SECOND WEEK OF ADMISSION
When I reached the ward in the morning of the second week of admission, the client had already catered for her personal hygiene. Routine care was rendered, breakfast served, medication given and vital signs checked and recorded.
At the time of ward rounds, the client has no complaints, the wound site was inspected, and was found dry and healing. The doctor made no changes in the client’s treatment.
Daily nursing processes were carried out and recorded as required. On the ninth day, the remaining stitches were removed, and the wound dressed aseptically as ordered by the doctor. She continued with her treatment as prescribed.
On Thursday, the 14th of January 2010, at around 8 am, doctors came on general ward rounds and the client has no complaint to give. She was declared fit for discharge so she was discharged and to come for review on the 21st day of January 2010.
Throughout the care of the client, isolation and barrier nursing was implemented to prevent cross-infection to health care members and other clients. This was ensured by screening the client, wearing gloves and mask when coming into contact with body fluids, and proper handwashing techniques. The client’s left-over food was thrown away, plates, cups, and spoons washed and placed separately for her alone. All instruments and equipment used for the client were properly disinfected and sterilized as well as used clothing and bed linen.
PREPARATION OF PATIENT/FAMILY FOR DISCHARGE AND REHABILITATION
The preparation of Miss Naa Akosua and their family began on the day of admission and this was known to her and her mother that after a good medical and nursing care, she would be discharged home to continue her care at home. When Akosua and her mother were informed of the possible date of discharge they were overwhelmed so I took the chance to educate them on the disease condition again.
Health education on nutrition was given and on balance diet and examples of foodstuffs that are nutritious were mentioned to her like protein foods; meat, fish, sushi just to mention but a few to help build worn-out tissues, vitamins to boost up her immune system and carbohydrates to provide the required energy as well as minerals.
Proper refuse disposal to prevent contamination and spread of diseases in their house was also made clear to them. Akosua and her family were educated against self-medication and advised to report any sickness to the hospital.
Meanwhile, proper food hygiene was over-emphasized and not left out. They were also informed about the review date on which the client should come to the hospital for review.
FOLLOW UP/HOME VISIT/CONTINUITY OF CARE
FIRST HOME VISIT
My first home visit was done on the 9th of January 2010 at 1:00 pm with her mother while the client was on admission. This was done to familiarize me with the living environment of the client and to correct practices or habits that may contribute to the ill health of Miss Naa Akosua and her family.
The house is located at the far end of the town Ejura, near a public place of convenience and a big refuse collecting dump. Some people cook and sell all kinds of foods at the edge of the park next to the refuse dump where Akosua usually buys food in the morning.
At the house, the compound was neat and rubbish was kept in a bucket without a lid and was emptied at the community’s refuse collecting dump every morning. I congratulated them for keeping the house neat but took the opportunity to advise them to cover the rubbish bin to prevent flies contaminating their foods. Also, all the windows in the house had mosquito-proof nets to prevent the entry of mosquitoes. There was one standpipe in the house.
Their house is a compound house and each room contains one family. Akosua and two sisters share a room.
The Ejura community has some social amenities which includes seventeen (17) basic schools, one (1) senior high school, one (1)Agric college, four rural banks, Agric development bank, a Commercial Bank, the Ejura farm which is one of the Nation’s farms, a 40-acre square market believed to be the third-largest after Mankesim and Takyiman and a Government Hospital. The hospital does receive referrals from the clinics of the surrounding towns and villages.
A community health nurse, Mrs. Prempeh Abigail was contacted and all the necessary information about my client; Miss Akosua Naa especially about the unhygienic way the food vendors go about preparing their food and the closeness to the rubbish dump to the clients’ house.
I thanked them for their warm reception and left around 4 pm.
On the 19th day of January 2010 at around 2:00 pm, I made the second home visit to my client’s house after her discharge. This was a scheduled visit to see whether things have been going on well with her after discharge. Together with Mrs. Prempeh
Abigail the community health nurse, we reached the house and were warmly welcomed. Akosua could even walk to embrace me. She looked fine and neatly dressed.
Food prepared in the house was in good and hygienic condition and leftover foods were kept in the refrigerator. I also reminded them of the review date should incase the joy of her discharge after a successful surgery made her forget.
I inquired if Miss Naa Akosua was encountering any health problems but she said there were none. The community health nurse told me that she had done a health talk for the community especially those in that area and those who sell food around the park to improve their hygiene.
Akosua Naa and the family were not exceptions to the health talk. All the education I gave them was also emphasized.
I informed the family of the day of my next visit which will be the last official visit and the time for termination of care.