Missed Opportunitites for Interprofessional Practice

Summary

The discharge case conference discusses Mr. Potter, a 78-year-old post-coronary bypass patient with TMJ issues and arthritis. He's stable but anxious about medication and recovery, particularly gardening. The team, including nursing, occupational therapy, and pharmacy, addresses his concerns, plans for cardiac rehab, and suggests equipment for ADLs. The priority is cardiac education, medication adjustment, and managing his TMJ pain before potential surgery.

Takeaways

• 👨‍⚕️ Mr. Potter is a 78-year-old male who had a coronary artery bypass surgery and is now ready for discharge.
• 🏠 He will be discharged to his home with his wife and is set to start cardiac rehab.
• 💊 Mr. Potter is anxious about taking his medications and has concerns about his recovery.
• 🌱 He is eager to return to gardening, which is causing him stress due to his current health condition.
• 🏥 The team needs to complete discharge counseling and address his concerns about medication and recovery.
• 🧍‍♂️ Occupational therapy has been working with Mr. Potter on activities of daily living and stress management.
• 🛌 Mr. Potter might benefit from a bath chair for showering to conserve energy.
• 🦿 Physical therapy has been assisting with mobility and transfers, but he struggles with central precautions.
• 💊 Pharmacy suggests changing Mr. Potter's statin to a VA formulary drug to address cost and compliance issues.
• 🤝 The importance of cardiac education, medication education, and lifestyle adjustments for Mr. Potter and his wife is highlighted.
• 📞 A follow-up with the dentist is needed to manage Mr. Potter's TMJ issue and limit non-steroidal use before potential surgery.

Q & A

Who is the primary patient being discussed in the case conference?

The primary patient being discussed is Mr. Potter, a 78-year-old male in room 262.

What was Mr. Potter's initial plan before the discovery of his coronary artery disease?

Mr. Potter initially planned to undergo TMJ surgery a month ago.

What procedure did Mr. Potter undergo for his coronary artery disease?

Mr. Potter underwent stenting on one vessel due to his coronary artery disease.

Why was Mr. Potter readmitted to the hospital after his initial discharge?

Mr. Potter was readmitted due to stent restenosis, which led to him undergoing coronary artery bypass surgery.

What is the current status of Mr. Potter's recovery from the cardiac standpoint?

Mr. Potter is stable, his vitals and labs are all right, and he is recovering well from a cardiac standpoint.

What are Mr. Potter's main concerns about his recovery?

Mr. Potter is concerned about taking his medications and is anxious about his recovery, specifically mentioning gardening.

What additional health issues does Mr. Potter have besides coronary artery disease and TMJ?

Mr. Potter also has arthritis, which causes him pain in his knees and hands.

What occupational therapy interventions has Mr. Potter been engaged with?

Mr. Potter has been engaged in standard activities of daily living, energy conservation training, stress management, breathing techniques, and ergonomics related to his gardening interest.

What physical therapy issues has Mr. Potter been facing?

Mr. Potter has difficulty with bed mobility and transfers, and he struggles with stair navigation, often not following safety precautions.

What medication change is recommended for Mr. Potter due to his complaints about taking his meds?

It is recommended to change Mr. Potter's statin to Simvastatin, which is on the VA formulary, to address his complaints about medication costs.

What is the plan for Mr. Potter's discharge and follow-up care?

Mr. Potter is planned to be discharged to home with his wife, with arrangements for cardiac rehab and medication education. There is also a need for follow-up with his dentist and managing his TMJ issue.