Questions
Integrates the professional role of leader, teacher, communicator, and manager of care to plan cost-effective, quality healthcare to consumers in structured and unstructured settings.Discussions are designed to promote dialogue between faculty and students, and students and their peers. In discussions students:
Demonstrate understanding of concepts for the week
Integrate scholarly resources
Engage in meaningful dialogue with classmates
Express opinions clearly and logically, in a professional manner
Discussion Questions
Planning for our patients during times of transitions (for example: hospital to home, home to rehabilitation facility) involves collaboration with a number of healthcare professionals. Please address the following questions:
How does your facility promote interprofessional collaboration during times of patient transitions?
What is the role of the nurse in patient transitions?
What gaps can you identify in this process related to quality of care? (If you are not currently in practice, please use a previous role or clinical experience in your answers.)
Class: Most hospitals are implementing Transitional Care and hiring BSNs as transitional care nurses! There are several models out there. Dr. Coleman is the guru of transitional care (Care Transitions, 2014). There is also Dr. Naylor’s Model and Project Red (AHRQ, 2016). So I am sure many of you are using bits and pieces of these.
Our discussion this week will help us meet the following program outcome and course objectives:
PO#7: Integrates the professional role of leader, teacher, communicator, and manager of care to plan cost-effective, quality healthcare to consumers in structured and unstructured settings
Objectives:
-Use nursing ethical principles in health promotion to advocate for and empower diverse groups in support of their health.
-Determine appropriate collaboration efforts in health planning for vulnerable populations.
Please address the following questions:
How does your facility promote interprofessional collaboration during times of patient transitions?
What is the role of the nurse in patient transitions?
What gaps can you identify in this process related to quality of care? (If you are not currently in practice, please use a previous role or clinical experience in your answers.)
You are only required to post an initial answer post and ONE follow-up post each week.
Please make your TWO posts each week on any of the eight days allotted from preview Sunday to closing Sunday that work with your schedule. Both posts may be on the same day.
No late deduction will be taken for late assignments but communicating a plan is helpful if you are able.
Solution
Interprofessional Collaboration
Nurses are engaged in numerous care transitions because patients are always leaving the hospital to receive care at home or in other out-of-hospital care settings. Therefore, they collaborate with members of the interdisciplinary teams to facilitate the transition process (Sharma, O’Hare, Antonelli, & Sawicki, 2014). Although other care providers are important in the transition, process, health care that promote interprofessional collaboration during care transitions recognize the role of the nurse and address gaps in the process related to quality of care.
I work in a healthcare organization that recognizes the importance of effective transition of patients from the hospital care to home or any other out-of-hospital care setting. The healthcare facility uses the WHO proposed model that engages care providers, the patient, family, caregivers, and the community in supporting effective transition (Sharma, O’Hare, Antonelli, & Sawicki, 2014). Nurses are critical actors in the interdisciplinary teams. Whenever they engage in care transition, they play three main roles, the patient’s voice through advocacy, the source of information about the patient to other players in the team, and the coordinator of the transition. However, some transitions are more successful than others because of gaps in the care process. Some of the emerging gaps include lack of adequate knowledge about families and the community about emerging diseases, such as chronic illnesses, lack of adequate support from caregivers and families out of the hospital, and lack of cooperation from the patient, family or other caregivers (Scotten, Manos, Malicoat, & Paolo, 2015). Regardless of the gaps, the facility strives to provide the most successful transition care to patients.
The healthcare facility recognizes the need for effective care transition because it is inevitable for patients to leave the hospital. Hence, it has been providing training to nurses who support the transition to play their effective role as advocates and coordinators of the transition. Regardless of the gaps, the hospital posts a high level of satisfaction among patients and their families.
References
Scotten, M., Manos, E. L., Malicoat, A., & Paolo, A. M. (2015). Minding the gap: Interprofessional communication during inpatient and post discharge chasm care. Patient Education and Counseling, 98(7), 895-900.
Sharma, N., O’Hare, K., Antonelli, R. C., & Sawicki, G. S. (2014). Transition care: future directions in education, health policy, and outcomes research. Academic pediatrics, 14(2), 120-127.
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
