Regina Gaither, age 57, was admitted to Carolinas ContinueCARE Hospital at Pineville from Novant Main with primary diagnoses of subdural hematoma s/p craniotomy and acute respiratory failure related to neurological injury.

Situation:

Patient had a past medical history of ESRD, HTN, and tobacco use. She presented to the ER after falling and striking her head. She underwent decompressive craniotomy and evacuation with removal of bone flap. Patient had a trach placed because she was unable to protect her airway along with suffering from a neurological injury. She also had a peg placed. Prior to coming here, the patient was independent and lived at home with her significant other. She went to outpatient dialysis on Tuesday, Thursday and Saturday. Her goal was to go to a stroke rehab program for continued rehabilitation and return to her previous level of functioning.

Solution:

While here, she was followed by physical, occupational and speech therapy, dietitian, wound care nurse, ENT, Nephrology and Pulmonology.

Results:

During her 44-day stay here, the patient was able to wean off oxygen and get decannulated. She passed a swallow evaluation and was eating a pureed diet with nectar thick liquids. She was eventually eating enough and no longer required nocturnal tube feedings. She slowly progressed with physical and occupational therapy. She was tolerating being out of bed for her dialysis. She was very motivated and an active participant in her plan of care daily. She was being followed by acute inpatient rehab and was accepted to the Brain Injury program at Atrium-Pineville. She was also cleared to return to her outpatient dialysis clinic upon completion of the Brain Injury Program. Ms. Gaither graduated from Acute Rehab and is currently at sub-acute rehab receiving dialysis at her previous outpatient clinic.