Answer 7

  • Paulina now has 2/10 pain when ambulating with partial weight bearing with a standard walker that is comfortable for her. She has been cleared of any other serious pathology and has lingering weakness in her gluteus medius and minimus muscles. 
  • I: Make sure that Paulina’s family is informed of her discharge day if they are the ones that are able to transport her home. 
  • D: Discuss and document. Discuss with Paulina the nature of the rehabilitation for post-operative posterolateral total hip replacement. Advise her to monitor for symptoms of infection, DVT, and potential failure of prosthesis. Facilitate setting up an appointment with the family doctor if possible to ensure that her hypertension is being managed. Encourage a follow-up appointment with the surgeon and a referral to outpatient physiotherapy to ensure her hip is also being managed. Document her current mobility, the status of her short and long-term goals, and her treatment up to date.
  • E: Educate the patient on their condition, on the home exercise program, next steps, symptoms of infection, DVT, potential failure of prosthesis, and importance of continuing physiotherapy. 
  • Educate the patient on falls prevention. Since this patient fell leading to their hip surgery, it important to educate the patient on falls prevention to reduce the risk of any future falls.
    • Make sure lighting in the house is bright 
    • Any change in flooring has to be clearly shown by an indicator
    • A clean house with less clutter decreases the chance of falling
  • A: Assess the patient’s level of understanding of the condition, outcome measures, and goals by getting the patient to dictate back to you what you have previously gone over. This also allows the patient to ask questions and leads to the last part of discharge.
  • L: Listen to the patient’s concerns and allow them to ask questions. Answer their questions and leave your work contact information (such as a work email) in case they would like to contact you or in case another healthcare provider in Paulina’s circle of care is looking for a handover report