Hospital to skilled nursing in fourteen checked items: NU585's Unit 8 handoff sends a heart failure patient with her weight thresholds, flagged drug changes and INTERACT early-warning signs. Searches like "nu 585 unit 8 assignment example", "nu585 unit 8 sample" and "nu585 unit 8 example" land here.
A Discharge Weight at the Top: A Care Transition Handoff From Hospital to Skilled Nursing Facility After a Heart Failure Admission
[Student Name]
Purdue University Global
NU585: AGNP II Clinical - Frail Elderly Focus
Unit 8 Care Transition Handoff
[Instructor Name]
[Date]
The patient is a composite; weights, doses, times and results are bracketed, and the confirmation column is left blank for the receiving nurse.
Page 1: Act Before the First Clinician Visit
Discharge weight: [68.2] kg, dry weight, on the hospital's standing scale at [06:00] today. Confirmed: [initials].
1. Reason for stay: fluid overload from her known heart failure, with a weak left ventricle, EF about [30] percent; diuresed [5] kg; acute kidney injury, creatinine peaked at [1.9], now [1.4]. Confirmed: [ ].
2. Code status and POLST: DNR; selective treatment, including hospital transfer. Copy attached. Confirmed: [ ].
3. Goals, in her words: "Get strong enough to go back to my apartment." Confirmed: [ ].
4. Medications, each with what, how much, why and when last given:
a. [Furosemide] 40 mg twice daily. Changed, raised from 20 mg daily for fluid overload. Last dose [08:00] today; next due [18:00]. Confirmed: [ ]. b. [Lisinopril] 10 mg daily. Held for kidney injury; restart to be decided at the first clinician visit when creatinine is rechecked. Last dose [three] days ago. Confirmed: [ ]. c. [Carvedilol] 6.25 mg twice daily. Continued. Last dose [08:00]. Confirmed: [ ]. d. [Spironolactone] 12.5 mg daily. New, for heart failure. Last dose [08:00]. Confirmed: [ ]. e. [Metformin]. Stopped during the kidney injury; not restarted. Confirmed: [ ]. f. [Apixaban] 5 mg twice daily. Continued. Last dose [08:00]. Confirmed: [ ]. Each medication line gives the time of the last dose, because a dose given at 14:00 and repeated at 18:00 on arrival is a familiar transfer error.
5. Parameters: call the provider for a gain above 1 kg overnight or above 2 kg across seven days; systolic blood pressure below [95]; potassium above [5.5]; new shortness of breath or swelling. Confirmed: [ ].
Page 2: Function, Cognition and Care
6. Function before admission: independent at home with a cane. Function now: walks 30 feet with a walker and one assist; needs help with bathing. Confirmed: [ ].
7. Cognition: delirium on hospital day 2, resolved; CAM negative on day 4. Baseline: independent in her own affairs. Confirmed: [ ].
8. Diet: 2-gram sodium; fluid limit [1.5] liters a day. Confirmed: [ ].
9. Skin: stage 2 pressure injury on the sacrum, [2 by 1] cm, with dressing instructions attached. Confirmed: [ ].
10. Labs: sodium [134], potassium [4.6], creatinine [1.4] on the day of discharge. Repeat basic metabolic panel in [three] days. Confirmed: [ ].
11. Pending result: urine culture from day [3]; owner: hospitalist [name], who will call the facility with the result. Confirmed: [ ].
Page 3: Follow-Up and Watching
12. Appointments: cardiology in [two] weeks; therapy evaluation on arrival. Confirmed: [ ].
13. Early signs for aides, borrowing from the INTERACT program's Stop and Watch list: eating or drinking less, new swelling of the legs, more tired or sleepy, shortness of breath, new confusion, weight up on the morning scale. Calls to the provider use the SBAR format (Ouslander et al., 2011). Confirmed: [ ].
14. Hospital contact for questions: [name, phone], 24 hours a day for [72] hours. Confirmed: [ ].
Why This Order
The handoff follows the receiving team's first 72 hours, not the hospital's course, because the facility needs to act before it needs history. Medication changes, parameters and the held drug are on page one; function and skin, which the facility will assess on arrival, come second. Transitions after heart failure admissions carry a high risk of readmission, and structured transitions that put the patient's own goals and medication changes at the center have reduced readmissions (Coleman et al., 2006). The daily weight against the discharge weight is the facility's single most useful measure for early decompensation, which is why it sits above everything else. Guideline-directed therapy for her reduced ejection fraction continues, with the ACE inhibitor restart flagged rather than forgotten (Heidenreich et al., 2022).
References
Coleman, E. A., Parry, C., Chalmers, S., & Min, S.-J. (2006). The care transitions intervention: Results of a randomized controlled trial. Archives of Internal Medicine, 166(17), 1822-1828. https://doi.org/10.1001/archinte.166.17.1822
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., Fang, J. C., Fedson, S. E., Fonarow, G. C., Hayek, S. S., Hernandez, A. F., Khazanie, P., Kittleson, M. M., Lee, C. S., Link, M. S., ... Yancy, C. W. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure. Circulation, 145(18), e895-e1032. https://doi.org/10.1161/CIR.0000000000001063
Ouslander, J. G., Lamb, G., Tappen, R., Herndon, L., Diaz, S., Roos, B. A., Grabowski, D. C., & Bonner, A. (2011). Interventions to reduce hospitalizations from nursing homes: Evaluation of the INTERACT II collaborative quality improvement project. Journal of the American Geriatrics Society, 59(4), 745-753. https://doi.org/10.1111/j.1532-5415.2011.03333.x
How this NU585 Unit 8 example is structured
The handoff is organized by the receiving team's first 72 hours rather than by the hospital's course. Anything a facility nurse must act on before the first clinician visit, doses due tonight, weight limits, a held drug, sits on page one. Each medication line answers four questions: what, how much, why it changed and when it was last given, since a dose given at 14:00 and repeated at 18:00 on arrival is a familiar transfer error. Parameters are numeric: call if weight rises more than 1 kg in a day or 2 kg in a week, or if systolic pressure falls below 95. The final box borrows from the INTERACT program, developed to reduce avoidable hospital transfers from nursing facilities, listing its Stop and Watch changes aides can report and noting that calls use the program's SBAR format. Hospital contact details for questions close the document.
Get an NU585 Unit 8 example written to your instructions
Handoffs change with the setting on each end, so the sample starts from yours: the diagnosis, the sending and receiving sites, and the role your Unit 8 prompt assigns, plus the rubric and any template. Written item by item, with numeric parameters, flagged drug changes and blanks for the receiving side, it turns around in 24-48h, with no charge for the first. 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.
NU585 Unit 8 questions, answered
What is INTERACT?
A quality improvement program, Interventions to Reduce Acute Care Transfers, developed by Ouslander and colleagues to help nursing facilities identify and manage changes in condition before they lead to avoidable hospital transfers. Its tools include the Stop and Watch early warning list for aides, SBAR communication forms and care paths. A handoff can borrow those tools for the facility side while describing the program accurately.
Which items matter most in a hospital-to-facility handoff?
Medication changes with reasons and last-dose times, code status and goals, pending results with an owner, baseline and current function, cognition including any delirium, and specific monitoring thresholds. Follow-up appointments and a contact for questions complete it. Your section may supply a template; if so, follow it and add anything from this list that it omits, noting the addition.
Should the handoff be written by the hospital or the facility?
Prompts differ. Some cast the student as the discharging clinician, others as the facility clinician receiving and reconciling the documents. Say which role the handoff takes in the first line. The sample writes from the hospital side and leaves the facility's confirmation column blank, which also keeps it clear of anything another clinician would sign.