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Knee Replacement (Home Care)

Developed by: MGH Institute of Health Professions, Partners Home Care

Overview

A) Wound Assessment

This case presents a patient who was recently discharged to her home after a total knee replacement. Her hospital course was complicated by a wound infection requiring IV antibiotics for 3 days. The patient was changed to oral antibiotics in preparation for hospital discharge. The student will be expected to conduct a focused home visit by demonstrating a basic patient assessment, perform a wound assessment and care.

B) Medication Reconciliation

This case presents a patient who was recently discharged to her home after a total knee replacement. Her hospital course was complicated by a wound infection requiring IV antibiotics for 3 days. The patient was changed to oral antibiotics in preparation for hospital discharge. The student will be expected to conduct a focused home visit by demonstrating a basic patient assessment, perform a medication reconciliation and respond appropriately.

C) Comprehensive Home Assessment

This scenario presents an elderly woman who is 7 days postoperative from a total knee replacement. Her post surgical course was complicated by a wound infection, requiring IV antibiotics for 3 days and then changed to oral antibiotics in preparation for hospital discharge. The student will be expected to conduct a home admission which incorporates a patient assessment for wound, pain and cardiopulmonary status; home safety assessment; medication reconciliation; perform point-of-care PT/INR testing, and respond appropriately to test results.

Description

Learning Objectives

A) Wound Assessment:

  1. Perform general and focused assessment competently and safely
  2. Deliver prioritized care that is patient centered
  3. Encourages patient self care when appropriate
  4. Evaluate pain management and develop appropriate intervention
  5. Develop plan of self improvement based on reflective debriefing

B) Medication Reconciliation:

  1. Perform general and focused assessment competently and safely
  2. Deliver prioritized care that is patient centered
  3. Encourages patient self care when appropriate
  4. Evaluate pain management and develop appropriate intervention
  5. Develop plan of self improvement based on reflective debriefing

C) Wound Assessment:

  1. Perform comprehensive patient assessment competently and safely
  2. Analyze and interpret physical findings and diagnostic results and intervene appropriately
  3. Evaluate pain management and develop appropriate intervention
  4. Determine the functional capacity of an older adult in the home and apply appropriate interventions
  5. Evaluate home safety risks and appropriately intervene and/or deliver teaching
  6. Demonstrate effective communication and teaching strategies for the older adult
  7. Deliver prioritized patient-centered care in a home setting
  8. Critically reflect performance and develop a self-improvement plan
Nurse of the Future Nursing Competencies©

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