Upon discharge from the hospital following total knee replacement surgery, a patient covered by Medicare with limited financial means will require six weeks of IV antibiotic therapy. The patient wants to go home. During the assessment, the nursing case manager discovers the patient lives alone, has no support at home, and lacks the dexterity to perform the infusion. What is the nurse’s next step?

The nurse’s next step in this situation would be to assess the patient’s specific needs and develop a plan of care that ensures the patient’s safety and well-being during the IV antibiotic therapy at home.

First, the nurse should assess the patient’s physical condition and overall health to determine if the patient is stable enough to receive the IV antibiotic therapy at home. This assessment would include evaluating the patient’s vital signs, wound healing progress, pain level, and any potential complications or risks associated with the therapy. The nurse should also review the patient’s medical history and any relevant laboratory results to gather additional information about the patient’s health status.

Next, the nurse should assess the patient’s home environment to ensure that it is suitable for administering the IV antibiotic therapy. This assessment would include evaluating factors such as cleanliness, availability of electricity, accessibility to necessary supplies, and any potential hazards or safety concerns. The nurse should also consider the patient’s living arrangements, such as whether the patient has a dedicated space for the therapy and if there are any pets or other individuals who might pose a risk to the patient’s healing process.

Since the patient lives alone and lacks the dexterity to perform the infusion, the nurse should assess the patient’s support system and determine if there are any family members, friends, or neighbors who can assist with the therapy. If no support is available, the nurse should explore other options, such as contacting community resources or healthcare agencies that can provide assistance with home health services. The nurse should also consider the patient’s financial situation and determine if there are any financial barriers that may prevent the patient from accessing the necessary support.

Based on the assessment findings, the nurse should collaborate with the patient, the healthcare team, and other relevant stakeholders to develop a comprehensive plan of care. This plan should address the patient’s physical, emotional, and psychosocial needs during the IV antibiotic therapy at home. The plan may include coordinating home health services, arranging for a caregiver to assist with the therapy, providing education on infection control and medication administration, and implementing strategies to promote the patient’s independence and self-care abilities.

In addition to the plan of care, the nurse should establish a system for ongoing monitoring and evaluation of the patient’s progress and response to the therapy. This may involve regular follow-up visits, phone calls, or electronic communication to assess the patient’s symptoms, monitor for complications or adverse reactions, and address any concerns or questions the patient may have. The nurse should also ensure that the patient has access to appropriate resources and support throughout the duration of the IV antibiotic therapy.

In conclusion, when faced with a patient who requires IV antibiotic therapy at home but lacks the necessary support and dexterity, the nurse’s next step is to conduct a comprehensive assessment of the patient’s needs, evaluate the home environment, explore available resources, and develop a plan of care that addresses the patient’s specific circumstances. By taking these steps, the nurse can ensure that the patient receives safe and effective care at home and achieves the desired outcome of successful recovery from total knee replacement surgery.