TapestryCare™ Story - Managing CHF in Rural Kansas
Updated: Nov 16, 2018
Today's story comes Mary Beth, our amazing NP seeing patients in rural Kansas and Missouri. A little bit on the technical side, but suffice it to say, this patient is one sick person. Before Tapestry was in that
building there is no way he would not have been rehospitalized (or worse) numerous times. By introducing a new standard of care to rural nursing facilities we are saving lives!
Very ill man with EF of 15%. Patient was readmitted to facility after a hospital stay for CHF . During his hospitalization he lost 20 lbs+ of fluid. On admission to the our facility he was very weak, falling and very dizzy.
I checked labs and Orthostatic Vital signs - BP sitting 95/60, standing he would he drop into 60’s-50’s/30’s. We even checked a set on camera and I witnessed how pale and lightheaded he became. Meanwhile labs demonstrated acute on chronic renal failure. The patient's Bumex was held for 24 hrs. Midodrine was started. He did gain about 3 lbs over 48 hrs but did well clinically. Bumex was then restarted half dose.
Another set of labs were drawn 4 days later which showed resolution of his acute renal failure. He did at that point gain 3 more lbs back therefore bumex was increased to his previous dose. Weight remained stable. Patient progressed in PT.
He was no longer symptomatic when he went from sitting and standing, one last set of labs were drawn prior to D/C to make sure he was tolerating the increased dose of bumex. Cr remained at baseline
About 6 days prior to D/C he developed an abrasion with surrounding cellulitis which was successfully treated with a course of Keflex.
He was discharged with follow up plans to see PCP as well as the local CHF clinic.
Tapestry Telehealth’s TapestryCare ™ program brings these practitioners directly to the bedside. And what’s unique about the program is that Tapestry Telehealth assigns a dedicated practitioner to each facility. That practitioner gets to know you, your patients and your staff, and integrate seamlessly into you daily care routines.
So even rural nursing homes can have a full-time nurse practitioner who is available on weekdays, on scheduled daily rounds, or on demand to see patients and assess medical issues or changes in medical conditions.
More importantly, rural nursing homes may be able to take advantage of these programs at no cost. Talk directly to one of our professionals to learn how you can access quality telemedicine for your rural nursing facilities.