NOTE. this paper is link to the community teaching presentation

Note: This is an individual assignment. In 1,500-2,000 words, describe the teaching experience and discuss your observations. The written portion of this assignment should include:

1.Summary of teaching plan

2.Epidemiological rationale for topic

3.Evaluation of teaching experience

4.Community response to teaching

5.Areas of strengths and areas of improvement

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Technology and reimbursement patterns have increased the amount of surgery performed on an ambulatory basis. Hospitals all over the country are experiencing a rise in the number of surgical patients who come into the hospital and go home on the same day; cases that previously required at least an overnight stay in the hospital. The move to outpatient treatment can significantly affect a hospital’s use of beds and its overall organization. However, the move to outpatient care also poses some risks, especially to patients with difficult medical histories. The move from inpatient to outpatient care is driven by cost containment, as well as by new technologies. However, there are risks to care provided in the ambulatory setting. For example, advanced age (especially older than 70 years) is associated with increased hospital stay and perioperative morbidity and mortality. Additionally, the type of surgery is important in the risk assessment.

In the following three case scenarios, determine if the patient has an increased risk for surgical complications based on their current health status and medical history. Write a 1-2 paragraph response for each scenario, and determine the following:

1. Does the patient’s medical history pose a potential risk for complications prior/post surgery? Explain your reasoning.
2. Based on the patient’s current health status and their medical history, should they receive surgery or be evaluated and treated outside of the ambulatory care setting? Explain your reasoning.

Case Scenario 1:

Mr. Rogers is a 51-year old male. During his pre-operative examination, he tells the nurse, “I have an ache in my right foot”. He offers an explanation, suggesting, “I must have stepped on something or twisted my ankle. Maybe I got bitten by a bug when I was outside yesterday”. The nurse notes that the patient’s ankle is reddened, slightly swollen, and warm to the touch. However, his temperature is within normal limits. Mr. Roger’s ankle is x-rayed and there is no fracture noted. He has full range-of-motion of his right ankle. Mr. Rogers has a preexisting medical condition of gout. He is scheduled for outpatient surgery on his thyroid.

Case Scenario 2:

Mr. Sanders is a 61-year old male who presents with nausea and has been vomiting for two days. He is also experiencing mental confusion. His blood glucose is 796 mg/dL. He is a newly diagnosed diabetic and has not been getting medical treatment. Intravenous regular insulin is administered to Mr. Sanders in order to bring his blood glucose level down to a normal level. Further tests show that his Hemoglobin A1C is 10.3%. Mr. Sanders has a preexisting medical condition of coronary heart disease and hypertension. He is scheduled for outpatient surgery on his thyroid.

Case Scenario 3:

Mrs. Miller is an 88-year old woman who presents with nausea, vomiting, and severe abdominal pain. Further tests reveal that her white blood cell count is 13,000/mm3. Her physical examination reveals that her abdomen is distended and very tender to the touch. Her doctor suspects that she has acute pancreatitis. Mrs. Miller has a preexisting medical condition of heart failure and gastroesophageal reflux disease (GERD). She is also scheduled for outpatient surgery on her thyroid.