Built on the Project RED checklist, the NU475 Unit 4 discharge plan gives nineteen post-discharge tasks for a man with cirrhosis an owner, a due time, a confirmation and a fallback. Searches like "nu 475 unit 4 assignment example", "nu475 unit 4 sample" and "nu475 unit 4 example" land here.
Nineteen Tasks, Each With an Owner and a Fallback: A Discharge Transition Plan After Hepatic Encephalopathy
[Student Name]
Purdue University Global
NU475: Providing Transition Care - Chronic Disease and Palliative/Hospice Spheres
Unit 4 Assignment
[Instructor Name]
[Date]
Composite patient written as a model document. Drug names, doses and days are bracketed; nothing here is a prescribing instruction.
The Transition in Three Sentences
He goes home to his house [50] miles from the liver center, where his wife, 70, will be his main caregiver. The two failures most likely to bring him back are a lapse in [lactulose] titration, so that stools slow and confusion returns, and a gap in [rifaximin] supply, since it usually needs prior authorization. Every row below traces either to one of those two risks or to a component of Project RED, and each row says which.
Project RED, the Re-Engineered Discharge, bundles discharge tasks such as reconciling medicines, booking appointments, reviewing pending tests, teaching with teach-back and calling the patient after discharge. In a randomized trial at an urban academic hospital, patients who received it had about 30 percent fewer combined emergency visits and readmissions within 30 days (Jack et al., 2009).
Before Discharge
Each row: task; owner; due; how completion is confirmed; fallback. Tag in brackets after the task.
1. Submit [rifaximin] prior authorization [R2 supply]. Case manager. Hospital day [2]. Approval letter in chart. Fallback: manufacturer assistance application filed the same day.
2. Confirm outpatient pharmacy has [rifaximin] in stock [R2 supply]. Case manager. Day before discharge. Call logged with pharmacist's name. Fallback: first fill from the hospital outpatient pharmacy.
3. Reconcile medicines, including the corrected [spironolactone] order [RED: reconcile]. Pharmacist and nurse. Day before discharge. Signed reconciled list. Fallback: prescriber reviews at discharge.
4. Book hepatology visit within [7] days [RED: appointments]. Unit clerk. Before discharge. Printed date on discharge sheet. Fallback: telehealth visit.
5. Book metabolic panel on day [5] for diuretic dose change. Unit clerk. Before discharge. Printed date and lab location. Fallback: home health draws it.
6. Book paracentesis for day [12] [RED: appointments]. Unit clerk. Before discharge. Printed date. Fallback: earlier slot if belly tightens.
7. Assign owner for pending ascitic fluid culture [RED: pending tests]. Discharging physician. Before discharge. Owner's name in discharge summary. Fallback: hepatology nurse checks on day [3].
8. Refer to home health for nursing visits [RED: post-discharge services]. Case manager. Day before discharge. Agency acceptance, start date. Fallback: second agency on county list.
9. Teach wife stool counting and [lactulose] titration, with teach-back [R1 lactulose]. Nurse. Each day from day [3]. Wife states target and adjustment. Fallback: repeat with son present.
10. Teach daily weights and when to call, with teach-back [RED: teach-back]. Nurse. Day before discharge. Wife demonstrates scale and log. Fallback: home health repeats on first visit.
11. Teach warning signs of returning confusion [R1 lactulose]. Nurse. Day before discharge. Wife names three signs. Fallback: written sheet in refrigerator.
12. Send discharge summary to primary care and hepatology [RED: transmit summary]. Discharging physician. Day of discharge. Fax or portal receipt. Fallback: clinic nurse calls to confirm.
13. Give written after-hospital care plan [RED: written plan]. Nurse. Day of discharge. Copy signed by wife. Fallback: mailed copy.
First 72 Hours
14. Home health start of care [RED: post-discharge services]. Agency nurse. Within [48] hours. Visit note faxed to hepatology. Fallback: case manager calls agency at 48 hours.
15. RN telephone call [RED: telephone reinforcement]. Unit nurse. Day [2] after discharge. Call note: stool count, weight, first [rifaximin] dose taken. Fallback: second call on day [3].
16. Confirm [rifaximin] picked up [R2 supply]. Unit nurse, in the same call. Day [2]. Wife confirms bottle in hand. Fallback: case manager contacts pharmacy.
First 14 Days
17. Metabolic panel drawn. Home health or lab. Day [5]. Result in chart. Fallback: hepatology repeats at visit.
18. Hepatology visit. Hepatology. By day [7]. Visit note. Fallback: telehealth.
19. Paracentesis. Procedure unit. Day [12]. Procedure note. Fallback: earlier if weight rises by [five] pounds in a week.
