Planning and Prioritizing – Collaboration and Delegation

Prompt:
As a coordinator of patient care, nurses occupy roles in leadership.  Choose one patient from this week’s scenario and  identify different health care team members across the care continuum that are either involved in or impacted by care coordination and discuss how you would establish relationships to collaborate to improve patient care outcomes in transitions of care.   

Include at least 2 current references.

I have chosen one patient for this work:

SCENARIO
ADULT DIABETES MELLITUS

You are an RN, working 7 AM to 3 PM on a 30 bed medical unit in a community teaching hospital. The day staff consists of a nurse manager, 5 RNs, 4 PCTs (Patient Care Technicians), and a unit clerk.  Patient rounds with the hospitalist, nurse practitioner, physician specialists and charge nurse occur at 8 AM. A Hospitalist and Nurse Practitioner coordinate the medical care of patients admitted to this unit. A Registered Dietician (RD), Pharmacist, Case Manager, and Social Worker are assigned to this unit.

You arrive and receive report for your assignment as follows:
Sharon Haskins      Age: 56 years

    Weight: 84 Kg
Admitting Diagnosis:      Uncontrolled Diabetes Mellitus, Renal Insufficiency
              Past Hx:  Hypertension, Peripheral Arterial Disease
    Diet: 1800 cal 2 Gm Na ADA diet
              Medications:
        Metformin 1000 mg PO BID
        Glipizide XL 10 mg PO daily
        Lisinopril 10 mg PO daily
        Cilostazol 100 mg PO BID
        Morphine sulfate 3 mg IV q3h PRN pain left leg
    Received Morphine x 2 during night with moderate relief
    Fingerstick blood sugar 0600: 328
    Labs:
HgA1c: 11.2
Hg 10.1 Hct 34.2
K 5.2
BUN 86
Cr 2.1
    Diagnostics:
        Ankle brachial index:
            Left: 0.54
            Right: 1.1
    Consults:
        Vascular surgeon to discuss possible AV shunt placement, angioplasty left lower extremity
        Endocrinologist re: insulin therapy