Making a Safe Transition Paper
In December 2014, changes were made in Medicare payment rules. Hospitals are now penalized when a patient returns within 30 days for treatment of the same problem. One of the targeted medical diagnoses for this payment change is chronic obstructive pulmonary disease (COPD). Therefore, it is essential that the interdisciplinary team be utilized to ensure a safe transition between the acute care setting and home for the patient with COPD.
Using APA format, write a six (6) to ten (10) page paper (excludes cover and reference page) that addresses the disease management needs of adult patients with COPD for a safe transition between the acute care setting and home and the role of the interdisciplinary team in that transition.
A minimum of three (3) current professional references must be provided. Current references include professional publications or valid and current websites dated within five (5) years. Additionally, a textbook that is no more than one (1) edition old may be used.
The paper will consist of four (4) parts
Parts 1, 2, and 3 will focus on a disease management issue for the patient with COPD and the role of the interdisciplinary team in this issue.
Part 4 is the conclusion and needs to evaluate the effectiveness of the interdisciplinary team in making this a safe transition for the patient with COPD.
Part 1: Medication Adherence
Part 1 must include the following:
1. Two common classes of medications used to manage COPD are bronchodilators and corticosteroids. Why are these medications used to manage COPD? .
2.What are some common side effects of these classes of medications? Which of these side effects would be reported and why? Which side effects would not be reported and why? .
3.Describe any special instructions that would be included with each class of these medications. For example, food-drug interactions and medications that should be avoided. .
4.Which health care discipline, in addition to the RN, is best suited to help with medication adherence? How will this team member collaborate with the RN, the patient and the family to help promote medication adherence and a safe transition to home? .
Part 2: Dietary Modifications
Part 2 must include the following:
1.What is the role of diet in managing COPD? What changes need to be made to the present diet? What role does culture play with diet? .
2.What obstacles might be encountered when informing the patient about the changes in diet? .
3.Which health care discipline, in addition to the RN, is best suited to help with dietary modifications? How will this team member collaborate with the RN, the patient and the family to help promote healthy eating and a safe transition to home? .
Part 3: Physical Activity
Part 3 must include the following:
1.What is the role of physical activity in managing COPD? .
2.How would the RN promote adherence to a daily activity routine? .
3.Which health care discipline(s), in addition to the RN, are best suited to help with physical activity? How will this (these) team member(s) collaborate with the RN, the family and the patient to help promote physical activity and a safe transition home? .
Part 4: Conclusion
Part 4 must include the following:
1.A detailed conclusion that includes an evaluation of the effectiveness of the interdisciplinary team in making a safe transition for the patient with COPD
M6A3: Making a Safe Transition Paper
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Making a Safe Transition Paper
Introduction
Chronic obstructive pulmonary disease is a disease causing blockage of air flow resulting to breathing problems. Chronic obstructive pulmonary disease is a progressive disease, meaning that it gets worse at time goes by. With time, patients experience difficulties in breathing. COPD arise in a situation where the diameters of the marginal airways start becoming small, making it difficult for patients to breathe properly (Global Initiative for Chronic Obstructive Pulmonary Disease, 2009). COPD is an irreversible process that can only be managed but certain types of treatment. Several people diagnosed with COPD are cigarette smokers or people who use to smoke cigarettes. Another cause of COPD is exposing the lungs to certain conditions that might cause irritation like polluted air, chemical fumes and dust. All these greatly contribute towards developing COPD. Patients suffering from COPD, display several symptoms including: tightening of the chest, shortness of breath, wheezing and constant coughing (Global Initiative for Chronic Obstructive Pulmonary Disease, 2009). This paper seeks to address the disease management needs of adult patients with COPD for a safe transition between the acute care setting and home and the role of the interdisciplinary team in that transition.
