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    Nurs 478

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    This document provides a case study overview of an 85-year-old Native American male patient who presented to the emergency room with a right hip fracture. Key concerns included a history of falls, vision impairment, medication noncompliance, social support needs as a widower, and prior hospitalizations. The BOOST model was applied to identify problems in the areas of medications, psychological concerns, physical limitations, interventions, health literacy, patient support, prior hospitalizations, and palliative care. References are provided related to improving care transitions, patient portals, hip fracture recovery, medication information, and local community resources.

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    Nurs 478

    Uploaded by

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    174 views12 pages
    This document provides a case study overview of an 85-year-old Native American male patient who presented to the emergency room with a right hip fracture. Key concerns included a history of falls, vision impairment, medication noncompliance, social support needs as a widower, and prior hospitalizations. The BOOST model was applied to identify problems in the areas of medications, psychological concerns, physical limitations, interventions, health literacy, patient support, prior hospitalizations, and palliative care. References are provided related to improving care transitions, patient portals, hip fracture recovery, medication information, and local community resources.

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    This document provides a case study overview of an 85-year-old Native American male patient who presented to the emergency room with a right hip fracture. Key concerns included a history of falls, vision impairment, medication noncompliance, social support needs as a widower, and prior hospitalizations. The BOOST model was applied to identify problems in the areas of medications, psychological concerns, physical limitations, interventions, health literacy, patient support, prior hospitalizations, and palliative care. References are provided related to improving care transitions, patient portals, hip fracture recovery, medication information, and local community resources.

    Copyright:

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    Flag for inappropriate content
    Download as pptx, pdf, or txt
    174 views12 pages

    Nurs 478

    Uploaded by

    api-641781710
    This document provides a case study overview of an 85-year-old Native American male patient who presented to the emergency room with a right hip fracture. Key concerns included a history of falls, vision impairment, medication noncompliance, social support needs as a widower, and prior hospitalizations. The BOOST model was applied to identify problems in the areas of medications, psychological concerns, physical limitations, interventions, health literacy, patient support, prior hospitalizations, and palliative care. References are provided related to improving care transitions, patient portals, hip fracture recovery, medication information, and local community resources.

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    of 12

    OLDER ADULT

    GROUP PROJECT
    IMPROVING CARE
    TRANSITION
    Lynda Attalah
    Natalie Birkel
    Nick Camacho
    Maria Hurtado
    Krystianna Roscover-Morse
    November 15, 2022
    CASE STUDY
    OVERVIEW
    Joaquin Espinoza (Senita group)
    ● 85 year old male patient
    ● Full code with NKDA
    ● Dx:Right Hip Fracture
    Situation:
    ● ER transfer due to right hip fracture
    ● Right hip replacement
    Background:
    ● Past medical history: HTN, Gout, Back Pain,
    Glaucoma, “Bladder Issues”
    ● Medications: HCTZ/lisinopril; irbesartan;
    allopurinol; gabapentin; oxybutynin; unknown eye
    drops; OcuVite
    Psychosocial:
    ● Native American(Tohono O’odham nation)
    ● Religious preference: Catholic
    ● Widower
    ● One daughter 2
    Physical Assessment
    WHAT IS CONCERNING
    ABOUT CASE
    Patient concerns
    Physical injury
    • History of falls
    • Two story housing structure
    • Tendency for wandering
    • Worsening vision
    Health illiteracy/noncompliance
    • Improper cane use
    • Unable to recall appointment information
    Social support
    • Feelings of burden
    • Depression
    • Decreased QOL 3
    BOOST MODEL 8P’S

    Problems with Meds Psychological

    • Current medication concerns • Current Psychological


    • Two antihypertensives Concerns
    • Unknown medication: eye • Widower
    drops • Changes to independence
    • Actions taken as an RN • Burdening his daughter
    • Educate about medications • Actions taken as an RN
    • Educate about importance • Services in the community
    of taking blood pressure • Community Involvement
    • Know all medications
    • Carry a list
    4
    BOOST MODEL 8P’S

