Mr. Ransyshyn
Mr Ransyshyn is an 84-year-old man who arrives by ambulance from your local nursing home with a brief Transfer Note which reads “Weak.” He is unable to give any information about himself.
- After you calm your rising anger, what do you need to know to safely and completely manage him?
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- In your department what are the mechanisms for accessing this information?
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Discussion: Mr. Ransyshyn
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complete medical history is key
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DF
view history and underlying dx
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history has to be sought out from elsewhere besides the primary source
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good info.
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Definitley need to call the SNF and look at EMS run sheet.
yup
always call the nursing home
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this info is so important!
Communication with nursing home, ems and family
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I’m learning
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that;s exactly what we do
should request a hand off from NH
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good
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good
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connect to nursing home
helpful
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makes sense
Communication is essential to quality patient care!!!!
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good history is important
C
Applying principles of comprehensive geriatric assessment in the care of older people will improve the outcomes for the patient and assist with safe discharge
I make it a point to send back notes to the referring nursing home if for nothing else to establish a feeling that communication with other health care providers should be professional standard.
Good move! We can’t complain about other institutions not sending us information — and then not send information to other institutions! Smoothing transition points is good for everyone — certainly for the patient, but also much less likely to end up in a bounce-back on your next shift (“she’s still coughing and it isn’t clear whether the Emerg doc did an X-ray or not!”)
In our area, some nursing homes will not take a patient back on the weekends if there have been any changes to their medications in ER, increasing EIP’s at some of the busiest times.
communication is key
communicate whit family
hay que buscar mas información en la entrevista
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urology
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unfortunately the nursing home is often very poor at providing a history of the patients that they send to the ER, even when you call them
Communicating with other healthcare providers is important to gather information about patients.
the key is the NH and the person who made the deicision to transfer him, why did they transfer him, what was the acute change and what is this patient’s baseline?
I would be more than happy to have more communication from my colleagues in the ER to assist in the assessment of LTC patients, and also to ensure understanding of assessment/investigation results and treatment plan when patients are being sent back to LTC. (In my experience, this rarely happens.)
You may want to check out the protocol for returning patients to LTC which is included in the “related resources” page at the end of this module. You might share it with the director of the ED where most of your patients go and suggest implementing it to improve info flow.
ODB list may not be 100% complete.We’ve been caught out before relying on it. The patients actual med records will show you if he’s been refusing meds,unable to swollow, or how much prn stuff is being used.
it is very useful to get as much information as possible in a patient who is sent to be assessed more so when the patient cannot provide any
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it is very important to communicate with the referring source as to the background of patients as it facilitates the asessment and proper treatement of geriatric patients in er