Bronchodilators and Corticosteroids
COPD can be managed using two standard classes of medication namely bronchodilators and corticosteroids. Bronchodilators are preferable because they make breathing comfortable. Bronchodilators relax the lung muscles as it widens airways. Patients with a long-term condition of COPD can benefit from bronchodilators to reduce the narrowing and inflammation of lungs. Bronchodilators help patients open the airways to ease breathing; doctors may recommend short-acting bronchodilators in cases of emergency or in case of quick relief. These types of medications can be in the form of inhalers or liquid added to the inhaler. Corticosteroids are also referred to as steroids prescribed for several medical conditions like COPD. For COPD, Corticosteroids are used to repress the immune system from being damaged and also reducing inflammation to ensure smooth flow of air to the lungs. For some patients with COPD, the airways are usually inflamed resulting to difficulties in breathing. Corticosteroids can be prescribed alongside bronchodilators because if the two medications are combined they make breathing to be more efficient (Kinman, 2014).
Medication side effects
Coughing and running nose are some of the common occurrences among patients with COPD; patients might not report it as a problem. Some of the side effects that can be reported includes; dry mouth, blurred vision. For bronchodilators, the common side-effects that can be reported are shaking and increased pace of the heart beat. Other severe side effects from this type of drug include allergic reaction displayed in the form of rashes. Patients using corticosteroids may not report when experiencing headache, change in their voice and common cold. They might report sore throat, infection in the mouth, diabetes and high blood pressure (Kinman, 2014). Doctors issue special instruction for each of this medication for example when using bronchodilators; it is important to use it with a spacer or a holding chamber. Rinsing the mouth and gargling the mouth with water after using Bronchodilators prevents some of the side effects. When using corticosteroids, it should not be used for a quick relief; the medication should be taken with food or even milk. In addition, this drug cannot prevent a patient from any attack that has started. Patients are advice not to stop taking this type of medication before consulting a doctor (Kinman, 2014).
Medication adherence
Registered nurses assist patients in managing symptoms by teaching patients some coping skills. Registered nurses teach about self-care and perform referrals where necessary. For severe cases of COPD, patients need to be carefully monitored in hospital. In this case, physician’s role is important as they work together with nurses. Adherence and diligence towards medication are important in managing COPD. For patients with acute symptoms of COPD, steroids are administered intravenously with specific amounts being considered after six to twelve hours before switching to oral dosage. This process takes long requiring close monitoring by experienced and more qualified medical personnel like physicians. Physicians can only achieve the desired results by working in collaboration with nurses in this process. To monitor the patient after the oral dosage process for over two weeks, the brown bag technique has proven to be effective. After discharge, patients need to bring all his medication during his appointment and also describe how he used the drug. (Global Initiative for Chronic Obstructive Pulmonary Disease, 2009). The brown bag technique is an inclusive process because the physician, the pharmacist and the nurse can monitor the adherence and identify potential interaction or certain error during each visit. The patients’ family can be included by educating them about COPD a process that can either be done by the physician in collaboration with the nurses. Both patients and the family members are taught how to observe some of the usual symptoms associated with COPD and contact the healthcare providers if the symptoms get worse. The collaboration efforts between the physician, family members and nurses help in the patient’s transition process from hospital to home safely (Global Initiative for Chronic Obstructive Pulmonary Disease, 2009).
Dietary Modifications
Good nutrition lowers the infection in the body, for patients with COPD it is crucial to reducing the risk of by maintain a healthy diet. In addition, some of the lung diseases react with certain nutrients. It is important to consult either the doctor or dietitian about the potential interaction of certain medicines. Certain changes need to be considered for patients suffering from COPD. Maintaining weight needs to be the first step, being overweight means the heart and lungs will need to do extra work resulting breathing problems. On the other hand, being underweight results to feeling weak and tired as one is at risk of acquiring several other infections. COPD patients requires allot of energy to breathe compared to the average people .the breathing muscles requires ten times more calories. Allot of calories is important to produce enough energy .energy produced from calories prevents weakening of pulmonary muscles and the diaphragm. Most patients need extra protein to reduce infection; the main sources of protein are meat, fish, egg, poultry and dairy products (Fein and Fein, 2000).
Drinking a lot of fluids is also essential as it helps in secretion in the pulmonary. Fluids are important because they present dehydration therefore for patients with COPD needs 8-12 cups of fluids daily. The best source of fluids is water, patients with COPD needs to take plenty of water because they usually develop heart problems limiting fluids. It is also advisable that patients with...