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Case Study: You are providing skilled nursing visits to a home health patient who has been discharged home with a new Unna Boot for a wound on her left calf and a broken bone in her left foot. Your home health agency will be staffing a home health aide for her 12 hours/day. You will delegate the application and removal of the Unna Boot to your home health aides. Prepare a 300- word paper addressing the following: 1. Describe the process that you will use for this delegation starting with the patient assessment. 2. How will you determine your home health aides’ competence in this task? 3. What specific instructions will you leave in the home for your home health aides? 4. What follow-up will you provide? 5. Cite your professional and/or legal basis for this delegation.

User Pabrams
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In initiating the delegation process for the application and removal of the Unna Boot, a comprehensive patient assessment is crucial. Begin by evaluating the wound's condition, assessing any signs of infection, and ensuring the patient's left foot's stability considering the broken bone. Determine the patient's ability to tolerate the Unna Boot, considering allergies or sensitivities. Communicate with the patient to address concerns and gather relevant medical history.

Competence evaluation of home health aides involves a combination of training, observation, and ongoing assessment. Provide hands-on training sessions on Unna Boot application and removal, emphasizing hygiene and patient comfort. Observe aides performing the task and provide constructive feedback. Regular competency reviews and refresher courses should be scheduled to ensure sustained proficiency.

Leave explicit instructions for home health aides, including a step-by-step guide for Unna Boot application and removal. Provide information on recognizing signs of complications, such as increased pain or skin irritation. Include emergency contact details and a clear escalation protocol for unforeseen issues.

Follow-up is essential for continuous quality assurance. Conduct periodic assessments of the Unna Boot application by aides, addressing any identified issues promptly. Maintain an open line of communication, encouraging aides to report challenges or uncertainties. Regular team meetings can facilitate knowledge sharing and address emerging concerns collaboratively.

Delegation in this context is grounded in the professional scope of practice, ensuring that tasks are assigned to individuals with the appropriate training and competence. Legal basis stems from adherence to state nursing regulations and the Nurse Practice Act, which defines the scope of nursing practice and responsibilities.

In conclusion, a systematic approach to delegation involves thorough patient assessment, ongoing competence evaluation, clear instructions, and diligent follow-up. By adhering to professional and legal standards, this delegation ensures optimal care for the home health patient with a wound and a broken bone.
User NBW
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