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QUESTION
Discuss strategies to support and empower the patient living with a long-term condition (LTC) and their significant others when planning their discharge from hospital A is a 31-year-old man Dillon Hunt, who was refereed to ED by his GP 2 weeks after returning from a tour in West Africa. Members of his touring group admitted elsewhere with Katayama Syndrome (acute schistosomiasis), which was caused by bathing in a waterfall in Mali. On admission Dillion was ill with a fever and a dry cough, but no diagnosis could be made. Two weeks later he was readmitted with fever accompanied by diarrhoea. Lymphadenopathy and a mild hepatomegaly had developed. Laboratory tests showed Schistosomiasis serology had n ow become positive, as well as one live and several dead Schistoma mansoni eggs were found in his stools. He was treated with praziquantel (Biltride), in response to which he developed a severe allergic reaction with rigor, fever and a drug-related rash for which corticosteroids were needed. However, he did not fully recover, and lymphadenopathy remained. Further intensive investigation revealed several immunologic abnormalities: decreased number of CD4 cells were found, 0.42 (Normal values 0.51-1.55). He repeatedly refused HIV testing, but finally he requested it after revealing that in Mali he had several sexual contacts, and that he was treated locally as having syphilis. Dillon began receiving antiretroviral therapy (ART) with stavudine, lamivudine, and efavirenz. Meanwhile, his 25-year-old partner and 9-month-old daughter were diagnosed with HIV infection. His CD4 counts have now come up and he is ready for discharge to be planned. Guidelines Before you start your essay, think about what sort of management would be most suitable for Dillion Hunt and her family and what members of the MDT team would be able to provide care for Dillion. Review the evidence in the literature to support this. From your knowledge and understanding of the patient’s condition
| Subject | Nursing | Pages | 11 | Style | APA |
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Answer
Introduction
The purpose of this paper is to present strategies to support and empower patients who are living with a long-term condition. According to The King’s Fund (2019), long-term conditions are diseases for which there are no cure but are managed with pharmacotherapeutics and other treatments. The aim of this essay is to design and discuss a discharge plan aimed to empower a patient with a long-term condition. The long-term condition affected Dillon and perhaps his family is human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). Dillon requires basic care package. A simple discharge planning process is needed since he has minimal on-going need for social care and health; he has an ability and capacity to function normally at home, community setting and at the workplace. A discharge plan (provided in Table 1) is discussed in this essay. Besides, legal and ethical considerations relating to provision of care to Dillon and his family are also provided at the end this essay prior to a concluding statement. Dillon’s case should be managed by a multidisciplinary team (MDT) for realization of better outcomes.
Dillon’s Simple Discharge Planning
A discharge planning is a fundamental aspect of an effective care. On-going care needs be taken into consideration (National Institute for Health and Care Excellence (NICE) 2018). Other important factors include homelessness, eligibility for health and social care funding, contact information after discharge, arrangements for continuing social care support, and support that might be required by the patient in the community (NICE 2018). Patient and the family in discharge planning should also be taken into consideration to help meet holistic social care needs have been met and on-going care needs (Bangsbo, Duner, & Liden 2014). Lastly, the pathophysiology of HIV infection requires a lifelong antiretroviral therapy. HIV infects CD4+ T lymphocytes as well as monocytes and it leads to their deletion over the long-term thus leading to immunodeficiency. The patient may become susceptible to opportunistic infections. Hence, discharge plan considers management plan for both HIV infection and opportunistic infections (Becerra, Bildstein, & Gach 2016). With the above considerations in mind, the following is Dillon’s discharge plan.
Table 1: Discharge Planning for Dillon with Consideration of His Family
References
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Bangsbo, A, Duner, A, & Liden, E 2014, ‘Patient participation in discharge planning conference’, Int J Integr Care, vol. 14, e030. DOI: 10.5334/ijic.1543. Becerra, JC, Bildstein, LS, & Gach, JS 2016, ‘Recent insights into HIV/AIDS pandemic’, Microb Cell, vol. 3, no. 9, pp. 451-475. DOI: 10.15698/mic2016.09.529. Department of Health 2003, Confidentiality: NHS Code of Practice. Available from: [31 Dec 2019]. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/200146/Confidentiality_-_NHS_Code_of_Practice.pdf Department of Health 2019, The Common Law duty of confidentiality. Available from: https://www.health-ni.gov.uk/articles/common-law-duty-confidentiality [31 Dec 2019]. Feyissa, GT, Lockwood, C, Woldie, M, & Munn, Z, 2019. ‘Reducing HIV-related stigma and discrimination in healthcare settings: A systematic review of quantitative evidence’, PLoS ONE, vol. 14, no. 1, e0211298. https://doi.org/10.1371/journal.pone.0211298. Ghiasvand, H, Waye, KM, Noroozi, M, Harouni, GG, Armoon, & Bayani, A, 2019. ‘Clinical determinants associated with quality of life for people who live with HIV/AIDS: a Meta-analysis,’ BMC Health Services Research, vol. 19, Article number: 768. Available from: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4659-z [27 Dec 2019].
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