This is a 65-year-old male who presented to Franklin Square Medical Center with complaints of thigh pain and diagnosed with left hip septic arthritis. Patient had a prolonged hospitalization complicated by a thigh abscess, DVT and PE. A call was made for an Urgent SNF referral to Orchard Hill Healthcare and Rehabilitation Center, and was admitted for Rehab and Wound Care Services the SAME DAY.<\/p>\n
Maintain Safety<\/strong> – Fall Risk Due to functional decline, upon admission the patient required moderate assistance with mobility, transfers and all self-care tasks. He was receiving Occupational and Physical therapy 5 times a week. Upon discharge, he was independent with all self-care tasks, climb 12 stairs, and was able to ambulate 200+ ft with a walker. <\/p>\n Patient was safely discharged to home with Community Home Health and will be followed up by his community Physician Dr. Deepak Seth.<\/strong><\/p>\n A 77-year-old female was discharged home after being hospitalized at University of Maryland Rehab & Orthopaedic Institute. Unfortunately, the patient kept experiencing falls at home. A call was placed by our partner, Home Call Home Health to the Urgent SNF Hotline and the patient was admitted to Orchard Hill Healthcare and Rehabilitation Center the same day. She has a PMH of Rheumatoid Arthritis, Hypotension, T2 Non-Displaced Odontoid Fracture, and Cervical Stenosis.<\/p>\n Monitor Labs<\/strong> – Including CBC, CMP, BMP Upon admission, Patient exhibited functional decline due to decreased musculoskeletal condition and fatigue requiring moderate assistance with ADL\u2019s and ambulation. Patient was receiving occupational and physical therapy 5 times a week. Upon discharge, she was independent with all self-care tasks, and able to ambulate 300+ feet with supervision.<\/p>\n Patient returned home safely with her nephew. She will be seen by Home Call and continues to work with therapy at home.<\/strong><\/p>\n An 83-year-old female presented to Franklin Square Emergency Department to treat an infection s\/p hip replacement. The patient had recently relocated to Maryland and planned to move into her daughter\u2019s home, but soon realized the home was not ready to accommodate the patient\u2019s needs. A call was made for an Urgent SNF referral to Orchard Hill Healthcare and Rehabilitation Center. The patient was directly admitted from the Emergency Room, receiving nursing and rehabilitation care.<\/p>\n Wound Care<\/strong> Upon admission, patient exhibited functional decline due to decreased musculoskeletal condition and fatigue requiring moderate assistance with ADL\u2019s and ambulation. Patient is receiving occupational and physical therapy 5 times a week. She is now able to ambulate 120+ feet with a rollator and stand by assist. <\/p>\n Patient continues to work with therapy<\/strong><\/p>\n A 56-year-old female (P.D.) admitted to Orchard Hill Rehabilitation and Healthcare Center after hospitalization at Life Bridge, Sinai Hospital of Baltimore, with admitting diagnosis of COPD, OSA, Diabetes, and Anemia. She was admitted in need of further testing of her OSA.<\/p>\n Plan of Care Reviewed weekly with our Cardiac and Pulmonary IPC Teams led by Cardiologist, Dr. Jeremy Pollock and Pulmonologist, Dr. Schwartz. The onsite respiratory therapy and the ability to test the continued need for Nocturnal Support made Orchard Hill the campus of choice for this patient.<\/p>\n The patient plans to return home when her rehab stay is complete. She has been managed well by the team at Orchard Hill and is proud to report she has had a continuous, uninterrupted stay.<\/p>\n 46-year-old unfortunate male (E.H.) admitted to Orchard Hill Healthcare and Rehabilitation Center after an extended stay at University of Maryland Medical Center with admitting diagnosis of Traumatic Brain Injury secondary to Motor Vehicle Crash requiring the need for mechanical ventilation. Patient arrives with Trach and Peg tube.