Preliminary Care Coordination Plan

 

 

Preliminary Care Coordination Plan
1. For this assessment, you will develop a 3–4-page preliminary care coordination plan for a
selected health care problem. Include physical, psychosocial, and cultural considerations for this
health care problem. Identify and list available community resources for a safe and effective
continuum of care.
2. Before you complete the instructions detailed in the course room, first select one of the following health care problems or issues:
 Health Literacy
• Physical considerations: Low health literacy can lead to poor health outcomes and difficulty managing chronic diseases.
• Psychosocial considerations: Low health literacy can cause emotional distress, anxiety, and depression.
• Cultural considerations: Cultural beliefs and practices may influence an individual.
• Community resources: Health literacy programs, patient education materials, and health navigators can provide resources and support for individuals with low health literacy.
 Environmental Health
• Physical considerations: Environmental hazards such as air pollution, lead exposure, and toxic waste can cause physical health problems.
• Psychosocial considerations: Environmental hazards can cause emotional distress, anxiety, and depression.
• Cultural considerations: Cultural beliefs and practices may influence an individual’s exposure to environmental hazards.
• Community resources: Environmental health clinics, community clean-up programs, and advocacy groups can provide resources and support for individuals affected by environmental hazards.
After you have selected one of the problems/issues from the list above, return to the detailed instructions in the course room to complete your assessment.
Scenario
Imagine that you are a staff nurse in a community care center. Your facility has always had a dedicated case management staff that coordinated the patient plan of care, but recently, there were budget cuts and the case management staff has been relocated to the inpatient setting. Care coordination is essential to the success of effectively managing patients in the community setting, so you have been asked by your nurse manager to take on the role of care coordination. You are a bit unsure of the process, but you know you will do a good job because, as a nurse, you are familiar with difficult tasks. As you take on this expanded role, you will need to plan effectively in addressing the specific health concerns of community residents.
Instructions
Develop the Preliminary Care Coordination Plan
Select one of the health concerns in the Assessment 01 Supplement: Preliminary Care Coordination Plan [PDF] Download Assessment 01 Supplement: Preliminary Care Coordination Plan [PDF]resource as the focus of your care coordination plan. In your plan, please include physical, psychosocial, and cultural needs.
Identify available community resources for a safe and effective continuum of care.

 

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