PART 1: Discussion Board PostAfter reading the required module readings:

Describe patient characteristics associated with a high risk of readmission to hospital, and explain

why. Next, describe how gaps in care during transitions may occur if the health care team does not

communicate or have other lapses in their roles when providing discharge or transitional care for

these patients. Use examples from your work experience, if applicable. Describe how the addition

of Naylor's Model of Transitional Care, or another similar model, may help in easing transitions in

care among older adults. Explain how the nurse can be utilized to provide education and

communication as a member of the health care team during the discharge and transition in care

process.

Your post should be around 400 - 500 words (about 1 page).

Be sure to cite from the required readings in your post, and include references for any material cited

that was not provided in the course readings/viewings.

Readings;

https://www.chcf.org/wp-content/uploads/2017/12/PDF-Care TransitionsIB.pdf

Readings: https://www.myamericannurse.com/transitional-care-can-reduce-hospital-readmissions/

to do:

just the discussion based off of the readings and just answering the questions in your own words

word count: 450-500 excluding references