discharge from hospital in nursing

DISCHARGE OF THE CLIENT FROM THE HOSPITAL

INTRODUCTION

• The patient, the family, medical staff, nursing staff, social worker, dietician all work together to coordinate the discharge.• The doctor plans the discharge with the patient and

leaves a written order on the patient’s chart.

• The patient may have concerns regarding managing own care at home.• Provisions such as home health care may be needed, as

ordered.• Assessment needs to be done as to what help the patient will

need at home.• Discharge planning involves the entire healthcare team.

DISCHARGE PLANNING /PREPARATION

1.Discharge preparation : Nurse is responsible for ensuring that the patient is to be discharged. • Discharge from the hospital should never come unexpectedly

to patients and his /her family members • His /her discharge should be planned from the time of his

admission and he should be informed sufficiently early of the day he or she can leave the hospital.

• Any discharge instructions reviewed with the patient must also be put in a written form for the patient to take home. • They need to be specific, written in terms the patient

can understand, thorough, and legible.• Make sure family members are notified of pending

discharge / for transportation.

PHYSICAL CONSIDERATION

* Physical interventions for the inpatient with impaired activity include direct physical care related to patients health problems for example, Rehabilitation of the client.

PATIENT AND FAMILY TEACHING

• Patient and family teaching is vital important in discharge planning. • It will be planned before patient going to discharge

from the hospital. • Nurse’s will have responsible and major role in

patients teaching.

TOPICS INCLUDED FOR PRE DISCHARGE TEACHING

• Medications and drugs • Diet • Wound care • Using equipments•

• Taking medications.• Exercise programs.• Physical therapy• Changing dressings / bandages.• Injections or respiratory treatments.• Any home health care.• When to follow up with the doctor.

DOCUMENTATION OF DISCHARGE

• Chart the date and time of discharge.• How patient left the facility.• Any special instructions given to the patient.• Make a notation that the patient’s personal

belongings were sent with the patient.

TYPES OF DISCHARGE

* Planned discharge * Transfer

TRANSFER

• Patients may be transferred from one room to another for several reasons.• Sometimes it is at the patient’s request for a

different type of room or a more compatible roommate.• Medical staff may request it – change in level of

care, i.e. ICU to Med-Surg or vice versa.

CONTINUE

• The nurse will collect the patient’s chart and medicines.• Document date / time of transfer; reason for

transfer; patient’s attitude toward the move.• Introduce the patient to the personnel caring for

him/her in the new room.• Orient patient to new room; comfort.

TYPES OF DISCHARGE

* LAMA (Left against medical advice) due to any personal reasons of the patient. * Absconded : Patient went out of the hospital without doctors or other staff knowledge. Or patient may Abscond or leave the hospital without any prior information

DISCHARGE PROCEDURE

• No patient should be discharged without the doctors written orders. • Instructions regarding further care, medications, treatment, follow

up etc• Before the patient leaves the hospital, the nurse should make

confirm whether he has paid all the hospital bill. • Patients and family teaching regarding medications, diet and self –

care.

• Handover the patient belongings