<\/p>\n Provide Peritoneal Nutrition- Wean PEG tube and advance diet as tolerated Maintain Patent Airway- Wean as Tolerated- GOAL MET Patient is non-ambulatory and continues to make small gains in therapy. He requires assistance with all ADL\u2019s and continues to make gains in self feeding and grooming.<\/p>\n Orchard Hill\u2019s On-Site Respiratory Therapist worked alongside the Speech Language Pathologist as well as the other members of the Clinical Care team and are excited to share he has been successfully trach weaned.<\/p>\n Through weekly collaboration of our clinical team and the Leadership of our In-House Pulmonologist Dr. Mitchell Schwartz, the patient\u2019s trach tube was removed, and oxygen therapy was discontinued. 59-year-old, male (W.C.) admitted to Orchard Hill Healthcare and Rehabilitation Center after a 22-day hospital stay at Sinai with Admitting Diagnosis of Acute CHF, UTI and Acute on Chronic Renal Failure requiring dialysis.<\/p>\n Monitor Fluid Balance<\/strong>– 1200 ml Fluid Restriction Daily Respiratory Therapy Oversight on Campus Patient required frequent medication adjustments, diligent fluid restriction and increased weight monitoring.<\/p>\n At Orchard Hill, we are able to #TreatInPlace under the Leadership of our Multi-Disciplinary Specialty Physicians. Orchard Hill\u2019s Campus of Excellence Operates Under the Guidance of On-site Cardiologist, Dr. Jeremy Pollock; Nephrologist, Dr. Kamel Sewar and Pulmonologist, Dr. Mitchell Schwartz.<\/p>\n This Patient\u2019s overall care needs exceeded his ability to care for himself at home and he decided The Care at Orchard Hill was #NextToHome. With our on-campus dialysis center, the patient could enjoy more quality in his days with less travel time therefore less fatigue to and from Dialysis Treatments.<\/p>\n 59-Year-Old Admitted to Orchard Hill Healthcare and Rehabilitation Center after a Hospitalization at GBMC for Acute on Chronic Respiratory Failure and CHF. She has a history of Sleep Apnea and Diabetes.<\/p>\n Medication Management-Insulin, Lisinopril, Metoprolol, Torsemide and Coumadin Maintain Adequate Oxygenation- Chronic Oxygen therapy @ 4LPM on Admit. Patient was discussed and followed weekly by our in-house Pulmonologist, Dr. Mitchell Schwartz. Her day to day plan of care was guided by our Clinical team, including our own in house, Respiratory Therapist.<\/strong><\/p>\n Upon admission, Patient was moderate to max assist to roll in bed. She worked hard and with the assistance of our PT and OT 5 days a week, patient was able to slowly make gains. Upon discharge to home, patient was ambulating 40 feet with a roller walker.<\/p>\n Patient returned home with her daughter 30 pounds lighter and requiring less oxygen therapy than prior to the hospitalization. Patient returned home on 3 liters per minute and continued with her Bi-pap treatment regimen. She will continue to follow with her community Pulmonologist, Dr. Rhee.<\/strong><\/p>\n 62-year-old female admitted to Orchard Hill Nursing and Rehab Center after a 7 day stay at Good Samaritan. She was admitted with Acute Exacerbation of COPD with hypoxia. Patient was bed bound prior and was being treated for severe back pain s\/p spinal surgery.<\/p>\n Medication Management<\/strong>: Baclofen for muscle spasms, pain management Maintain Nocturnal Support<\/strong>: Our in-house Respiratory Therapist assisted with Bipap Daytime Compliance Trials and taught the patient how to self-apply<\/p>\n Maintain Adequate Oxygenation<\/strong>: Patient weaned from 3 LPM on Admission to Room Air on DC Smoking cessation education was provided. <\/strong><\/p>\n Dr. Schwartz, Pulmonologist, followed patient in center weekly and lead our Pulmonary IDT team round table discussion.