Promoting High Quality Patient Centered Care (Case Study Sample)

As a visiting nurse you are assigned to the following patient. As you visit her home and enter her bedroom she makes the following statement:
“I am so old I’ve lived 96 years. My husband died 14 years ago. I have 4 grown daughters, 7 grandchildren and 15 great-grandchildren. I believe I am a burden to my daughters now”. The patient has a chronic history of elevated blood pressure, a pacemaker, and recently hospitalized for heart failure (NYHA Stage III). Her oxygen saturations are normal on room air. She has bouts of acute back and neck pain due to spinal stenosis and uses Ben-Gay Ointment to treat the pain and occasionally takes a Oxycodone. The patient is experiencing age-related sensory loss related to vision and hearing. She has a hearing aid but won’t wear it because “they never work right.” She will wear her glasses for reading. At home the patient’s ADLS are limited to napping, sitting in the bedroom reading and watching TV. Her daughter who is a retired nurse, is treating a small decubitus ulcer, which recently formed on the sacrum area. She resides on the second floor of the house and refuses to go down the stairs to be with family due to fear falling. She has a walker but doesn’t like taking it when using the bathroom down the hall. She prefers to hold on to the wall. Her appetite is good.
The woman lives with her oldest daughter and son-in-law who are 74 years old. The daughter is in good health but recently her adult child with 4 children under the age of 6 years old moved-in back home with the parents. The patient loves her great grandchildren but complains that the children are up at all hours of the night and her sleep is frequently interrupted. She attended church regularly until 5-years ago and misses the services and seeing other people. She takes Ativan once a day for her nerves and to help her sleep. She admits she is “terribly depressed” but “anti-depressants don’t work for me.” She is dependent on her daughter for care but adamant that she does not want to be in a nursing home. Her brothers, sisters and friends have all passed away. The oldest daughter manages the patient’s daily needs including bathing, feeding, and meds. Her daughter does her best to cope with caring for her mother but has little time if any for herself and frequently feels exhausted by the end of the day. The patient’s other daughters work and are seldom able to assist the older daughter with the patient’s care.
Her health coverage is Medicare with supplemental insurance. Medical cost includes medications only. Although she visited her physician annually, she stopped going 2 years ago because she was not confident anyone could help her get up and down the 20 stairs in her daughter’s house and back and forth to the car, and she say’s “I am dying anyhow so it doesn’t matter.”
This assignment is worth 75 points. It will be graded on synthesis of knowledge and your response to the questions on the following page. Please review the grading rubric for this case study found with this assignment and upload your WORD Document in CANVAS.
Case Study Questions –
1. What are safety concerns for this patient and give support how these concerns were determined and why these issues are significant for the patient and /or family.
2. What actions will you take to promote high quality Patient Centered Care for this patient?
3. Referring Master’s Textbook Chapter 10 principles and theories related to patient education, what patient education or teaching strategies would work best for this patient and family and why?
For Title Page use APA Format. See sample found in CANVAS with Assignments
APA Format, 1 to 2 page double spaced.
References – Minimum of three peer reviewed references published within ten years.