Patient Carlos
Oral Health
Prevention of CLABSI
Social Determinants of Health
Ongoing Cancer Treatment
Communication:
When mother is helping Carlos at home with oral care regimen, if she identifies a concern she should be given contact information for the primary team. If provider is contacted, they should reach out to other appropriate disciplines for consultation as needed. If patient experiences painful mucositis, he can be prescribed mouthwash and analgesics as needed.
Discharge Plan:
-Dentistry recommends brushing with proper technique twice a day using a soft toothbrush and flossing once a day to reduce oral biofilm.
-Primary team reiterates dentistry's recommendations to mother and patient and stresses importance of oral health, personal hygiene (bathing, clean linens, clean clothes, and ambulation) to prevent CLABSI at home
-Nursing to continue education and promote these techniques with Carlos and mother
Communication:
-Social Work could give mother resources and contact information if she needs assistance with transportation, financial issues, and mental health services
-Nursing can give mother educational materials to have at home regarding care. Also contact information if she has concerns or questions.
Discharge Plan:
Carlos will be seen for regular outpatient chemotherapy treatments. He may need transportation assistance to get to appointments. Mother may need caregiver assistance. Mother may need financial assistance due to expense of chemotherapy. Social Work can offer resources for transportation, financial support, and caregiver resources.
Disciplines:
-Dentistry recommendations for personalized oral hygiene plan, types of treatments, routine dental visits
-Primary provider team receives dental recommendations, stresses importance of oral health to patient and mother, prescribes medicated treatment as needed
-Nursing to educate, promote and encourage oral care
Discharge:
-Dentistry recommends a regimen for Carlos. Soft toothbrush, routine dental visits, lip care, non-cariogenic diet, hydration, fluoride use
-Medical team agrees and promotes and educates to mother and patient
-Nursing promotes and educates patient and mother regarding oral care plan for home.
-Whole team stresses to Carlos and mother about importance of this regimen for goal of oral health, prevention of mucositis, and prevention of CLABSI.
Care Issues:
-Oral care reduces issues during cancer treatment. Nursing reports that Carlos has mouth pain from mucositis and is unwilling to brush teeth independently.
Care Issues regarding post discharge oncology care:
The assignment prompt implies that the Pediatric Oncology Team recommends continuing chemotherapy treatment outpatient near his home. The prompt implies that Carlos will still be a patient of the Pediatric Oncology team in Ann Arbor, but will go to the West Branch Medical Center for treatments because that is closer to his home in Roscommon.
Disciplines:
-Pediatric Oncology Medical Team: recommends continuing outpatient chemotherapy, develops plan for dosage and frequency of treatment
-Social Work: offers transportation resources, and financial support resources
-Nursing: Educates patient and family regarding chemotherapy treatment and possible side effects
Communication:
Mother and patient should be given contact information for the outpatient chemotherapy center, contact information for the transportation assistance program, contact information for the financial support services, and potential caregiver assistance when Carlos needs to go to appointments but mother is working.
Discharge:
-Recommendation from primary oncology team to continue treatment near home
-Recommendation from dentistry to to see dentist regularly near home and continue oral care regimen at home to treat/prevent mucositis and prevent CLABSI
-Continue personal hygiene and mobility to prevent CLABSI
-All teams to stress importance of continuing self care at home, educate patient and mother
Care Issues to be addressed pre-discharge:
Nursing reports the mother is frustrated while trying to encourage Carlos to brush his teeth.
Social Work assessment of home environment, cleanliness, transportation issues, caregiver issues, caregiver burden, financial burdens, insurance issues, resources for counseling.
Home is in rural area, Social Work could offer transportation resources for chemotherapy appointments and routine dental appointments.
Disciplines:
-Primary team and Dentistry to recommend what Carlos needs post discharge
-Social Work to assess need for assistance to achieve those discharge goals in home environment
-Nursing to help educate and encourage care at home.
Care Issues regarding preventing CLABSI at home:
-Link between poor dental health and bloodstream infections -Importance of oral care
-Importance of personal hygiene
-Importance of mobility
Communication:
-Mother and patient should be given discharge materials regarding preventing line infections. Also they should be given contact information if they identify concerns or questions of infection at home.
Disciplines:
-Dentistry stresses importance of dental health, brushing with proper techniques to reduce biofilm (to prevent CLABSI)
-Primary providers reiterate dentistry's recommendations and educates mother and patient
-Nursing encouraging oral care, personal hygiene and mobility