Hospital Discharge Paper

Patients are often readmitted to hospitals with exacerbated diseases or severe forms of illnesses due to poor care post-discharge. Readmissions are associated with higher mortality and morbidity and high healthcare costs. Health promotion is thus integral to any patient during discharge from a hospital. Often, patients require health messages to prevent readmissions and promote their health. This paper discusses the health education on evidence-based practices for Tina’s diagnosis to prevent readmission.

Hospital Discharge Paper

Diabetes Mellitus is a group of metabolic disorders characterized by high uncontrolled blood sugars above 126mg/dl fasting blood sugars (Glovaci et al., 2019). There are two types of diabetes based on their etiologies. Diabetes type 1 is caused by an autoimmune disease that destroys beta cells that produce insulin while type 2 diabetes is caused by insulin resistance, decreased insulin production, or a combination of both (Glovaci et al., 2019). Eating junk foods, being overweight, and genetic predisposition can expose one to diabetes.

According to Gregory et al. (2018), wound cleaning, infection prevention, activity, exercises, diet, medications, and preventing dehydration is crucial. In addition, they should be taught how to measure glucose and administer insulin as per the prescription, interpret instructions and respond accordingly (Gregory et al., 2018). A healthy diet is also integral since a poor diet such as junk foods are the leading cause of uncontrolled blood sugars.

Asthma is an obstructive upper respiratory system condition that involves inflammation, swelling, and narrowing of the trachea hence the production of mucus that causes breathing difficulties. Asthmatic attacks are often acute and caused by allergens. According to Castillo, Peters, and Busse (2017), one effective way of avoiding asthmatic attacks is avoiding allergens such as dust, pollen, cold, heat, and certain smells.

In addition, as an asthmatic patient should always carry an inhaled bronchodilator to relieve symptoms which are often sudden and severe. Quitting smoking and avoiding pets’ fur are also effective methods to prevent asthma medical emergencies and readmissions.

Dehydration occurs when the body loses more fluids than it replaces, making water unavailable for normal metabolic processes. According to Gregory et al. (2018), heart failure is the leading cause of readmission, followed by hypoglycemia and hyperglycemia. Dehydration is common in heart failure and acute renal injury, resulting in increased water loss in several ways.

The most common source of dehydration is poor fluid intake and increased water loss in the kidneys. Diarrhea and vomiting are also major culprits. It is possible to prevent dehydration through proper glycemic control, taking enough water, and preventing infections (Gregory et al., 2018). Seeking healthcare services early helps prevent exacerbation of illness and development of their severe forms.

Infections are rampant and contribute more than half the total medical cases. Microorganisms find their way past host first-line defenses (for example, skin) and mount an attack producing significant effects on the individual. As Mishra et al. (2017) notes, it is possible to prevent infections through simple hygiene and sanitation procedures. Washing hands regularly, drinking treated or boiled water, and proper disposal of wastes have been effective methods of minimizing infection and preventing readmissions. Sanitizing hands and cleaning surfaces is an added advantage in preventing infections.

Wound care is vital in wound healing. Foot ulcers are prevalent in diabetic patients and take a lot of care and time to heal. They can lead to progressive, irreversible destructions of bones, tissue, and joints (Mishra et al., 2017). During care, they should be covered to prevent the entry of pathogens. Always clean wounds with clean water and dress with sterile dressings.

Alternatively, dressing at the hospital instead of doing it at home can prove advantageous in infection prevention, control and healing (Dhar et al., 2020). The dressing should be timely and as per the physician’s prescription. The dressings should also be suited to allow air circulation through the wound. The areas should also be kept devoid of water and other fluids. Wound care entails monitoring and dressing, especially for diabetic patients. With appropriate wear, regular wound assessment, and early referral of complications, wounds can be effectively managed (Mishra et al., 2017).

Medications are essential for patient recovery. Inject insulin in the lower abdomen, thigh, and upper arm. Always remember the dosage and frequency depending on the type of insulin, for example, soluble insulin. Antibiotics and other medications should be well labeled and recorded, and the patients should be reminded adherence. An adherence support member is required if the patient tends to forget quickly or has medication adherence problems (Gregory et al., 2017). More so, ensure you get more medications before they are used up to avoid missing doses.