<\/strong><\/p>\n Upon admission, Patient required maximum assistance for transfers secondary to chronic back pain. She was able to ambulate in PT. OT worked with her muscle atrophy. Upon Discharge, she was successful in ambulation 30-60 feet without assistance.<\/p>\n Patient returned home alone with help from her supportive daughter after a 36-day LOS in Orchard Hill Nursing and Rehab. She understands how to use her Bipap can now self-apply. <\/strong><\/p>\n She will be followed up by her Primary Physician Michael Zang and her Pulmonologist, Dr. Dubin.<\/p>\n Urgent SNF Case Study This is a 65-year-old male who presented to Franklin Square Medical Center with complaints of thigh pain and diagnosed with left hip septic arthritis. Patient had a prolonged hospitalization complicated by a thigh abscess, DVT and PE. A call was made for an Urgent SNF referral to Orchard Hill Healthcare and […]<\/p>\n","protected":false},"author":1,"featured_media":2477,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"ngg_post_thumbnail":0,"footnotes":""},"acf":[],"yoast_head":"\n
\nPain Management<\/strong>
\nMonitor Labs and Vitals<\/strong> – Weekly BMP, CBC, and CMP
\nDVT Propholaxis<\/strong> – Apixaban
\nWound care<\/strong> \u2013 Daily wound care and weekly rounds<\/p>\nTherapy<\/h3>\n
\nUrgent SNF Case Study<\/h3>\n
Nursing Interventions<\/h3>\n
\nMedication Management<\/strong> – Aspirin, Hydrocodone-Acetaminophen, Gabapentin, Lisinopril, Oxycodone
\nMaintain Safety<\/strong> – S\/P Falls and C-Spine Fracture, Cervical Collar
\nMonitor Vitals<\/strong><\/p>\nTherapy<\/h3>\n
\nUrgent SNF Case Study<\/h3>\n
Nursing Interventions<\/h3>\n
\nMaintain Safety Awareness<\/strong>
\nMonitor diagnostic testing & laboratory studies<\/strong>
\nMedication Management<\/strong> – Antibiotic treatment & Pain Management<\/p>\nTherapy<\/h3>\n
\nPulmonary Case Study<\/h3>\n
Nursing Interventions<\/h3>\n
\n
Respiratory Interventions<\/h3>\n
\n
\nPulmonary Case Study<\/h3>\n
Nursing Interventions<\/h3>\n
\nEducate patient and family on care of PEG tube upon discharge
\nMonitor Vitals and Labs- Blood Sugars<\/p>\nRespiratory Interventions<\/h3>\n
\nMaintain Adequate Oxygenation- Wean as Tolerated- GOAL MET<\/p>\nTherapy<\/h3>\n
\nDue to the patient\u2019s overall complexity and continued care needs, Patient currently continues with Long Term Care at Orchard Hill. The Caring Clinical Team and Engaged Activity Department make the Environment at Orchard Hill #NextToHome<\/p>\n
\nCardiopulmonary Renal Case Study<\/h3>\n
Nursing Interventions<\/h3>\n
\nDialyze three times weekly
\nTreat Infection<\/strong>– IV Cefepime UTI
\nMaintain Hemodynamic Stability<\/strong>– BP\u2019s Vary- frequent Medication titrations needed
\nMaintain Proper Diet<\/strong>– Renal Low Sodium<\/p>\nRespiratory Interventions<\/h3>\n
\nMaintain Nocturnal Support<\/strong>– Auto-Cpap 5-20 at Hour of Sleep
\nMaintain Adequate Oxygenation<\/strong>– 4 LPM via Nasal Cannula<\/p>\n
\nPulmonary Rehab Case Study<\/h3>\n
Nursing Interventions<\/h3>\n
\nMonitor Fluid Balance- Daily Weight monitoring, Diuretic therapy
\nMonitor Labs- BBG and INR monitoring
\nDecrease Anxiety<\/p>\nPulmonary Interventions<\/h3>\n
\nMaintain Nocturnal Support- Bipap 18\/8 at hour of sleep and as needed
\nBronchodilation- Duoneb Q4H and PRN and Advair
\nPacing and Endurance with ambulation and all exertion
\nSecretion Clearance Device- Flutter valve TID x 10 breaths
\nWeekly Education with Guide to Living with Lung Disease Handbook<\/p>\nTherapy<\/h3>\n
\nPulmonary Rehab Case Study<\/h3>\n
Nursing Interventions<\/h3>\n
\nPrednisone for edema
\nMonitor Vitals and Labs<\/strong><\/p>\nPulmonary Interventions<\/h3>\n
\nBronchodilitation<\/strong>: Nebulized therapy was given QID upon initial admission then switched to MDI for portability on discharge.<\/p>\nTherapy<\/h3>\n
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