Why the Two Risks Lead
Lactulose is the first-line treatment for hepatic encephalopathy, titrated to two or three soft stools a day, and rifaximin is added to prevent recurrence (Vilstrup et al., 2014). In a randomized trial, rifaximin reduced breakthrough encephalopathy and related hospitalizations over six months compared with placebo (Bass et al., 2010), but only for patients who had it. A plan that sends him home without the drug in hand has not removed the risk.
Caregiver Copy
The copy for his wife keeps the same rows but replaces the owner column with a phone number and writes due dates as calendar days, such as "Tuesday, [date]: blood test at the lab on Main Street." Teaching rows become lists of what she has already shown she can do.
What the Plan Cannot Solve
Transport at night is not solved. If he becomes confused after dark, she will not drive the [50] miles, and the nearest emergency department is [22] miles away. The plan names 911 for that case. Communication between hospital and primary care is another known weak point: discharge summaries often reach primary care late or not at all (Kripalani et al., 2007), which is why row 12 has a named fallback.
References
Bass, N. M., Mullen, K. D., Sanyal, A., Poordad, F., Neff, G., Leevy, C. B., Sigal, S., Sheikh, M. Y., Beavers, K., Frederick, T., Teperman, L., Hillebrand, D., Huang, S., Merchant, K., Shaw, A., Bortey, E., & Forbes, W. P. (2010). Rifaximin treatment in hepatic encephalopathy. New England Journal of Medicine, 362(12), 1071-1081. https://doi.org/10.1056/NEJMoa0907893
Jack, B. W., Chetty, V. K., Anthony, D., Greenwald, J. L., Sanchez, G. M., Johnson, A. E., Forsythe, S. R., O'Donnell, J. K., Paasche-Orlow, M. K., Manasseh, C., Martin, S., & Culpepper, L. (2009). A reengineered hospital discharge program to decrease rehospitalization: A randomized trial. Annals of Internal Medicine, 150(3), 178-187. https://doi.org/10.7326/0003-4819-150-3-200902030-00007
Kripalani, S., LeFevre, F., Phillips, C. O., Williams, M. V., Basaviah, P., & Baker, D. W. (2007). Deficits in communication and information transfer between hospital-based and primary care physicians: Implications for patient safety and continuity of care. JAMA, 297(8), 831-841. https://doi.org/10.1001/jama.297.8.831
Vilstrup, H., Amodio, P., Bajaj, J., Cordoba, J., Ferenci, P., Mullen, K. D., Weissenborn, K., & Wong, P. (2014). Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology, 60(2), 715-735. https://doi.org/10.1002/hep.27210
How this NU475 Unit 4 example is structured
The narrative page states the transition in three sentences: where he is going, who will be with him, and which two failures would most likely bring him back, a lapse in lactulose titration and a gap in rifaximin supply. Every row that follows traces to one of those risks or to a Project RED component, and the plan labels which. Grouping follows the time each row falls due, before discharge, first 72 hours, first 14 days, so an unfinished line stands out immediately. Teaching appears as rows too, each with a teach-back check and the person who must demonstrate it, usually his wife for stool counting and daily weights. The caregiver copy strips the owner column down to phone numbers and rewrites due dates as calendar days. A short closing note lists what the plan cannot solve, such as night transport.
Get an NU475 Unit 4 example written to your instructions
Is the setting a skilled nursing facility, home with hospice, or an apartment with no caregiver? Say which, or share the course scenario, and include the rubric and any required template. A plan with an owner, date and fallback on each line is delivered in 24-48h, and a first sample carries no charge. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU475 Unit 4 questions, answered
How detailed does the owner column need to be?
Name a role, not just a department. Case manager, discharging hospitalist, home health intake nurse and unit clerk each mean something specific, while the team means nothing. If your course wants actual names, use placeholders for composite cases. The sample also adds a confirmation column, so a reader can see what proves each task was finished before the patient needed it.
Should the plan mention cost and insurance?
When a new medication or service depends on coverage, yes. A prescription the patient cannot fill ranks among the likeliest ways a plan breaks down in its first days. The sample shows prior authorization for an expensive gut antibiotic started on the second hospital day, with a manufacturer assistance program named as the fallback in case the insurer delays.
Can the plan be written for a different condition?
Certainly. The pattern of owner, due date, confirmation and fallback applies to heart failure, stroke, COPD or any chronic condition your course sets. Send the case and the rubric, and the rows will follow that patient's real risks, whether the danger is a missed anticoagulant level or an oxygen supplier who has not confirmed delivery.