2.0 Methods 2.1 Research aims and questions This research aims to explore the process of discharge from the emergency department at Whakatāne Hospital within the Bay of Plenty District Health Board (DHB) and the resources patients require to effectively self-manage at home. More specifically: 1. What is the frequency of sharing paper based information to patients upon discharge from Whakatāne Hospitals Emergency Department? 2. What are the patient’s views of discharge information and their optimal route for receiving information? 3. What are the nurse’s perspectives of the KRAMES patient education handout within the ED? 2.1.1 Population Patients attending ED over a two week period A total of 20,294 patients attended the Whakatāne ED in 2015, with approximately 57 people in a 24 hour period. The ratio of male to female attending the department is equal. In 2015, 30 patients attend the department each day were of Māori descent, equal with European. All RNs employed at Whakatāne ED There is a total of 22 nurses working within the ED either part of full time. Other nurses from the bureau come work in the department when necessary also. A total of 18.83 full time equivalent nurses work for the department including the Charge nurse for the department. Shift times vary throughout the weekday and weekends with an average of four nurses on the morning shift and four in the afternoon. Only two nurses are rostered on a night shift. About 50 percent of the nurses are
Improving the quality of discharge planning in acute care include addressing the lack of appropriate staff and patient education about appropriate planning for discharge (4). This includes implementing proper discharge teaching regarding signs and symptoms to seek medical attention, management and care of medical equipment, and access to community resources (4, 5). Other challenges are patients with complex comorbidities too difficult to discharge as well as lack of community supports and equipment for newly discharge patients and lack of rehabilitation and nursing home beds (4). Consequently, acute care units are pressured to vacate hospital beds in response to the growing elderly population. Hospital professionals tend to focus discharge teaching and preparation on medical areas such as diet, activity, treatments, and medications (5). Community referrals to appropriate services at the time of hospital discharge does not often happen contributing to poorer patient outcomes and re-hospitalizations
Discharge planning is used to create a plan of care for a patient who is leaving a care setting. An evaluation is done to determine the patient’s continuing care needs once they have left the care facility. When patients are send back home or to a facility that does not require full time nursing care assistance, programs need to be put into place to ensure that the patient is receiving the proper continuation of care post discharge. Proper discharge planning can decrease the chances of a hospital readmit, help in recovery, ensure medications are prescribed and given correctly, and adequately prepare family or caregivers to assume proper post discharge care. According to the Family Caregiver Alliance, “It is important, not only for patients, but family
(Mann, 2014, p.2) These strategies include: broadening access to primary care services; focus on individuals who frequently utilize the emergency department (super-utilizers); and targeting the needs of individuals with behavioral health problems. (Mann, 2014, pp 2-4) Many resources and processes have been implemented in order to help decrease inappropriate emergency department visits. This paper is going to demonstrate some resources and processes that are in place to help individuals obtain health care at the appropriate health care setting.
S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results.
Ineffective discharge teaching often leads to unnecessary admissions to the hospital resulting in negative patient outcomes and decreased patient satisfaction. This negatively impacts the well-being of the patient and creates a financial burden on institutions. As a result, this universal practice issue requires a call to action on the part of the nursing profession. Nurses can proactively assist in assuring incidents of readmission do not occur. Nurses as educators play a critical role in the successful transition of patients from hospital to home. The overall goal of discharge education is to ensure there is an exchange of critical information between the patient and nurse in which plans of care are understood and followed. The research
The significance of the study is to discuss and clarify why bedside reporting is the best method of patient handoff. The benefits associated with this kind of bedside reporting and if implemented, how it will be of help to
Discharge planning is a routine feature of health in many countries. The aim of discharge planning is to reduce hospital length of stay and unplanned readmissions to hospital, to improve the co-ordination of services following discharge from hospital thereby bridging the gap between the hospital and community (S. Shapperd, 2008). The focus of this story is discharge planning that occurs while
Registered Nurses have a lot of responsibilities, including caring for a diversity of patients, performing physical exams, helping the doctor during surgery, preparing rooms and equipment for other patients, being able to handle sudden deaths, suggesting medications, etc. They are known for their critical thinking and problem-solving skills. Typical schedules for Registered Nurses are five days a week for a eight hour period, even though you do not have to work five straight days of the week. The day shift is usually from six a.m. to two-thirty pm, the evening shift is from two-thirty pm to eleven pm, and lastly the night shift is from ten-thirty pm to seven a.m. They take a thirty minute lunch break and two fifteen minute breaks in between shifts. Nurses also work twelve-hour
The National Patient Safety Goal 13 was to encourage patients to actively involve in their own care as a patient safety strategy. As per the Joint Commission (2007), the teach-back method is the preferred method to address that goal. According to Fenwick ( n.d.), “Teach-back can help providers communicate with people with low health literacy, but it can also help with communicating overall—even with people with proficient health literacy”. Both the National Quality Forum and The Joint Commission endorse the teach-back method for use in teaching and proper administration of discharge instructions for both the patients and caregivers (Fenwick, n.d.). The American Medical Association also provides the tool kit to educate health care professionals in the use of the teach-back method (Fenwick, n.d.).
Most of the time, a nurse has about ten patients within an eight hour day, however, during high stress imes or if a worker calls teh day off, a nurse could take care of up to thirty to forty residents. The CIPP could try to lessen
Currently, at Rutland Regional Medical Center (RRMC) there is no structured process for case management to provide handoff to the primary care offices when patients are discharged from the hospital. The transition of care from hospital to home is a critical time, during which the risk of adverse event occurrence is high. According to Shivji, Ramoutar, Bailey, & Hunter (2015), 19%-23% of patients experience an adverse event following discharge to home. Elderly patients are at greater risk due to functional and cognitive limitations; this is compounded by the presence of co-morbidities and multiple providers (Nelson, & Carrington, 2011). According to the Rutland County Health Assessment (2012-2015), by 2017 it is estimated that the elderly (age > 65) will comprise approximately 21.1% of the county’s population. Clear, concise, and timely communication with cooperative care providers at discharge is critical for the elderly population (Morris & Hoke, 2015). Furthermore, according to Lattimer (2011), the lack of cooperation between providers at discharge can endanger patients ' lives and waste fiscal and human resources. The purpose of this paper is to examine the problem of handoff communication to primary care offices and to plan a recommendation for change to provide a consistent and structured process; thereby ensuring the safety of the community during transitions of care.
al, 2003). A systematic review of research consisting of effective discharge planning and how it affects hospital readmission rates was conducted. The review identified that effective discharge planning does have a direct correlation with the reduction of readmission rates. Patients that understand their diagnosis, medications and what to expect tend to have a better transition to home or nursing home. Also patients given support and information related to new medications and diagnosis are more successful at managing their health at home. Including the PCP is a great way to ensure the patient will have the necessary care and support to continue to succeed at home.
Constant patient turnovers, visitors and numerous workers in and out of the emergency area can make it difficult for staff to maintain patient confidentiality. Due to lack of space and to give quick group report,
Discharge planning and management with an elderly person can become very complicated and should be approached with an open mind and the willingness
Using the seven key principles of the hospital discharge process devised by the Department of Health (DH, 2003), this case study will critically analyse the process of an elderly patient who was discharged from a local acute trust. It begins by providing a definition of discharge planning, before providing a brief biography of the patient, including a rationale of why this patient was selected, details of her past medical history, reason for current admission, any issues raised and details of any care provided. Throughout this case study, in accordance with the Nursing and Midwifery Council (NMC, 2008) and the Data Protection Act (1998), the patient shall be referred to as Mrs. Blue to maintain anonymity. Although the