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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