Discharge Placement: After-Hospital Care

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

In 2011, there were approximately 3.3 million readmissions to hospitals, raising healthcare costs and negatively impacting patient health. Two important contributors are discharge planning and education. Many patients do not receive enough of either, and are sent home misinformed about their diagnosis and medications. In order to decrease readmissions, hospitals should utilize interactive patient systems to educate patients while they are in the hospital. This will increase patient knowledge of their diagnosis, as well as make it easier for nurses to go over discharge teachings with the patient. This gives

It is necessary to involve the individual in the plan of care and support. Encourage the individual to make choices. This includes their needs, their culture, their means of communication, their likes and dislikes, wishes and feelings, advance directives, beliefs and values, involvement of their family and other professionals. This should be considered and documented. Also, there must be evaluation in assessing effectiveness in the plan of care.

Once you have followed the guidelines, you can then come to a decision if or not your patient holds mental capacity.

Studies have found that improvements in hospital discharge planning can dramatically improve the outcome for patients as they move to the next level of care (Alliance, 2016). Moreover, Patients, family caregivers and healthcare providers all play roles in maintaining a patient's health after discharge. And although it's a significant part of the overall care plan, conversely there is a surprising lack of consistency in both the process and quality of discharge planning across the healthcare system (S. Shapperd,

Patient will meet basic psychological needs and demonstrate appropriate expression of feeling for the duration of this shift.

David and Anne may also need professional support in some cases. The support provided could be from cultural support, spiritual organizations, psychologist, psychiatrist and occupational therapist. The main aim for these referrals is to ensure that the individuals obtain holistic assessment and are assisted accordingly. The holistic assessment includes physical assessment, spiritual assessment, and psychological, social and cultural support. This is important so that the external support can relate to preferences and needs associated to treatment, care and support. The holistic assessment is often done by multidisciplinary group including the healthcare professionals. The treatment made should be tailored to match the individual needs (Shear, Marion and Kenworthy, 2013).

First, we will complete a chart review, this includes his name, sex, age, previous level of functioning, diagnosis, hospitalization date, any weight bearing status, Doctors name, medical history, past evaluation, any assessments performed and any other information that could assist the therapy process.

“Establishing a care plan that meets the patients’ needs and allows for appropriate interventions as symptoms change.” Patient’s without decision making ability comprise a large portion of the long term care population.” Jenna the IDT 
(interdisciplinary team) has to have continuing conversations with the patient’s family or decision maker, to help make decisions. “

Purpose: The focus of this assignment is identifying patient’s needs and analysis and synthesis of details within the written client record and planning an appropriate discharge plan with necessary patient teaching of the disease process.

In evaluating the outcome and measuring the success of the team, we went back to the objective that was established to determine if these were met within the timeline specified?

SSA received a phone call from Verna Goecke-PRPV inquiring if the Bond family was aware of Katlyn’s discharge from the facility. She stated that she had not heard from Mr. Bond regarding the discharge notice and according to Katlyn she had not discussed the discharge arrangements with her parents. SSA shared that two messages had been left on Karen Kohn’s cell phone. We discussed that in the event the family did not arrive to the meeting location this morning, PRPV was willing to transport Katlyn to the family home. Verna asked SSA to email the family’s home address in the even they needed to transport Katlyn to the home.

The extensive literature that supports the need to create a viable discharge planning process that includes developing tools in order to avert potential ADEs is critically important in reducing readmission rates and improving patient safety (Anthony, Chetty, Kartha, McKenna, DePaoli, Jack, 2005; Cardinal Health, 2013; Carey, 2014; Jack, Chetty, Anthony, Greenwald, Sanchez, Johnson, …Culpepper, 2009; Paul, 2008). Therefore, waiting until a discharge order has been written before beginning the discharge process is no longer an option. As mentioned, this dilemma is multifaceted which will take a comprehensive process evaluative approach. However, for the purpose of this discussion the area of focus is in creating a framework that addresses

It is always important to consider what will happen to this patient after they are discharged. Is the patient capable of attending to their own activities of daily living unassisted? Will this patient require long term care? Has the patient any family or friends willing to assist the patient at home? Will the patient require a home help service and if so can they afford it? Does

As a community social services assistant, I work directly with pediatric patients that have been discharged from St. Vincent Hospital. When meeting with patients post discharge, I have noticed that they are often confused about the types of services they require. I have considered various options to address this issue and have come up with a potential solution. Hospital admissions can be overwhelming for young children; I am suggesting we trial providing homecare information in a more fun and less intimidating manner. I am suggesting we hire a popular local clown named Claris who performs at children’s parties .Claris is passionate about helping children, and would be able to explain homecare information in a fun and interactive way that would be easier for children to understand.