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Difficulty: MediumCollaboration with Interdisciplinary Team

A nurse is coordinating care for a client who had a permanent colostomy placed 2 days ago and is preparing for discharge. The client is tearful, refuses to look at the stoma, and states, 'I do not know how I will ever afford all of these pouches and supplies.' Which of the following actions by the nurse reflect appropriate collaboration and delegation? (Select all that apply.)

  1. Request a consultation with the wound, ostomy, and continence nurse (WOCN) for specialized stoma care education.Answer
  2. Refer the client to a medical social worker to assist with identifying financial assistance programs for ostomy supplies.Answer
  3. C
    Delegate the initial emptying and assessment of the ostomy pouch to the unlicensed assistive personnel (UAP).
  4. Arrange for a registered dietitian to review dietary modifications that help minimize ostomy output odor and gas.Answer
  5. E
    Assign the licensed practical nurse (LPN/LVN) to develop the comprehensive home discharge teaching plan.
  6. F
    Delay the social worker consultation until the client demonstrates emotional readiness to look at the stoma.

Answer

The nurse should consult the WOCN for stoma education, refer to a medical social worker for financial assistance, and arrange for a registered dietitian for dietary modifications.
Effective interdisciplinary collaboration involves utilizing the specialized expertise of various team members to meet comprehensive client needs. A WOCN addresses the complex clinical and educational needs of a new ostomy, a social worker navigates critical financial barriers, and a dietitian manages nutritional adjustments. Together, these referrals ensure a safe and holistic discharge plan.

Step-by-Step Solution

1
Analyze the client's current clinical and psychosocial needs.
The client has a new ostomy (needs specialized teaching), financial concerns (needs resources), and potential dietary management needs.
Identifying specific deficits allows the nurse to determine the appropriate interdisciplinary team members for collaboration.
2
Evaluate the correct roles for interdisciplinary referrals.
WOCN is selected for expert stoma care, social worker for financial resources, and dietitian for nutrition management.
Effective collaboration requires matching the client's needs with the specific expertise of allied health professionals.
3
Assess the appropriateness of delegation to other nursing staff.
Initial assessments (UAP) and developing initial teaching plans (LPN/LVN) are identified as inappropriate delegation.
The RN must retain tasks requiring advanced clinical judgment and the nursing process.

Key Concept

Interdisciplinary collaboration and appropriate delegation in complex discharge planning
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Topics

Collaboration with Interdisciplinary Team

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