Discharge Of Patient

SESSION 2C: DISCHARGE OF PATIENT IN HEALTH FACILITY

Learning Tasks

• At the end of this session each learner is expected to be able to:
• Define discharge
• Identify types of discharge
• Outline the purposes of discharge
• Explain procedure for discharge of a patient

Discharge a patient

DISCHARGE OF PATIENT IN HEALTH FACILITY

• Definition of term Discharge
• Discharge:

Is an official permission granted to a patient to leave the health facility 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

TYPES OF DISCHARGE

There are two types of discharge

1.Official discharge: Patient is evaluated by a physician and is discharged if he/she is medically ready to leave, the hospital 2.Discharged against medical advice (DAMA): Patient decide to leave hospital without physician's approval

PURPOSE OF DISCHARGE

• Fulfil patients’ and relative’s request
• Facilitate a return of the patient to his family after recovery or for home based care
• Assist a patient to transfer positively from a dependent to a more independent role
• Help relatives to provide an environment that best meet the needs of the patient

Obtain relative and community support of the client during convalescence at home

PROCEDURE FOR DISCHARGE

• Assessment:
• Needed information about the physical, emotional and psychological needs of a client
• Disabilities and limitations that will extend after discharge
• Home plans if well understood
• Areas to be involved in teaching the client

Family involvement in continuing support to the patient at home

PROCEDURE FOR DISCHARGE cont…

• Preparation of the patient:
• Patient’s chart and discharge summary note
• Admission and discharge register
• Daily returns form (census sheet)
• Medication for home use
• Educational pamphlets as required

Specific equipment needed upon discharge

DISCHARGE A PATIENT

• Steps for discharging a patient from the hospital
• Start planning for discharge early while the patient is still in hospital
• Verify discharge orders from patient’s doctor
• Collaborate with appropriate heath team members

Order any equipment or supplies patient will need to take home Coordinate with patient and family regarding time and day of discharge and mode of transportation Talk with patient about his future expectation regarding his health Encourage patient to verbalize his concern and be alert of nonverbal clues Discuss with family or significant others on how they can help the patient to maximize potential Teach on self-care at home where possible and supply written instructions Evaluate patient’s understanding of teaching

STEPS FOR DISCHARGING A PATIENT FROM THE HOSPITAL cont…

Assist patient to put together all his belongs and assist him in packing Collect required medication for home use from pharmacy. Repeat instructions for use to patient and relatives Give the discharge form (discharge summary) to patient and make sure the instructions regarding medication, diet, exercise and date for follow up appointment are clear Collect patient’s valuables and countercheck with him to make sure that everything is in order Assist client to dress his home clothes Instruct patient or relatives to settle the hospital bills Escort client to his transport and say ‘bye’ Strip the bed and put linen into the laundry bag Clean the bed thoroughly using disinfectant and re make it Empty the locker or bed side table and clean for the next client Wash hands and clear up equipments

SUMMARY

Discharge is an official permission granted to a patient to leave the health facility Plan for patient’s discharge should start early, and be incorporated in patient’s total care. It should not be left until the day of discharge

EVALUATION

• What assessments will you make before discharging a patient?

What are the preparations of a patient for discharge?

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Bunker Rosdahl, C. (1999). Basic nursing (7th ed.). New York: Lippincott Williams & Wilkins.

Kozier, B., Erb, G., Blais, K., & Wilkinson, J. M. (1995). Fundamental of nursing: Concepts, process and practice (5th ed.). Oakland, CA:

Wesley.KMTC-VVOB. (2009). Skills lab project: Nursing procedure manual.

Kenya.Lynn, P. (2011). Taylor’s clinical nursing skills: A nursing process approach (3rd ed.). New York: Lippincott Williams & Wilkins.

MOHSW. (2008). Basic nursing procedures: A manual for nursing practice in Tanzania (3rd ed.). NCP: KIUTA.

• Moshi, N., & Karungura, J. (2005). Basic nursing procedures. KCMC Nursing Profession
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Potter, P., & Perry, A. (2005). Fundamentals of nursing (6th ed.). USA: Mosby Rider Ellis, J. (1992). Basic nursing skills (5th ed.). New York: Lippincott Williams & Wilkins Thomas, C. (1993). Taber’s cyclopedic medical dictionary. Philadelphia: F. A. Davis.

Barbara K. Timby, Nancy E. Smith-Introductory Medical-Surgical Nursing, 10th Edition (Lippincott's Practical Nursing) – Lippincott Williams & Wilkins (2009).pdf.