Inactivity exacerbates existing conditions, and physical activity is one way to improve an individual’s health. Morning run, jogging, walking, and riding bicycles are some valuable activities. Lifting weight is an effective way of maintaining and improving muscle power. Take enough rest between exercises. Do not lift heavy weights due to underlying metabolic problems. Further, as Volkert et al. (2019) observes, too much work/exercise can lead to hypoglycemia. Exercises can lead to dehydration and hypoglycemia when overdone. Do exercises with precaution.

A healthy diet is crucial in the recovery and regeneration process. Vegetables and fruits should make up half of the meals, proteins a quarter, and the rest carbohydrates (Cradock et al., 2017). Take foods rich in proteins such as fish, milk, and eggs and foods rich in other minerals such as liver and kidneys. Carbohydrates are essential in preventing hypoglycemia. Avoid sugary foods and high glucose content foods such as potatoes. Do not overeat; take enough. Healthy diet and exercise interventions significantly affect the recuperation of diabetic patients and prevent readmissions (Volkert et al., 2019).

Follow-up helps ensure continued care and helps mitigate arising complications early. Follow-up for wound care and glucose regulation is very vital (Mishra et al., 2020). Book appointments with the hospital and come back regularly to ensure health complications do not arise. Come back to the hospital when blood sugar is consistently high, the wound fails to heal, deterioration of health with an inability to perform activities of daily living (Mishra et al., 2020)

Preventing disease relapse thus preventing readmission is very vital. Patient and family education on evidence-based practices to prevent readmission is also very crucial. As seen above, diabetes and asthma have several complications, and health promotion during and post- discharge is paramount. Nurses and other healthcare providers must collaborate to give accurate and valuable information to the patient and their families to aid in the patient’s healing and recovery without complications.

References

  • Castillo, J. R., Peters, S. P., & Busse, W. W. (2017). Asthma exacerbations: pathogenesis, prevention, and treatment. The Journal of Allergy and Clinical Immunology: In Practice, 5(4), 918-927. https://doi.org/10.1016/j.jaip.2017.05.001
  • Cradock, K. A., ÓLaighin, G., Finucane, F. M., Gainforth, H. L., Quinlan, L. R., & Ginis, K. A. M. (2017). Behavior change techniques targeting diet and physical activity in type 2 diabetes: A systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 1-17. https://doi.org/10.1186/s12966-016-0436-0
  • Dhar, A., Needham, J., Gibb, M., & Coyne, E. (2020). The outcomes and experience of people receiving community‐based nurse‐led wound care: A systematic review. Journal Of Clinical Nursing, 29(15-16), 2820-2833. https://doi.org/10.1111/jocn.15278
  • Glovaci, D., Fan, W., & Wong, N. D. (2019). Epidemiology of diabetes mellitus and cardiovascular disease. Current Cardiology Reports, 21(4), 1-8. https://doi.org/10.1007/s11886-019-1107-y
  • Gregory, N. S., Seley, J. J., Dargar, S. K., Galla, N., Gerber, L. M., & Lee, J. I. (2018). Strategies to prevent readmission in high-risk patients with diabetes: the importance of an interdisciplinary approach. Current Diabetes Reports, 18(8), 1-7. https://doi.org/10.1007/s11892-018-1027-z
  • Mishra, S. C., Chhatbar, K. C., Kashikar, A., & Mehndiratta, A. (2017). Diabetic foot. BMJ, 359. https://doi.org/10.1136/bmj.j5064
  • Rubin, D. J. (2018). Correction to: hospital readmission of patients with diabetes. Current Diabetes Reports, 18(4), 1-9. https://doi.org/10.1007/s11892-018-0989-1
  • Volkert, D., Beck, A. M., Cederholm, T., Cruz-Jentoft, A., Goisser, S., Hooper, L., Kieswetter, E., Maggio, M., Simon-Reynaud, A., Sieber, C. C., Sobotka, L., Asselt, D., Wirth, R., & Bischoff, S. C. (2019). ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition, 38(1), 10-47. https://doi.org/10.1016/j.clnu.2018.05.024