Discharge

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

This week’s reflection paper focuses practice-based evidence and the operation of the theoretical framework of person-in-environment as each relates to discharge planning at UMPC Mercy Detoxification Unit (UPMC-MDU).

Each organisation has its own strategic goals and objectives. Take hospital discharge as an example, discharge patient when they are medically fit it is the priority so they will have more beds available for patients who are in need. However, from care home’s point of view, meeting residents’ needs are more important. Therefore ways to overcome these organisational differences can be identified by Improve understanding of other people’s roles, responsibilities and challenges, which led to achieving common objectives. Still using the same example of hospital admission and discharging, care home can work closely with local GP or even professionals from hospital to come up with agreed ways of working to prevent hospital admission. In our local area, we have elderly care specialist nurse from surgery to visit care homes to review resident’s medical needs so to reduce the case of hospital admission. In addition, the surgery will make a courtesy call to care home if their resident has been discharged from hospital recently to provide support and advise so to reduce hospital

Patient safety and quality of care are vital outcomes in the healthcare system. As professionals dealing with human lives, we consider these topics as core to our practice. In 2005, the Quality and Safety Education (QSEN) project was created in response to the challenges recognized in preparing nurses with the knowledge, skills, and attitude (KSAs) essential in providing safe and high-quality care to every patient (QSEN, 2012). This QSEN collaboration was the product of the strategies developed by the Institute of Medicine (IOM) report Crossing the Quality Chasm in 2001 and Health Professions Education: A Bridge to Quality in 2003 (Armstrong, G. & Barton, J., 2014). There were six competencies identified in the QSEN curriculum that includes patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics, and safety. In this paper, the QSEN competency, evidence-based practice will be discussed in relation to achieving quality and safety to the nursing process.

All medical professionals, certainly all nurses are familiar with the phrase “discharge planning begins on admission”. However, during my tenure as a case manager on the floor, patients were frequently surprised that I wanted to discuss discharge planning so soon. I frequently had to reassure patients that we were not “trying to kick them out”. Continuing my research related to the implementation of multidisciplinary rounds (MDR), I wondered what the patient’s perception of having an entire group of people at the bedside discussing the discharge plan would be. My qualitative research question is: What is the patient’s perception of MDR during the first six months of implementation? Because I am interested in MDR from the patient’s perspective without regard to cultural context, a phenomenological research study would best answer my question (Melnyk & Fineout-Overholt 2015).

Safe practice played a great role in addressing patient safety. The safe practice that endorsed by the National Quality forum and supported by the Agency for Healthcare research and quality had address few critical aspect to improve patient safety 6; by creating culture of safety, matching health care need with service delivery capability, facilitating information transfer and clear communication, safety in specific setting or process of care and increasing safe medication use.6, 7

Improve discharge process from hospital- improve communication and understanding of the discharge process with patient along with personnel dedicated to assisting through the transition

Where will your patient be going after discharge? Is the discharge plan safe? Who will be there to assist the patient? Did you have a role in the discharge plan for your patient? Currently, the patient is working on getting off of his IV Dilaudid, until then the patient will not be discharged. Multidisciplinary teams that are involved with helping to create a patient discharge plan are PT/OT, as the patient has gotten a below the knee left leg amputation. The discharge plan isn’t in place yet, therefore, I am unsure if the plan is safe or not. The nurse and the patient’s family members, whom are very involved, will be their to assist the patient in discharge. I unfortunately, wasn’t their to assist the patient with his discharge plan, however, I am extremely lucky to have cared for my patient, as I gained a great amount of knowledge and was able to gain confidence in many of my nursing

It would be best to use a multifaceted approach to Mr. Yoder’s discharge planning. We can use the help of his son as well as any support groups in the community and continue to implement the help of a home health nurse.

Discharge planning starts immediately when the client is admitted to the hospital. It consists of the client, significant others, the environment, professionals, and information, which all can have either a positive or negative impact on discharge planning. A.D is a 13-month-old toddler who’s developmentally unable to care for herself, so her significant others become the most important element in facilitating her discharge. Both of A.D’s parents have steady incomes and are present throughout the day to take care of her. They participated in the treatment regimen by giving the nurse all the diapers to weigh, disclosing everything she ate and drank and performed suctioning using a bébé mouche. Also, her family asked a lot of questions in respects

Many families considering next care site options are not prepared and in need of some type of direction. Families may not know the range of available options or understand the benefits of each or have well-thought-out plan for therapeutic goals. The Case manager should be the advocator and organizer for their patients. Making a good long-term care decision requires proper information, but one must realize such decisions are often made during a stressful period as part of a hospital discharge. Case management intervention and guidance is well suited for this role. The case managers have two major roles in these transitions: one to ensure the continuous delivery of care and secondly to advocate to ensure decision making is in the best interest

I was thinking about adding in the Discharge Instructions in Allscripts a box indicating Care Coordination Status:

Some people might say care planning is the most natural thing in the world, so why do we need policies and legislations in place to show us how to do it? (Care planning in health and social care – Marjorie Lloyd - page 1).

The study examined the effectiveness of the multiple interventions used in transitions of care. Thus, reducing patient readmission. In this research, a qualitative method was incorporated and adults that will discharge to home, are included in this study.

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: