The Preparation of Patient And Family for Discharge and Rehabilitation
The preparation of the patient/family for discharge started on the day of admission and continued until the end of hospitalization. This was done to help the patient to adjust to the hospital environment and live a healthy and normal life after hospitalization.
They were assessed on their level of knowledge of the condition. Based on their knowledge, they were educated on the cause, predisposing/risk factors, incidence, clinical manifestations, diagnostic investigations, treatment, prognosis, and complications of the condition and complications of its management. Their misconceptions and misinformation were clarified. They were encouraged to express their fears and concerns and to ask questions. The questions they asked were answered in a simple, clear, and professional language. They were also assessed on their knowledge about the condition after the education. They were also educated on the need to observe her personal hygiene needs.
She was reminded to check the surgical incision daily and to report to the hospital if redness or purulent discharge or discharge appeared. She was informed that she was no longer going to menstruate but may have a slightly bloody discharge for a few days. She was encouraged to take adequate fluid to maintain bowel and urinary function. She was informed of post-operative fatigue which gradually decreases, to resume activities gradually, and to avoid sitting for long periods to prevent thromboembolism. she was advised to avoid wetting the incisional site, straining, lifting, having sexual intercourse until she gets permission from the surgeon. They were advised to report immediately to the hospital if they noticed any vaginal or wound discharge, foul odor, excessive bleeding, any leg redness or pain, or an elevated temperature. They were also educated on personal hygiene especially oral hygiene twice daily, the adverse effects of over-the-counter drugs, and the consequences of alcoholism on the individual, family, and nation as a whole. She was also educated on the need for her room windows to be netted, the need for both her and her children to sleep under ITNs, and to clear the clothes off the crossbar as it harbors mosquitoes.
They were reassured that I would visit them at home. She was encouraged to take a highly nutritious diet in order to increase her hemoglobin level to a normal level (12 – 16g/dl). She was also told to have enough rest in order to regain her health. Intake of fruits was also encouraged for her. She was again reminded of the date of review (25/11/11).
Her name was entered into the admission and discharge book and also the ward census chart. All her bills were covered by health insurance.
I helped her to pack the rest of her things into her luggage. I accompanied her to the entrance of the hospital where they boarded a taxi. I bade them goodbye when the car set off. They left the entrance around 12:15 pm on the day of discharge.
4.3 Follow Up/Home Visit/Continuity of Care
First Home Visit/Follow up (17/11/11)
My first home visit was made to Kutre Station, a vicinity in Berekum, which is about a 25minutes walk from the hospital on the above-stated date while Madam A. A. was still on admission. I had no difficulty finding the house because I went with her eldest son.
The reason for that visit was to enable me to get familiarized with Madam A. A.’s environment and the house she lives in and to verify whether the information she and her family gave to me about herself and her family were really true.
I also carried out that visit so that I could identify some potential health-related problems and remove any stressful situation that can hinder the progress of Madam A. A.’s condition.
I walked to her house with her eldest son around 11:00 am. We walked for about 25minutes from the hospital entrance before we finally arrived. On the way, I told her eldest son about my objective for the home visit. She is a tenant in a three-story building built with blocks and roofed with aluminum sheets just by the road that leads to Kutre with house number H97/3. It is like a rectangle with one of its lengths erased (where another building with five rooms has been built). The veranda is also well cemented. The building was painted with a yellow paint, with good ventilation and drainage systems with no stagnant water. The environment was also well kept with good pipe-borne water, well-furnished baths, and toilets. She lives in a single room on the topmost left corner of the three-story building with the inside painted with light blue and a well-furnished ceiling.
We entered the house, greeted the other tenants, and climbed upstairs to her room. On arrival, there was nobody to welcome us and I needed not introduce myself to her eldest son because he already knew me. On observation, her environment was well kept with a clean tank for collecting water. Her cupboard was full of clean utensils and her gas stove also looked well kept. She had a well-covered rubbish bin which she temporarily disposes her to refuse into before emptying into the “Zoomlion’s” vehicle the next morning. The Zongo clinic is the health facility nearest to where she stays.
Her eldest son opened the door and invited me in. she has a well-furnished room with television sets, an electric fan, and four widows for ventilation with louvers and iron rods at the back but with no nets. The crossbar that divided where she sleeps from her chairs and where her other three children sleep was full of clothing. She and her children were not sleeping under an insecticide-treated mosquito net (ITN).
Her eldest son was asked about the information that Madam A. A. provided and he gave the same history as was given by Madam A. A.. He further added that he was surprised his mother was suffering from fibroid. He said the only known illness in the family would probably be diabetes since his stepfather has diabetes before he died. He was educated on his mother’s post-operative care. He was also educated on the need for the widows to be netted, the need for both his mother and siblings to sleep under ITNs, and to clear the clothes off the crossbar as they serve as a hideout for mosquitoes. I encouraged him to ask questions, express his fears and concerns. The questions he asked were answered tactfully and he was reassured of his mother’s health.
I thanked him and he assured me that he would personally see to it that whatever needed to be done was done before my next home visit. Fortunately, after we had descended downstairs, I met a Registered Midwife who works at the Holy Family Hospital, Berekum. We already knew each other so I introduced my client’s eldest son to her. She told us she was ready to take good care of Madam A. A. after discharge and that she would like to continue with her care after I terminated the care I was rendering to her. This was very pleasant to us because she lived on the first floor of the same-story building. We thanked her, bade her farewell, and together we came back to the hospital at 12:57 pm. I congratulated Madam A. A. on the ward on how she neatly keeps her room and surroundings after returning and told them everything about the visit.