Successful outpatient and home management for chronic, recurring leg ulcers reduces the need for hospitalization. The MLP should develop a teaching plan for home chelation, and written instruction must be provided to assist the patient or parent through each step of the procedure. Compliance with home chelation therapy must be monitored carefully. The MLP should coordinate yearly visits to ophthalmology and audiology specialists for early detection of possible adverse effects of deferoxamine mesylate. After a careful history and physical assessment are done, a health care plan using techniques proven effective in the past can be instituted and appropriate goals for hospitalization established.
Continuity of care is important for the hospitalized patient.
Thus, the assignment of a primary caregiver can help to reduce the stress of the hospitalization and associated fears. This individual should explain hospital procedures and specific treatment modalities to the patient carefully. Finally, the primary caregiver should also participate in discharge planning and referral to appropriate resources when indicated. In the outpatient setting, the MLP should focus on health maintenance, prevention, early recognition, treatment of complications, and patient education. Health care plans are developed to help patients maintain wellness and to be active participants in receiving the best possible care.