Interdisciplinary Collaboration for Heart Failure Discharge Planning

Medium Management Of Care Collaboration With Interdisciplinary Team

A nurse is participating in an interdisciplinary team meeting to discuss the discharge plan for a patient diagnosed with heart failure who has multiple comorbidities. The team consists of a physician, a social worker, a pharmacist, and a dietitian. As part of the collaborative process, the nurse must determine which actions are essential to ensure a comprehensive and effective discharge plan. Select all the actions the nurse should advocate for during this meeting.

Select all that apply:

Encourage the inclusion of a medication reconciliation process to avoid drug interactions.

Suggest that the patient attend an outpatient cardiac rehabilitation program.

Request a follow-up appointment with the physician within a week of discharge.

Ensure that appropriate dietary modifications are discussed and explained to the patient.

Advocate for a home health nursing visit following discharge to monitor vitals.

Plan for a referral to a psychologist to address chronic stress related to the patient's condition.

Hint

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