Definition of Discharge – Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority.
Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient’s family, and other team members, that focus on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
Definition of Discharge
Discharge planning is a centralized, coordinated, multidisciplinary process that ensures that the patient has a plan for conferring care after leaving the hospital.
Discharge from the hospital is the point at which the patient leaves the hospital and either returns home or is transferred to another facility such as one for rehabilitation or to a nursing home. Discharge involves the medical instructions that the patient will need to fully recover.
General Principles of Discharge of a Patient from Hospital:
1. Patient and family understands the diagnosis, anticipated level of functioning, discharge medications and anticipated medical follow up.
2. Specialized instructions or training is provided to the patient and family to ensure that proper care after discharge will be provided to the patient.
3. Community support systems are coordinated to enable the patient to return home.
4. Relocation of the patient and coordination of support system or transfer to another health care facility are performed.
Purposes of Discharge:
1. To ensure continuity of care by providing instructions and guidelines.
2. To prepare patient physically and emotionally for to transfer to the changed environment.
3. Determine need and make referrals for home health care or extended care services.
4. Ensure client ability to perform self-care after discharge.
5. Provide family members with knowledge and skills needed to administer care to client in a home setting.
Procedure of Discharge of a Patient From Hospital:
➤ Assess patient’s health care needs at the time of discharge using nursing history, care plan and ongoing assessment of physical abilities and cognitive function from time of admission.
➤ Assess patients and family’s need for health teaching related to home therapies, restrictions resulting from health alterations and possible complications.
➤ Assess with patient and family any environmental factors within home that might
interfere with self-care, e.g. – size of room, bathroom facilities, stairs etc.
➤ Collaborate with physician and staff in other disciplines, e.g. physical therapist, social workers etc.
➤ Consult other health team members about needs after discharge e.g. dietitian, social worker. Make appropriate referrals.
➤ Preparation before day of discharge :
- Suggest ways to change physical arrangement of home to meet patient’s needs if required.
- Provide patient and family with information about community health care resources.
- Conduct teaching sessions with patient and family as soon as possible duringh hospitalization in anticipation of preparation for discharge, e.g.-signs and symptoms of complications. Use of medical equipment etc.
➤ Day of discharge:
- Allow patient and family questions.
- Check physician’s discharge orders for prescription and change in treatments.
- Determine whether patient or family has arranged for transportation home.
- Check all closets and drawers for belongings. Obtains copy of valuables when required.
- Provide patient with prescriptions for medications ordered by physicians.
- Provide information about follow up visit and home health care facilities available.
- Provide printed teaching material as per patient’s requirement with necessary instructions.
- Obtain wheel chair for patients who are unable to ambulate
➤ Complete documentation of patient’s discharge in nurse’s notes.
➤ Ensure that the discharge summary from physician is ready.
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