Preliminary care and coordination plan to stroke
Globally people suffer from disproportionate health discrepancies like heart diseases and stroke. These diseases are the most potent risk factor of disability. Often the highest mortality rates occur in the southern United States. People who have survived from stroke experience loss of physical functioning; they may also suffer from depression, falls, and reduced life quality. A high percentage of readmissions are evident in inpatient rehabilitation. It hence calls upon continuum care for safe community foundations on terms of health care. Through effective practices, successive practices and heart-related complications prevented. Researches show that the vulnerable to stroke related complications tend to adapt to secondary illnesses due to lack of support services. They also lack a care coordination plan as well as limitations in health care provisions. The stroke survivors are minimal since they lack the stroke knowledge the risk factors know-how and also lack the symptoms and signs knowledge. This paper will discuss health goals, available community resources, the chronic care model, and Reducing care fragmentation. Further, discuss Patient-centered medical home Global work on chronicle illnesses. Evidence for better care Practice change Patient catered care medical home and Establish health goals under care coordination.
There are various health goals associated with chronic diseases—particularly stroke, attributed to heart dysfunctions. The health goals extend positive transitions for health outcomes. One of the best health goals helpful to stroke is regular physical exercise. The exercises are essential to strengthen the heart muscles ensuring proper circulation of blood. It hence prevents any clotting in the blood veins reducing the chances of stroke. The second health goal is eating more plant foods as compared to animal foods. The fatty component in animal protein has more risk of hypertension and stroke cases. Another health goal to prevent stroke is the maintenance of a healthy BMI. A BMI 25 is ideal to avoid heart complications.
There are preliminary care and coordination of various community resources. The resources are essential to ensure proper care in both outpatient and inpatient cases. For example, as a staff, the resources ought to function despite budget constraints from the management. One of the support is hospitals—the hospital centers where patients gather to get attention from the professionals who then address their health complications. Stroke cases require the facility to get help from the medical professionals who give prescriptions to cater to chronic illness. Another resource is the pharmacies. The resource has a well-defined system where medicine is sold to patients under guidelines from the doctor. Other resources include rehabilitation centers, education services, and also DME equipment providers. The funds can all utilized to address stroke.
The chronic care model assists clinical practitioner’s around the world in the transformation of health care. The services offered to treat patients who suffer from chronic diseases. Chronic condition requires adjustments ongoing to the person who is affected, and interactions needed with the health care system. Mostly all the people suffering from chronic diseases undergo multiple conditions as well. Consequently, various integrated delivery systems and managed care have shown a lot of interest in the deficiencies and looking for a way to correct the diseases. Such illnesses include heart disease, depression, and diabetes, among others.
Reducing care fragmentation is a tool kit used for coordinating care. The developed resources are very helpful in clinical practices and the transformation for better service to the patients. Care coordination refers to the deliberate organizing of activities for patient care. It also involves the facilitation of appropriate offering of health care services. They also have shared expectations concerning their roles carried out. However, they have teamwork, where they cooperate in working together and keeping the families of the patients updated.
Clinical practice change helps in clinical practices, hence transforming care offered to patients for the treatment of chronic diseases. It sustains and encourages the interactions among the providers and patients. Research has conducted that for clinical practice change to occur, there must be handwork, goals, and good intentions. There are five categories of instruments and tools used in the assessment of practice change. They include; evaluation of practice, health organizations, need practical tools to guide in improving the quality of the evaluation of chronic diseases. The other tool is shifting to the team- based care and tackling medical overuse.
The patient-oriented medical home stands out in clinical practices globally. They provide care, especially for the provision of services to patients with chronic related illnesses. The medical home started with the American academy of pediatrics. Their policies began about primary care with an emphasis on advanced communication with patients and improved medical services. They are consequently adapting proper coordination and intensive care, which ensure consideration for the patient. For successful chronic care, a collaborative approach is fundamental for the nurses to set realistic objectives. The step by step coordination helps the patient reduce blood sugar, cholesterol, and blood sugar. Primary care is essential, which aid in medication and proper lifestyle treatment practices.
There are various global works entitled to ensure effective clinical practices. The initiatives meant to make it easier, especially for patients with chronic illnesses. They function to ensure quality improvement in terms of health services for continuum care. They also ensure proper, satisfactory patient care plans. For example, for stroke and hypertension-related cases, advanced heart-related surgeries and treatments are currently present. Consequently eliminating and minimizing deaths due to the stroke. The private and public coordinate with other stakeholders globally to ensure standards in health care services.
There should be evidence for better health care services to help the staff nurse adopt best practices. The practices are of use to ensure the patient’s welfare is a priority. Improvements in chronic illnesses require the chronic care model. The model provides interventions that are evidence-based. Chronic illnesses such stroke require responsible actions and researches for proper continuum care. Past literature covers chronic conditions such as diabetes, asthma, depression, and hypertension under the chronic care model. Evidence is fundamental to provide resolutions for past failures and the overall betterment for chronic illness attendance.
For safe continuum care, changes in practice are essential. To ensure proper and practical changes, the chronic care model has attributed to the delivery system. The practices also ensure proper interactions between the providers and the patients. Consequently, caregivers such as staff nurses take up the practices and offer positive outcomes to patients. There are various change tools in line with better continuum care. They include practice assessment, team-based care shift, handling the medical care overuse, and also use of practice coaches.
To sum up, the medical home concept was adapted by the American Academy of Pediatrics. The initiative meant to achieve a child’s medical records and expand the need to acquire timely medical services. Consequently leads to proper coordination to take care, which ensures intensive focus for continuum health care. The principles guarding medical home care describe patient-oriented concerns.