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Discharge planning for patient and it's procedure

Discharge Planner job description focuses on facilitating a smooth and safe transition of patients from a hospital or healthcare facility to their next care setting. The role involves coordinating care, assessing needs, arranging services, and educating patients and families about post-discharge care. Key Responsibilities: Assess patient needs: Evaluate a patient's medical, physical, psychological, and social needs to determine the best discharge plan. Develop discharge plans: Create individualized plans that address the patient's specific needs and ensure continuity of care. Coordinate care: Work with healthcare professionals (doctors, nurses, social workers) to ensure all necessary services are in place before discharge. Arrange for follow-up care: Coordinate home healthcare, rehabilitation, or other post-discharge services. Educate patients and families: Provide clear and concise information about medication management, follow-up appointments, and other important aspects of post-discharge care. Facilitate referrals: Connect patients and families with appropriate community resources, such as social services or support groups. Advocate for patient needs: Support patients and families in accessing the care and resources they need. Maintain accurate records: Document all aspects of the discharge planning process. Essential Skills and Qualifications: Strong communication skills: Able to effectively communicate with patients, families, and healthcare professionals. Critical thinking and problem-solving skills: Able to assess situations, develop solutions, and make decisions under pressure. Knowledge of healthcare regulations and guidelines: Familiar with relevant laws, policies, and best practices. Compassion and empathy: Able to understand and respond to the emotional needs of patients and families. Bachelor's degree: Typically a bachelor's degree in nursing, social work, or a related field is required. Relevant experience: Previous experience in healthcare or social services is often preferred.

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GOVERNMENT NURSING COLLEGEHALDWANI Submitted By SATISH Louthani Bsc Nursing 1st Semester GNC Haldwani Skill presentation DISCHARGE PLANNING Submitted T o Miss.Geeta Arya Ma’am Tutor GNC Haldwani
DISCHARGE PROCEDURE
CONTENT : - • Introduction • Defilation • Objective • Types of discharge • Discharge planning • Discharge procedure • Purpose • Reason for discharge • Equipment • Departments to be informed • preliminary assessment • Procedure • After discharge • Documentation • Role and responsibilities of the nurse
INTRODUCTIO N •Hospital discharge corresponds the point at which impatient hospital care ends with ongoing care transferred to other primary ,common domestic environment . Indicating this , hospital discharge is not an end point, but rather One of multiple transitions within the patient ‘s health care journey
•Discharge of a patient means departure of a patient from the hospital . It is also known as dismissal of patient from the hospital DEFINITION
OBJECTIVE •T o complete obligation to hospital . •T o ensure proper medical care after discharge. •T o motivate the patient and relatives. •T o promote independence and self reliance throughout illness. •T o promote good public relations.
TYPES OF DISCHARGE •Types of discharge the patient should have depends on the condition of the patient as well as the decision of the patient and family members . There are different types of discharge , accordingly patient need to be prepare
•Planned discharge – Planned discharge means patient has completed the intial and actual management of disease in the hospital . Now patient does not need the direct supervision . Planned discharge is done when the patient’s condition stabilizer and patient is ready to go to home . The decision of planned discharge is taken by the attending physician or the consultant. •Abscond – Absconding – patient leaving the ward/ hospital without permission.
•Leave against Medical Request (LAMA) - This is also known as discharge against medical advice (DAMA) •In case of LAMA , doctor clearly explained the patient and family members that taking the patient from the hospital may impose risk to the life of the patient , but still patient on patient’s family want to take the patient to some other hospital or to the home. •In case of LAMA patient or patient’s relative will sign a declaration from saying that the risks and consequences of taking the patient from the hospital were informed to the patient or family. •Discharge summary will be provide by the hospital.
•Parole – Parole is used in psychiatric hospitals .The patient can be sent to home for 2-3 or 4 days by the approval of psychiatrist incharge . If patient does not return after the parole , the discharge process should be done according to the hospital protocol and policy. •Referral – Referral means shift the patient to other units or to the hospital for further management. •Discharge on request – In this type of discharge ,treatment is not complete, but by taking the patient out of hospital, there is no immediate danger to the life of the patient.
DISCHARGE PLANNING •The patient , the patient’s family members, medical 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 discharge planning should be ideal . Involve the patient and the family members in the discharge planning of the patient . The pneumonic that used to described the discharge planning is IDEAL.
•The IDEAL discharge planning approach focus on the key points of involving the patient and the family members in discharge process . •IDEAL •I – Include •D- Discuss •E – Educate •A – Assess •L - Listen
•Include – Include the patient and the family members in the process of discharge planning Following points need to be considered . Always include the patient and the family members in group meetings about the discharge. Recognize the family members who will provide care to the patient at home. Include them in the conversations. •Discuss – Five main area to avoid problems at home need to discuss with patient and the family members. It include: 1. Explain what life at home , will be like home
eat , and the activities to do or not to do. 2. Discuss the medications, purposes of each medication, how much to take ,how to take and the side effects of each medications. 3. Discuss the warning signs . Discuss with patient and the family members , how to identify the warning signs or potential problems . Instruct to write down the name as contact information of someone to call if there is a problem . Explain test results to the patient and family . If the test results are not a available at time of discharge, let the patient and his / her family members must know when it will be available. Discuss regarding the follow- up visit . Offer to make follow – up appointment for the patient.
