Entry 3: Assessment / Analysis and Planning

Situation- My patient was a middle-aged female who had a total hip replacement 4 days earlier and I was seeing her for the third time. See had been told she could go home the following day, which she was very excited about. In previous sessions she had been ambulating independently with a zimmer frame (ZF) and had trialled a wheeled zimmer (WZF) but was not confident with it.

Task- My task was to assess her mobility to determine what aid she would take home and to run through her exercise program to assess her understanding and performance of the exercises prior to discharge.

Action- Before starting I checked the progress notes to see if anything of relevance had occurred since I saw her last and checked her obs, all was good. Then I had a chat with my supervisor to tell her my plan. This included a walk with the WZF and if possible 2 elbow crutches (EC’s) as well as running through the exercises, she thought this was good plan.

I walked the patient 30m with the WZF and was happy she would be capable of using it at home, so I asked if she’d like to try EC’s and she said yes. After 2m with the EC’s she said she wasn’t comfortable and she said she’d prefer the ZF over the WZF, so she went back to her room with the ZF. We then went through the exercises and finished up.

Result- The patient decided that although she was ok with the WZF, she preferred and felt safer with the ZF. After liaising with my supervisor, I decided that because of the patient’s desire to go home, it would be best to discharge her with the aid she feels safe with rather than keeping her in hospital for longer to progress on to the WZF, she was booked for outpatients rehab anyway and she could progress to the WZF when she feels capable.

Evaluation- I think this was a good result because the patient and I were both happy, she was going home and I was satisfied she was safe to do so. I think my strengths here were my communication and my ability to think of the patient holistically, to enable her to go home happy.

Strategies- Giving the patient a certain degree of choice/freedom with their treatment seems to be a strategy that worked well for me on this occasion.

3 weeks down, 2 to go!

Ozzman out!