Posted: April 9th, 2015
For this assignment, the student is the case manager assigned to composing a discharge plan for a patient who does not want to consider any other plan than to return to their home. The student will select a hospitalized client and determine the patients discharge plan. The student will create a scenario where the family is in disagreement about future care plans for the patient. Focus is on two elements significantly influencing the process, the patient”s decisional capacity and the involvement of family members in decision-making. Discuss in terms of factors compromising the autonomy of the patient and the interdependency of family members. Examples for scenarios could include new onset CVA, with left-sided weakness, CHF with 4 admissions in the last 6 months, ESRD on dialysis, Status Post MVA with a TBI, metastasized pancreatic cancer, or another form of cancer. The student is to complete the discharge planning process from admission until discharge, completing the case management documentation. Complete an initial assessment at the time of admission, keeping in mind that discharge decisions are more easily reached and understood when the purpose and expected outcome for admission to treatment is agreed upon when a client is admitted for service
1. Identify any possible discharge needs at the time of admission. Is there anything that needs to be done at this time?
2.Determine the discharge level of care and destination. What was the basis for the decision? Why is it an appropriate level of care? Who was involved and what was their contribution?
3.How do you get the client to the discharge destination (transportation)? What is the follow-up?
4.Can include cognitive capacity, disagreement with the discharge between family members and healthcare team, conflicting ethical standards, refusal of services, spouse-partner unwillingness to have partner come home, unsafe living environments, and multiple failed discharge attempts.
5.Resolving issues by using Mattisons hierarchical ethical decision-making model may be helpful to research.
CategoryMastery 50 pointsReinforced 49-30 pointsIntroductory 29-0 pointsScore
Discharge Needs IdentifiedAll possible discharge needs identified at appropriate level of careSome discharge needs missing or appropriate level of care incorrectDischarge needs are not identified and care level is not appropriate
Discharge DecisionsDischarge destination identified with transportation and follow up noted. Basis of ethical decision- making clearly explainedDischarge destination identified but transportation needs not addressed or basis of ethical decision making unclearNo discharge destination identified and ethical decision making process not delineated
Discharge Conflict ResolutionIndividuals involved in discharge conflict identified with both ethical sides of the argument examinedIndividuals involved in discharge conflict identified but only one side of ethical argument examinedIndividuals involved in discharge conflict not identified or ethical arguments not examined
APA, spelling, grammarNo APA, spelling or grammar errors0-5 errors in APA, spelling or grammarMore than 6 errors in APA, spelling, or grammar
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