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preliminary_care_coordination_plan2.docx NURS-FPX4050 Preliminary Care Coordination Plan Capella University Coordinating Patient-Centered Care NURS-FPX4050 Preliminary Care Coordination Plan There is a need for ca ...

preliminary_care_coordination_plan2.docx NURS-FPX4050 Preliminary Care Coordination Plan Capella University Coordinating Patient-Centered Care NURS-FPX4050 Preliminary Care Coordination Plan There is a need for care support for stroke survivors' transitions to the community due to the high rates of hospital readmission as a result of the inability to obtain access to resources. My role as a new care coordination, is to ease the transition of care between the healthcare system and the community so the patient AB can get access to resources such as medical, social, and environmental services. Analyze a Health Concern and the Associated Best Practices for Health Improvement Health concerns MR AB is a 57 years old man who presented with aphasia, CT head showing what seems to be a subacute infarct in the left MCA territory. In addition to multiple stroke risk factors including cardiomyopathy and cocaine use. Per physician update, patient admitted withÂ acute ischemic cerebrovascular accident, elevated troponin, essential hypertension, chronic systolic heart failure, HLD, cocaine abuse. Anticipated dischargeÂ in 1-2 days. â€œIndividuals with disabilities â€¦ at increased risk of secondary complications related to a lack of access to specialized support services, lack of care coordination, and limited healthcare provider knowledge about healthcare needs of individuals with complex conditions such as strokeâ€ (Kitzman, Hudson, Sylvia, Feltner,& Lovins, 2017, p. 566). For these reasons, I decided to be proacti. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. .. . . . . . . . . . . . . . . . . . .. . . . .

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