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NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan CG

Preliminary care coordination Plan

NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan CG

 The significance of care coordination is its enhancement of patient compliance and assisting the patients in addressing non-medical needs. Care coordination also enhances professional and family care, giving capabilities and ensuring the patient’s bio-physical needs are met. Another benefit of a care coordination plan is reflected in the reduction of healthcare cost, improvement of the patient outcomes, and the utilization of a multidisciplinary team which ensures care effectiveness. The variety of care providers’ expertise coordinated also enhances the patient’s safety and quality of care. This paper presents a care coordination plan for a patient with Chronic Obstructive Pulmonary Disease. 

Chronic Obstructive Pulmonary Disease (COPD)

  According to Quaderi & Hurst (2018) Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of morbidity and mortality globally. Quaderi & Hurst’s study further reveals that the number of patients affected by COPD globally is approximately 328 million people. In a study by Sullivan et al. (2018), COPD has been one of the leading causes of death since 2020. The primary signs and symptoms of COPD as a debilitating illness are the disruption of airflow in the lungs, affecting the patient’s normal breathing. Other common symptoms of COPD are frequent chest infections and persistent wheezing. In the US, the number of COPD patients is approximately 12 million. Based on different studies, the leading cause of COPD in the US is the interference of the functioning of lungs by exposure to sufficient environmental stimulus. Examples of these environmental stimuli are household air pollution and tobacco smoking. Even though COPD is a major world problem, it can be treated and prevented. However, treating it depends on early detection and beginning the medication process. The prevention of COPD also depends on adopting standard health prevention measures. 

NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan CG

According to Sullivan et al., the common challenge experienced by COPD patients is the airflow limitation caused by the alveolar problems. Thus, COPD patients persistently exhibit respiratory system symptoms primarily manifesting through difficulty breathing. Since COPD adversely affects the patients’ health and is currently one of the significant health problems, the primary nurses have adopted care coordination to enhance care provision for COPD patients. The primary nurses’ utilization care coordination also plays a significant role in the early identification of COPD and the management and assessment of its cases. 

  ML is a 57 male patient with COPD diagnosed with the condition two years ago after complaining of breathing problems for some time. When ML was presented to the clinic, he complained of difficulty breathing on exertion and breathlessness. The mMRC scale in a score of 3 showed that ML was unable to walk 100 yards because of breathlessness. Besides, in the morning, he had coughs that produced yellow sputum together with persistent wheezing. The patient also reported that his symptoms have exacerbated to the extent that he has been afraid of living due to breathlessness experiences in the past six months. During the diagnosis, it was revealed that ML smokes more than seven cigarettes in a day which is approximately more than 30 pack years. The previous health records of ML also indicate that seven months ago, he experienced complications with COPD that were managed with antibiotics, salbutamol, and steroids. The medication helped with the difficulties, but the condition later worsened. Therefore, the coordination plan has been designed to assist with the care provision, treatment, and management of ML’s COPD case. 

Care coordination plan

 Patient: ML 

 Age ;50 years 

 Home Address; Manhattan, New York

Summary of the patient’s status and current problems; ML’s medical history presented the necessary information for COPD diagnosis. He has experienced three instances of COPD-related breathing complications in the last six months. ML also experiences persistent wheezing, and when he coughs, he produces yellow sputum. ML’s medical history also shows that he experiences breathlessness after walking short distances. ML also consumes at least seven cigarettes per day, translating to approximately 30 pack years. A spirometry test was conducted on ML confirmed that he was suffering from Chronic Obstructive Pulmonary Disease. 

NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan CG

Self-management behavior

 Attending a smoking cessation program: This will enhance the functioning of the lungs and slow down COPD progress significantly. Also, it will reduce the risk of coronary heart disease and lung cancer. The smoking cessation program will also improve ML’s survival rate.

 Pulmonary rehabilitation program attendance: this will help with exacerbated weight loss secondary to his COPD, reduce dyspnea and improve exercise tolerance. 

 Medication adherence: Enhance the effectiveness of the medication regimen and speed up the recovery process. 

 Community Resources:

 Pharmacy 

 Drugs and substance rehabilitation center 

 Fitness health center 

 Special care: 

Seeking specialists’ assistance: Attending the nearest rehabilitation and nursing center

Discipline: pulmonary rehabilitation and tobacco cessation.

Treatment goals: reduce complication risks and improve the patient’s quality of life.

Patient education: 

Self-management education: In collaboration with the healthcare professionals, the nurse care coordinator will provide self-management education to the patient to improve health-related quality of life and reduce hospital visits due to frequent complications of COPD. 

Vaccination: 

NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan CG

Pneumococcus and influenza vaccinations will be administered to prevent the risks of lower respiratory tract infections and frequent COPD complications. ML will be advised to vaccinate as prescribed to improve his quality of life. 

 The role of the family 

 The involvement of the patient’s family in care coordination enhances care outcome and quality of life (Sigurgeirsdottir et al.2020). The role of ML’s family in the care coordination will be to provide emotional support and ensure he takes his medications as prescribed. Where necessary, his family will act as his advocate. 

References

Quaderi, S. A., & Hurst, J. R. (2018). The unmet global burden of COPD. Global Health, Epidemiology and Genomics, 3. https://doi.org/10.1017/gheg.2018.1

Sigurgeirsdottir, J., Halldorsdottir, S., Arnardottir, R. H., Gudmundsson, G., & Bjornsson, E. H. (2020). Frustrated Caring: Family Members’ Experience of Motivating COPD Patients Towards Self-Management. International Journal of Chronic Obstructive Pulmonary Disease, 15, 2953–2965. https://doi.org/10.2147/COPD.S273903Sullivan, J., Pravosud, V., Mannino, D. M., Siegel, K., Choate, R., & Sullivan, T. (2018). National and State Estimates of COPD Morbidity and Mortality – the United States, 2014-2015. Chronic Obstructive Pulmonary Diseases (Miami, Fla.), 5(4), 324–333. https://doi.org/10.15326/jcopdf.5.4.2018.0157

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