Dora Smith Has Come To The Federally Qualified Health Center ✓ Solved

Dora Smith Has Come To The Federally Qualified Health Center Fqhc Fo

Dora Smith has come to the Federally Qualified Health Center (FQHC) for several problems she is experiencing. Your group performed an interprofessional team evaluation with the results in the case below. Your team is now meeting to create a plan for Dora. Dora Smith is a 52-year-old woman (DOB 6/1/68), that has been a patient at the Federally Qualified Health Center (FQHC) for the last 8 years. She attends her appointments sporadically.

The last time she was seen was 1.5 years ago. Note: The FQHC has behavioral health, physical health, dental, and pharmacy services all in one building PMH: Chronic low back pain Opioid use disorder Gastroesophageal reflux disease Depression High blood pressure Peripheral neuropathy bilateral feet Type 2 diabetes mellitus Medications Oxycodone 5 mg every 3 hours PRN Rantidine 150 mg every 12 hours Metoprolol 50 mg every 12 hours Hydrochlorothiazide 25 mg daily Gabapentin 600 mg every 8 hours Clonidine 0.3 mg every 8 hours Social history: Patient is divorced. She lives in a second-floor apartment with her medium sized dog Reason for visit: Recent fall 1 month ago when walking her dog (tripped on the dog leash).

She sustained a concussion and reports increased low back pain since the fall. Today, she reports severe pain in a tooth on bottom left side of her mouth that started about a week ago. Examination Vital Signs Temp: 99°F HR: 90 bpm BP: 159/85 mmHg RR: 12 bpm Height 5’2â€, Weight 170 lbs Labs (from ED visit 1 month ago) Laboratory Test Result Normal Range Sodium mEq/L Potassium 5.5 3.5-5.0 mEq/L Chloride mEq/L CO mEq/L Glucose mg/dL BUN mg/dL Creatine 1.7 0.6-1.1 mg/dL WBC 9,,,000/mm3 % Hgb g/dL Hct % Platelets 150,,,000/mm3 Dora was assessed in the dental clinic, prescribed antibiotics for an abscess and is to return in 12 days for a follow-up appointment. The next available appointment is one month from the dental clinic assessment visit.

Questions What are the issues? What is your desired outcome? What stakeholders will you need to work with to achieve your desired outcome? Describe in order, what major steps will need to happen to achieve your desired outcome? What unique strengths can each discipline bring to the team? How could your team include patients’ preferences into the plan? What strategies could you use if you encountered resistance from a colleague while working on a plan to achieve your desired outcome?

Paper For Above Instructions

Dora Smith's case presents a multifaceted health challenge that necessitates an interprofessional team approach for effective management. The primary issues she faces include chronic low back pain, opioid use disorder, severe dental pain due to an abscess, and other comorbid health concerns including peripheral neuropathy and type 2 diabetes. Additionally, her recent fall and subsequent concussion compound her health challenges significantly. Addressing these interconnected issues requires a coordinated action plan aimed at stabilizing her conditions while respecting her preferences and improving her overall quality of life.

Identifying the Issues

The present issues that need to be addressed for Dora include:

  • Chronic low back pain exacerbated by a recent fall.
  • Opioid use disorder, which needs consideration to prevent further dependency.
  • Dental issues, specifically an abscess that requires treatment.
  • Potential lack of adherence to medication and appointment schedules.
  • Social and environmental factors impacting her health, such as living alone in a second-floor apartment.

Desired Outcomes

The primary desired outcomes are to effectively manage her pain, treat the dental abscess, mitigate the risk of opioid dependency, and improve her overall health and adherence to treatment. Additionally, enhancing her independence and ability to manage her living situation is crucial.

Stakeholders Involved

To achieve these outcomes, collaboration among a variety of stakeholders is essential, including:

  • Primary care provider
  • Dentist
  • Behavioral health specialist
  • Pharmacist
  • Social worker or case manager
  • Patient and potentially a caregiver

Steps to Achieve Desired Outcomes

The following steps will be necessary to meet the desired outcomes:

  1. Conduct a comprehensive assessment of Dora’s current health, including a pain evaluation and review of her medications.
  2. Develop an integrated care plan, focusing on pain management strategies that prioritize non-opioid alternatives.
  3. Ensure timely dental care for the abscess, coordinating with dental services for appropriate follow-up post-treatment.
  4. Incorporate behavioral health support to address opioid use disorder and implement strategies for adherence to treatment.
  5. Engage with social work to explore resources for improving her living conditions and enhance her support system.

Unique Strengths from Each Discipline

Each discipline brings unique strengths to the team:

  • The primary care provider can manage chronic illnesses and prescribe necessary medications.
  • The dentist can address oral health issues and provide pain relief through dental treatment.
  • The behavioral health specialist can assist in handling the emotional and psychological aspects of chronic pain and substance use.
  • The pharmacist can ensure safe medication use and educate on alternatives to opioids.
  • The social worker can connect Dora with community resources and support systems.

Incorporating Patient Preferences

Involving patients like Dora in their care planning is crucial. Strategies include:

  • Engaging Dora in discussions regarding her preferences for pain management options.
  • Inquiring about her concerns and preferences regarding medication adherence.
  • Allowing her to express her goals and expectations regarding recovery and treatment.

Addressing Resistance Among Colleagues

In the event of encountering resistance among team members when proposing the care plan, effective strategies may include:

  • Open communication about the rationale behind the suggested changes and their potential benefits for the patient.
  • Using evidence-based data to support the proposed strategies.
  • Promoting a culture of respect and collaborative dialogue that values each member’s perspective.

Conclusion

Dora’s complex health issues necessitate a thoughtful and integrated care plan. By working collaboratively across disciplines and incorporating patient preferences, the team can enhance care quality and align treatment goals with Dora’s needs. Effective communication and addressing potential resistance will be essential throughout the process, ultimately reaching a successful outcome in enhancing Dora’s health and quality of life.

References

  • American Medical Association. (2021). Addressing Opioid Use Disorder.
  • Centers for Disease Control and Prevention. (2020). Pain Management.
  • National Institute on Drug Abuse. (2021). Is Opioid Use Disorder a Disease?
  • American Dental Association. (2020). The Importance of Dental Care.
  • World Health Organization. (2019). Pain Relief and Management.
  • American Association of Colleges of Nursing. (2021). Interprofessional Education Collaborative.
  • Substance Abuse and Mental Health Services Administration. (2020). Treatment Improvement Protocol.
  • National Diabetes Education Program. (2020). Understanding Diabetes Management.
  • National Institute of Neurological Disorders and Stroke. (2018). Peripheral Neuropathy Fact Sheet.
  • American Heart Association. (2021). Health Management and Patient Outcomes.

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