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Eastern Kentucky UniversityEncompass Doctor of Nursing Practice Capstone ProjectsBaccalaureate and Graduate Nursing2018Care Coordination: Using a Nurse Navigator in an Endoscopy Unit Judith L. Poe
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Step 1: Start by gathering all relevant information about the patient, including their medical history, current medications, and any recent hospitalizations or procedures.
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Step 2: Open the care coordination form and enter the patient's personal details, such as their name, date of birth, and contact information.
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Step 3: Identify the primary care physician or healthcare provider responsible for coordinating the patient's care.
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Step 4: Document any specific care needs or goals that the patient has, as well as any preferences or concerns they may have regarding their healthcare.
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Step 5: Review the patient's medical history and current medications, ensuring that all necessary information is accurately recorded in the care coordination form.
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Step 6: Assess the patient's risk factors and determine if any additional support services or referrals are needed.
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Step 7: Collaborate with other healthcare providers involved in the patient's care, ensuring that information is shared effectively and treatment plans are coordinated.
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Step 8: Continuously update and maintain the care coordination form as the patient's healthcare needs evolve or change.
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Step 9: Regularly communicate and engage with the patient and their family members to ensure that their care needs are being met and that they understand their treatment plans.
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Step 10: Seek feedback from the patient and their healthcare team to continuously improve the care coordination process.

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Individuals with complex medical conditions requiring multiple healthcare providers.
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Patients transitioning from one care setting to another, such as from a hospital to a nursing home.
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Elderly patients who may have difficulty managing their healthcare on their own.
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Individuals with chronic illnesses that require ongoing care and management.
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Patients with mental health conditions who may benefit from coordinated care and support services.
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People with disabilities or special needs who require coordinated care across different providers.
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Patients with a history of frequent hospitalizations or emergency room visits.
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Individuals with a high risk of readmission or complications following a procedure or surgery.
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Individuals receiving palliative or hospice care.
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Care coordination using a is a collaborative process that involves healthcare providers working together to ensure that all aspects of a patient's care are addressed in a comprehensive and timely manner.
Healthcare providers, including physicians, nurses, social workers, and other care team members, are required to file care coordination using a.
Care coordination using a can be filled out by documenting each patient's care plan, treatment goals, scheduled appointments, and communication between healthcare team members.
The purpose of care coordination using a is to improve the quality of patient care by ensuring that all healthcare providers are working together efficiently and effectively.
Information such as patient demographics, medical history, current medications, care plans, treatment goals, and any changes in the patient's condition must be reported on care coordination using a.
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