Clinical Decision-Making for Discharge Recommendations for a 63 Year Old Male with Foot Drop Status Post Great Toe Amputation: A Case Report

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Ku, Sigmund
Physical Therapy; Rehabilitation and Therapy
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Background and Purpose: Making a discharge recommendation from an acute care setting involves many factors and a coordinated team effort, and discharging a patient to an inappropriate setting can have adverse effects. Physical therapists have shown to be able to make appropriate and accurate discharge recommendations. The purpose of this case report is to apply a model of discharge decision making and analyze the results in the case of an older adult male with foot drop status post great toe amputation.Case Description: SF was a 63-year old male with a history of Type II diabetes mellitus, alcohol abuse, and cerebrovascular attack. He was seen in acute care status post left great toe amputation.Approach: Clinical decision-making in discharge planning was based on his function and disability, wants and needs, ability to participate, and life context. Information was analyzed in light of therapist experience, health care regulations, and opinions of medical team members. SF was recommended to be discharged to a subacute rehabilitation facility.Discussion: Although the patient’s personal wants were not consistent with the other three constructs, the physical therapists were able to exercise skilled clinical reasoning to recommend the appropriate discharge setting through the use of the implemented model of discharge decision making. Further studies are needed to establish the model’s validity and reliability.