Assessment-Preliminary Care Coordination Plan 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.

Assessment-Preliminary Care Coordination Plan 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.

Specific Goals for Addressing Cognitive Impairment in Aging and Elder Care

Enhanced Caregiver Support and Education

Research by Ismail et al. (2020) indicates that it is crucial to establish educational programs for caregivers and family members to train at least 80% of primary caregivers within the community within the next year. Additionally, remember to measure success by conducting assessments and surveys to evaluate knowledge retention and skill application.

Improved Access to Resources

Another goal is to Increase access to community resources by collaborating with local organizations and institutions, ensuring that 90% of individuals with cognitive impairment and their families are aware of available support services within six months (Ismail et al., 2020). Tracking progress through attendance records and feedback from users of these services is important.

Enhanced Safety Measures

To implement safety protocols in 100% of care facilities within the community to prevent accidents related to cognitive impairment within the next three months. Regular audits and incident reports will assess the effectiveness of these measures.

Regular Health Assessments

Nevertheless, to ensure that 70% of individuals with cognitive impairment receive regular health assessments and follow-ups by healthcare professionals within the next year. Tracing this is done through medical records and appointment logs (Ismail et al., 2020). Also, engagement in cognitive exercises and healthy activities can be encouraged by organizing workshops and events, aiming for a 20% increase in participation within six months. Evaluation will be based on attendance records and pre-and-post-participation assessments.

Collaborative Care Approach

Establishing interdisciplinary meetings involving healthcare providers, social workers, and community resources to discuss quarterly and update care plans for at least 90% of individuals with cognitive impairment is also necessary (Ismail et al., 2020). Attendance records and the implementation of revised care plans will measure success.

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