•Educate – Educate the patient and the family members in simple language about the condition of the patient . Education regarding the diet , exercise and medications should be given . Also educate regarding the changes that may be needed at home like side rails for elderly patients or anti skid mat in washroom to prevent the accidents. •Assess – Asses how well doctors and nurses has explained the diagnosis, condition , and the steps in the patient’s care to the patient and the family members and use teach back method to confirm.
•Listen - Listen to the patient and his/her families goals preferences , observations, and concerns.
DISCHARGE PROCEDURE The discharge procedure typically involves finalizing paperwork , setting any outstanding bills , providing post-care instructions and arranging transportation for the patient leaving the hospital or healthcare facility .
PURPOSE S •T o ensure continuity of care to patient after discharge •T o assist patient to complete hospital formalities before returning home. •T o assist patient to return to a state of optimal independent living. •T o assist the patient in discharge process. •T o acknowledge patients right in deciding to leave hospital.
REASON FOR DISCHARGE •Cured •Transfer to other hospital •Discharge at request •Discharge against medical advice •Death
DEPARTMENT TO BE INFORMED •Drug return to pharmacy department •Diet cancellation •Oxygen/ ventilator charges summary •Accounts department •Billing section
PRELIMINAR Y ASSESSMENT •Check doctor’s written orders for discharge •Inform patient and relatives about discharge •Document relevant discharge information • Make sure all the fees are included such as special investigation, special matters or devices, doctors or surgeon’s fees and narcotic drug used ( if any)
•Obtain discharge prescription after retaining the medicines to be continued for that day and after discharge . Send all other continued for that day and after discharge . Send all other medicines for refunding ( including ward replacement ) •Send chart to billing section with relevant information •One bill is ready and chart is received back in ward , ensure that bill is settled. Check the cashier’s signature in the discharge bill •Help the patient to obtain discharge summary , medical certificate and drugs •Ensure that patient is instructed regarding medication follow up, outpatient visit etc. •Accompany the patient up to transport near exit gate.
PROCEDUR E •Before the day of discharge , inform the patient’s family of the time and date of discharge •Obtain a written discharge order from the physician . If the patient discharge himself against medical advice , obtain the appropriate form •If the patient requires home medical care, confirm arrangements with the appropriate facility department or community agency
•On the day of discharge , review the patient’s discharge care plan ( initiated on admission and modified during his hospitalization) with the patient and his family . List prescribed drugs on the patient instruction sheet along with the dosage, prescribed time schedule , and adverse reactions that he should report to the physician . Ensure that the drug schedule is consistent with the patient’s lifestyle to prevent improper administrative and to promote patient compliance •Review procedures the patient or his family will perform at home. If necessary, demonstrate these procedures, provide written instructions , and check performance with a return demonstration
•List dietary and activity instructions , if applicable , on the patient instruction sheet and review the reason for them. •Check with the physician about the patient’s next office appointment ; if the physician hasn’t yet done so, inform the patient of the date , time and location •Retrieve the patient’s valuables from the facility’s safe and review each item with him. The obtain the patient’s signature to verify receipt of his valuables •Obtain from the pharmacy any drugs the patient brought with him •If appropriate, take and record the patient’s vital signs on the discharge summary form. Notify the physician if any signs are abnormal such as an elevated temperature
•Help the patient get dressed if necessary •Collect the patient’s personal belongings from his room •After checking the room for misplaced belongings , help the patient into the wheelchair, and escort him to the exit; if the patient is leaving by ambulance, help him onto the litter •After the patient has left the area, strip the bed linens and notify the housekeeping staff that the room is ready for terminal cleaning .
AFTER DISCHARGE •Record time date and condition of the patient at departure. •Send chart to medical record department and inform to the concern departments •After the patient has gone , the bed should be washed , blankets kept in sunlight , Mackintosh washed and dried. •The room and all utensils should be cleaned and kept ready for next use.
•In case of infected cases, utensils should be disinfected and the cleaned . The linen should be disinfectant and then send to laundry •When discharging the medicolegal cases , the patient’s dead body should be handed over to the police station should be informed about the patient’s discharge/ death •Patient or dead body is handed over to the police and asks the police to sign with date and time
DOCUMENTATIO N •Record the time and date of recharge •The patient’s physical condition •Special dietary or activity instructions •The type and frequency of home care procedures •The patient’s drug regimen •The dates of follow – up appointments •The mode of departure and name of the patient’s escort
ROLE AND RESPONSIBILITIES OF THE NURSE •Inform the patient and the relatives a day or so two before the discharge •Get the discharge slip prepared after checking the vital signs and examining the patient. •The nurses should see that the patient’s personnel hygiene is maintained; he is dressed in home clothes and has taken meals. •Hand over the patient’s belongings and valuables, which have been kept safely, to the patient or the relative under
•Complete the unit admission and discharge registers, casesheet and other records. •Handover the casesheet and other records to medical record department under proper receipt. •Inform the hospital authorities about the discharge if the patient is medicolegal. •Handover the discharge slip to the patient or relative. •See that the patient receives all the medicines as per discharge slip. •Check the hospital things before the patient leaves the ward. •Care of unit after discharge.
SUMMAR Y
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