During this rotation I participated in two site evaluations where I presented three history and physicals, two sets of pharm cards, an article pertaining to a patient I wrote about, and a summary of that article. The first H&P I wrote was about a patient that presented to the hospital for chronic but worsening generalized weakness. This was an interesting case as the weakness was found to be attributed to a urinary tract infection, yet the patient had no UTI signs or symptoms. The patient stay at rehab was focused on completing his antibiotic treatment and participating in physical therapy to regain strength with the goal of returning to his home. My second H&P was about a patient with osteomyelitis that required hip disarticulation but refused the surgery and was admitted to sub-acute rehab for antibiotics and further treatment. My third H&P was about a patient with a humerus fracture that is otherwise very independent and mobile. I chose the three different patients based on their varied diagnoses and how different their treatment plans were.

I also presented an article and summary pertaining to the patient with hip osteomyelitis requiring disarticulation surgery. The article was a retrospective study on patients who underwent debridement and skin flap reconstruction for treatment of stage 4 ischial ulcers with osteomyelitis, just like the patient I presented. I thought the article was interesting since it studied how well patients did after the procedure, considering they were previously deemed to only be candidates for hip disarticulation. The procedure was successful in the majority of the patients at one year follow-up, but further studies have not been done on this method, making it a great topic further research.

Lastly, I presented ten medications including their mechanism of action, indications, adverse effects, and doses. I chose medications that I saw were used commonly in long-term care, such as analgesics, neuropathic pain medications, anticholinergics, antihypertensives, and antiemetics. I received feedback during the site evaluations which included providing a more comprehensive plan for treatment of the patients, including a detailed diet, physical therapy needs, and goals of care pertaining to discharge.