NRS-460 Benchmark - Case Study: Timothy Smith -
Discharge Planning
Directions: Read the case study below. Evaluate the information and formulate a
conclusion based on your evaluation. Complete the critical thinking table and submit the
completed template to the assignment dropbox.
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the
complex management of disease during the discharge of a patient, and the additional aspects of
communication and safety in the work environment. The purpose of this assignment is to
participate in discharge planning for a patient utilizing communication and information
technology, and in a scenario where patient and provider safety is a concern.
PART I: Health History and Medical Information
Evaluate the health history and medical information for Timothy Smith, presented below.
Mr. Smith is ready to be discharged from the hospital. Timothy has been weaned off of
oxygen. His tube feedings have been discontinued and he is tolerating a pureed diet. To
facilitate safe discharge, the hospital case manager has set up services with a transitional
care manager from a Home Health agency. The goal is for Mr. Smith to attain safe
recovery and rehabilitation.
1. Broken left leg status
2. Weight bearing status: non-weight bearing, stand pivot with right leg only
a. Assistive devices: wheelchair
b. PICC line present for discharge
3. Left upper leg wound care: dressing changes as needed for open reduction
internal fixation (ORIF) on leg
4. Psychiatrist telehealth follow-up scheduled for a Zoom call upon discharge
5. Telehealth follow-up visit scheduled two weeks after discharge with Primary
Care Physician (PCP)
Lab Tests and Vitals
1. Room air, respiratory rate 16 breaths per minute
2. Vital signs are within normal limits
PART II: Critical Thinking Activity
Use the findings from your evaluation to complete the following:
© 2024. Grand Canyon University. All Rights Reserved.
, Home Health Care and Rehabilitation Therapy
During care coordination and transition of care planning, it is important to consider the type
and level of care a patient might need.
You are the transitional care
manager assigned to Mr.
Smith prior to discharge.
Based on Mr. Smith’s
assessment findings, develop
a discharge plan that
encompasses his care needs
following discharge. Your
response should be a
minimum of 200 words.
Discuss three to five
interdisciplinary roles that
will be essential in
supporting Mr. Smith’s home
health and rehabilitative
care needs. Your response
should be a minimum of 150
words.
You are the home health
nurse assigned to treat Mr.
Smith. Identify two areas of
concern that you might
prioritize during your initial
visit with him following
discharge. Your response
should be a minimum of 150
words.
Psychosocial and Spiritual Considerations
Providing holistic nursing care for patients with complex conditions requires that the nurse
takes into account the patient's psychosocial and spiritual needs.
Given the patient's current
situation, discuss ways in
which the nurse can take
into account and address
the patient's psychosocial
and
Discharge Planning
Directions: Read the case study below. Evaluate the information and formulate a
conclusion based on your evaluation. Complete the critical thinking table and submit the
completed template to the assignment dropbox.
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the
complex management of disease during the discharge of a patient, and the additional aspects of
communication and safety in the work environment. The purpose of this assignment is to
participate in discharge planning for a patient utilizing communication and information
technology, and in a scenario where patient and provider safety is a concern.
PART I: Health History and Medical Information
Evaluate the health history and medical information for Timothy Smith, presented below.
Mr. Smith is ready to be discharged from the hospital. Timothy has been weaned off of
oxygen. His tube feedings have been discontinued and he is tolerating a pureed diet. To
facilitate safe discharge, the hospital case manager has set up services with a transitional
care manager from a Home Health agency. The goal is for Mr. Smith to attain safe
recovery and rehabilitation.
1. Broken left leg status
2. Weight bearing status: non-weight bearing, stand pivot with right leg only
a. Assistive devices: wheelchair
b. PICC line present for discharge
3. Left upper leg wound care: dressing changes as needed for open reduction
internal fixation (ORIF) on leg
4. Psychiatrist telehealth follow-up scheduled for a Zoom call upon discharge
5. Telehealth follow-up visit scheduled two weeks after discharge with Primary
Care Physician (PCP)
Lab Tests and Vitals
1. Room air, respiratory rate 16 breaths per minute
2. Vital signs are within normal limits
PART II: Critical Thinking Activity
Use the findings from your evaluation to complete the following:
© 2024. Grand Canyon University. All Rights Reserved.
, Home Health Care and Rehabilitation Therapy
During care coordination and transition of care planning, it is important to consider the type
and level of care a patient might need.
You are the transitional care
manager assigned to Mr.
Smith prior to discharge.
Based on Mr. Smith’s
assessment findings, develop
a discharge plan that
encompasses his care needs
following discharge. Your
response should be a
minimum of 200 words.
Discuss three to five
interdisciplinary roles that
will be essential in
supporting Mr. Smith’s home
health and rehabilitative
care needs. Your response
should be a minimum of 150
words.
You are the home health
nurse assigned to treat Mr.
Smith. Identify two areas of
concern that you might
prioritize during your initial
visit with him following
discharge. Your response
should be a minimum of 150
words.
Psychosocial and Spiritual Considerations
Providing holistic nursing care for patients with complex conditions requires that the nurse
takes into account the patient's psychosocial and spiritual needs.
Given the patient's current
situation, discuss ways in
which the nurse can take
into account and address
the patient's psychosocial
and