    • Right hip fracture


    Principal
    • Vision Impairment
    Diagnosis
    • Falls
    • ADL’s
    Physical
    Limitations • Medication
    • Education/teaching administration
    Intervention •
    Rehabilitation
    s prior to
    DC • F/U with
    ophthalmologist • Rehabilitation
    Intervention •
    Ensure ability to
    s prior to
    DC assistance
    • Home services
    5
    BOOST MODEL 8P’S – HEALTH
    LITERACY AND PATIENT SUPPORT
    Health Literacy Patient Support
    Current concerns:
    Actions: Actions:
    • Member of the • Ensure correct/ • Connect patient &
    Tohono O’odham culturally daughter to a
    Tribe • Appropriate Home Health
    • Potential language Agency
    language barrier • Make sure patient • Have the patient
    • Worsening Vision teaches utilize the Tohono
    • Widow • Back and follow O’odham health
    up after resources
    • Lives with his
    • Discharge • Utilize the same
    daughter
    • Use audio teaching healthcare
    as well provider
    • As written
    teaching 6
    BOOST MODEL 8P’S
    PRIOR HOSPITALIZATION AND
    PALLIATIVE CARE
    Prior Hospitalizations: Patient has been brought to the ER
    several times in the last few months due to falls

    Fall proof the home, encourage cane usage, discuss importance of


    staying active

    Palliative Care

    Goal = increase quality of life Amory Park Center


    7
    WHAT P’S WERE
    CONCERNING OR
    OVERLOOKED?

    ? Most concerning Ps
    o Problems with medications
    o Patient support
    o Prior hospitalization

    8
    REFLECTION
    ON PRIOR
    CLINICAL
    ROTATIONS
    oVeteran Affairs
    o Implement community
    outreach programs
    o Offer transportation
    services
    o Access to patient
    portal

    9
    REFERENCES
    Elkind, E. & Higgins, K. 2018. Patient Portal Considerations. Nursing Informatics, 49(3), 9-
    11. http://dx.doi.org/10.1097/01.NUMA.0000530430.91645.34

    City of Tucson. (2022). Armory Park Center. City of Tucson.


    https://www.tucsonaz.gov/parks/ArmoryCenter

    Gattey, D. M. (2008). Dislocation of the lens 379.32 (Ectopia Lentis, luxation of the lens,
    subluxation of the lens). Roy and Fraunfelder's Current Ocular Therapy, 556–558.
    https://doi.org/10.1016/b978-1-4160-2447-7.50306-6

    González de Villaumbrosia, C., Sáez López, P., Martín de Diego, I., Lancho Martín, C.,
    Cuesta Santa Teresa, M., Alarcón, T., Ojeda Thies, C., Queipo Matas, R., & González-
    Montalvo, J. (2021). Predictive model of gait recovery at one month after hip fracture from a
    national cohort of 25,607 patients: The Hip Fracture Prognosis (HF-prognosis) tool.
    International Journal of Environmental Research and Public Health, 18(7), 3809.
    https://doi.org/10.3390/ijerph18073809 10
    REFERENCES
    Micromedex. (n.d.). Timolol. Retrieved from https://www-
    micromedexsolutions-com.ezproxy1.library.arizona.edu/micromedex2/
    librarian/CS/7CBA2B/ND_PR/evidencexpert/ND_P/evidencexpert/
    DUPLICATIONSHIELDSYNC/D933F5/ND_PG/evidencexpert/
    ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/
    evidencexpert/PFActionId/evidencexpert.DoIntegratedSearch?
    SearchTerm=Timolol&fromInterSaltBase=true&UserMdxSearchTerm=
    %24userMdxSearchTerm&false=null&=null#

    Pima Council On Aging. (n.d.). About PCOA. Retrieved from


    https://pcoa.org/about-pcoa/

    Potter, P.A., A.G., Hall, A., & Stockert, P.A.(2021). Fundamentals of


    nursing (9th ed.).Elsevier. 11
    References
    Teachback.org. n.d. How do we know someone understands?
    Retrieved from
    http://teachback.org/learn-about-teach-back/

    Tonhc.org. n.d. Clinical Services Available. Retrieved from


    http://www.tonhc.org/facilities/sells-hospital/

    12

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