Ruling Out Infection at Home Saves a Trip to ER
LIFESPARK COMMUNITY HOME CARE
For more information about the author, click to view their website: Lifespark
Jan 18, 2025
Minnesota - Twin Cities Metro Area
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One
Sunday morning in early August, Irene woke up with a badly swollen knee. She
thought about waiting until Monday to call her Lifespark Nurse Practitioner but
was afraid that bacteria from an infected tooth had migrated to her artificial
knee joint, something her orthopedic surgeon had warned her about. If left
untreated, an infected joint could require additional surgeries, which is why
she had taken prophylactic antibiotics before and after a recent dental
procedure.
The
last thing Irene, 74, wanted was another surgery, but based on previous
emergency room visits, she dreaded the thought of going to the ER. “You’re
sitting for hours next to people who are sick with the flu or COVID, when
you’re already not feeling well yourself,” she said. “The doctors are regular
GPs [general practitioners] so they’d probably just run some tests and send me
home with antibiotics, which I’m already taking.” She was also concerned about
the $100 co-pay, adding that she lives in low-income housing and has limited
financial resources.
Instead,
Irene called Urgent Response Services, Lifespark’s 24-hour nurse triage line.
Convenient,
efficient, and trusted
As a
member of Lifespark COMPLETE (LSC), Irene qualified for Urgent Response Services which
provides acute-level care for members in their homes. Within minutes, Leah
Castle, RN, BSN, Mobile Urgent Responder, was on her way, getting briefed by
the triage nurse on Irene’s concerns.
Once
at Irene’s home, Leah logged onto the secure portal to access key client
information, including Irene’s health history, medications, allergies, support
system, financial considerations, contingency plans, and goals of care. “Having
this level of detail at our fingertips helps us make more accurate, more
efficient assessments,” she said. “It also gives us a more complete picture of
the member, so we can offer recommendations that align with their goals and
lifestyle.”
After
taking Irene’s vitals, she drew some blood, took a photo of the worrisome knee,
and talked through her findings with the on-call provider. They were both
confident that it wasn’t a bacterial infection but would wait for the lab
results for confirmation. Leah sent a note to Irene’s COMPLETE team to schedule
a follow-up for the next week. In the meantime, Irene was to continue the
antibiotics, take a Tylenol every six hours, ice her knee, and keep the leg
elevated as much as possible.
Leah
dropped off the blood samples at the hospital lab for processing, and in less
than two hours, the on-call physician had the results. Leah called Irene to let
her know that the labs were negative for systemic infection and that her
inflammatory markers were within normal range.
Irene
was relieved. “This was so much better than going to the ER,” she said.
Rule-outs and rule-ins
In
Leah’s experience, older adults often go to the ER to make sure there’s nothing
seriously wrong. In fact, studies show that roughly 32% of hospital ER visits are non-urgent
and unnecessary. As a Mobile Urgent Responder, she’s able to rule out those
non-emergencies, efficiently and effectively, from the person’s home.
“That
was the case with Irene: she’s had both knees replaced and was very concerned
that she’d need more surgery,” Leah said. “We were able to put her at ease and
assure her that we would continue to monitor and manage her symptoms from
home.” If there is something to be concerned about, Leah added, the Mobile
Urgent Response team is able rule in the need for emergency care.
Building on career experience
Having
the confidence to make quick, accurate assessments and communicate them to
Lifespark’s medical experts comes from her diverse career background. One of
Leah’s first nursing jobs was on a cardiac step-down unit,
a fast-paced, intense environment where the nurses were constantly working
with different physicians and therapists. “I learned how to quickly build
trusting relationships with the providers and also with families during some of
the darkest moments of their lives,” she said.
Leah
said she grew professionally in that environment, gaining skills and knowledge
that prepared her for her next job, at a long-term acute care hospital. The
individuals she cared for had complex diagnoses and illnesses, such as
extensive wounds, traumatic brain injury, chronic kidney disease, and
respiratory failure. “Patients were here for two to six months or more, many of
them on ventilators and feeding tubes, so I got to know their families and
learned how to support them, too,” she said.
In
2017, Leah joined Lifespark Community Home Care as
their first on-call nurse. “Coming into the Home Care setting with my
background was powerful, because I knew what my clients had just walked out of,
whether that was the hospital or rehab, and now I could help them stay healthy
at home,” she said.
Seven
years later, she was recruited for Lifespark’s Mobile Urgent Response team. “I
feel like each step in my career has prepared me for the next one, and now, as
a Mobile Urgent Responder, I can be the eyes and ears of our providers in the
home,” she said. “I can also bring care and compassion and empathy to our
members, so they feel confident in the care we’re providing.”
Benefits of early intervention
The
Mobile Urgent Response team has been most successful when members call the
triage line before their symptoms progress to a critical level. The team has
been able to treat early symptoms of congestive heart failure (CHF) and chronic
obstructive pulmonary disease (COPD) in the home, often with a short-term
medication adjustment. However, if a CHF or COPD exacerbation isn’t treated,
the client would likely need to be hospitalized for IV therapy and increased
respiratory support.
Recently,
Leah collaborated with the on-call provider to diagnose a painful ear infection
that had developed quickly. The physician faxed a prescription for antibiotics
to the client’s pharmacy which they were able to pick up and start taking that
same day.
“It’s
really fulfilling and rewarding to be able to offer this service to our members
and their families who want to be supportive but can’t always be there in
person,” Leah said. “They’re in good hands with Lifespark.”
To
learn how Lifespark helps seniors stay healthy at home, visit Lifespark.com or call 952-345-8770.
- To view the original version of this article visit lifespark.com/ruling-out-infection-at-home-saves-a-trip-to-er/
- Seniors Blue Book was not involved in the creation of this content.
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