Discharge
Although discharge from a health care facility is usually considered routine, effective discharge requires careful planning and continuing assessment of the patient’s needs during his hospitalization. Ideally, discharge planning begins at admission.1,2
Discharge planning aims to teach the patient and his family about his illness and its effect on his lifestyle, to provide instructions for home care, to communicate dietary and activity instructions, and to explain the purpose, adverse effects, and scheduling of drug treatment. It can also include arranging for transportation; follow-up care; coordination of outpatient or home health care services, if necessary; and information about support services, if appropriate.
Equipment
Wheelchair, unless the patient leaves by ambulance ▪ patient’s chart ▪ patient instruction sheet and medication list ▪ discharge summary sheet ▪ plastic bag or patient’s suitcase for personal belongings.
Implementation
Verify a written discharge order from the doctor, along with medication reconciliation information. If the patient discharges himself against medical advice, obtain the appropriate form. (See Dealing with a discharge against medical advice.)3
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.7
Inform the patient’s family of the time and date of discharge as soon as it’s known. If the patient’s family can’t arrange transportation, notify the social services department. (Always confirm arranged transportation on the day of discharge.)1,2
If the patient requires home medical care, confirm arrangements with the appropriate facility department or community agency.
Review the patient’s discharge care plan, initiated on admission and modified during his hospitalization, with the patient and his family.2 (See Discharge teaching goals.) List prescribed drugs on the patient instruction sheet along with the dosage, prescribed time schedule, and adverse reactions that he should report to the doctor.8 Ensure that the drug schedule is consistent with the patient’s lifestyle to prevent improper administration and to promote patient compliance. Remind the patient to discard old medication lists when he returns home.
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