking and develop a healthy routine to support her mental health. The healthcare team in the case study appears to have overlooked social and individual factors and that may have led to Marcia being readmitted.
References
American Association of Colleges of Nursing. (2016). Clinical practice experiences FAQs. Web.
Cianelli, R., Clipper, B., Freeman, R., Goldstein, J., & Wyatt, T. H. (2016). The innovation road map: A guide for nurse leaders. Web.
Ridwan, E. S., Hadi, H., Wu, Y. L., & Tsai, P. S. (2019). Effects of transitional care on hospital readmission and mortality rate in subjects with COPD: A systematic review and meta-analysis. Respiratory Care, 64(9), 1146-1156. Web.
Sharpe, I., Bowman, M., Kim, A., Srivastava, S., Jalink, M., & Wijeratne, D. T. (2021). Strategies to prevent readmissions to hospital for COPD: A systematic review.Journal of Chronic Obstructive Pulmonary Disease, 18(4), 456-468. Web.