Discharge procedure and its types in hospital .pptx

Discharge and its types

1. Discharge procedure MS. POOJA SEN NURSING LECTURER ( MHN)

2. DEFINITION Discharge of patients from the hospital means , relieving a person hospital setting ,who admitted as an inpatient in the hospital . Discharge from the hospital means the departure from the hospital. Systematic process for preparing the client to leave the health care agency and for continuity of care. MS. POOJA SEN NURSING LECTURER ( MHN)

3. DEFINITION Discharge is the termination of care from a health care agency. Planning for discharge actually begins on admission, when information about the patient is collected & documented. Discharge from the hospital is the point at which the patient leaves the hospital & either return home or its transferred to another facility such as one for rehabilitation or to a nursing home. MS. POOJA SEN NURSING LECTURER ( MHN)

4. PURPOSES To prepare patient physically and psychologically for transfer to the changes environment . Prepare the family emotionally and psychologically for changing environment . MS. POOJA SEN NURSING LECTURER ( MHN)

5. DISCHARGE PLANNING The key to successful discharge planning is an exchange of information among the client, present care givers and those responsible for care after release. MS. POOJA SEN NURSING LECTURER ( MHN)

6. TYPES OF DISCHARGE MS. POOJA SEN NURSING LECTURER ( MHN)

7. 1- PLANNED DISCHARGE Planned discharge means patients has completed the initial & actual management of diseases in the hospital. Now patient does not need the direct supervision. Planned discharge is done when the patients condition stabilize & patient is ready to go home. MS. POOJA SEN NURSING LECTURER ( MHN)

8. STEPS OF PLANNED DISCHARGE Written order by doctor Discharge card. Informing other departments Check payment of the bills. Hospital glossaries taken back . Returning of the personal belongings. Arrangement for transport documentation MS. POOJA SEN NURSING LECTURER ( MHN)

9. 2- L A M A (LEAVE AGAINST MEDICAL ADVICE) When a client decide to leave the hospital against medical advice. In this condition client must sign a consent form for any legal responsibility for health status. The client signature must be witnessed and the form become part of the client record. When the client does not want to continuous his treatment and want to leave against doctor advice, patients gone with LAMA, Risk & complication explained to the patient & family members. MS. POOJA SEN NURSING LECTURER ( MHN)

10. 3- PAROLE DISCHARGE Parole is used in psychiatric hospitals. The patient can be sent to home for 2-3 days by the approval of psychiatric charges. If patient does not come or return after the parole, the discharge process should be done according to the hospital protocol. MS. POOJA SEN NURSING LECTURER ( MHN)

11. 4 – ABSCONDED DISCHARGE When the client leave hospital without any information to hospital authorities. During the treatment process, the client leaves hospital without clearing his dues. MS. POOJA SEN NURSING LECTURER ( MHN)

12. 5 – D O R (DISCHARGE ON REQUEST ) The client is not willing to take treatment from hospital on his personal request . Doctor gives discharge order while describing his condition. MS. POOJA SEN NURSING LECTURER ( MHN)

13. 6 -TRANSFER DISCHARGE Patient is referred to other hospital where his medical treatment can be continued because of better/specialized services. Example – Client admitted with cancer is referred to cancer hospital MS. POOJA SEN NURSING LECTURER ( MHN)

14. 8 - DEATH T he patients may die during his /her stays in the hospital. In this situation , it is nurses responsibility to hand over the body of the patients (decrease) to relatives after doing all formalities. MS. POOJA SEN NURSING LECTURER ( MHN)

15. 7 - REFERRAL DISCHARGE Referral means to the shift the patients to other unit or other hospital for further management. Example - From primary health centre to district hospital. MS. POOJA SEN NURSING LECTURER ( MHN)

16. DISCHARGE PROCEDURE The patient , family members, medical staff, nursing staff, social worker, dietician all work together to coordinate the discharge. The doctor plans the discharge with the patients and leaves a written order on patients charts. The discharge planning should be ideal. Involve the patients & family members in discharge planning of the patients. The ideal discharge planning approach focus on the key points. MS. POOJA SEN NURSING LECTURER ( MHN)

17. DISCHARGE PROCEDURE The ideal discharge planning approach focus on the key points. 1. Includes – the patients & family members in the process of discharge planning. Always include family members in group meeting. Recognize family members who will provide care to the patients. MS. POOJA SEN NURSING LECTURER ( MHN)

18. DISCHARGE PROCEDURE 2. Discuss – the five main area to avoid problem at home need to discuss with the patient & family. Discuss about home environment & activities. Discuss the warning signs. Explain test results to the family members. Discuss regarding follow up visit. MS. POOJA SEN NURSING LECTURER ( MHN)

19. DISCHARGE PROCEDURE 2. Discuss – the five main area to avoid problem at home need to discuss with the patient & family. Discuss about home environment & activities. Discuss the medications. Discuss the warning signs. Explain test results to the family members. Discuss regarding follow up visit. MS. POOJA SEN NURSING LECTURER ( MHN)

20. DISCHARGE PROCEDURE 3.Educate – Educate the patient & family members in simple language about the condition of the patients regarding diet, exercise and medications. MS. POOJA SEN NURSING LECTURER ( MHN)

21. DISCHARGE PROCEDURE 4. Assess – Assess how well doctors & nurses has explained the diagnosis , condition and steps in the patient care. 5. Listen – Listen to the patient & family goals, preferences observation & concern. MS. POOJA SEN NURSING LECTURER ( MHN)

22. STEPS FOR DISCHARGE PROCEDURE Do not discharge the patient without doctors procedure. Written consent/ instruction for discharge & take signature of patient in release form with time & date. Instruct the patients regarding care, medications & follow up. Make sure all instruction for care will be understand by patients & relatives. If relative want LAMA have him sign LAMA. Assist the patient to dress and hand over to belonginess with the sign of witnesses. MS. POOJA SEN NURSING LECTURER ( MHN)

23. STEPS FOR DISCHARGE PROCEDURE Collect discharge slip & hand over to patient and relatives. Complete the patients records & discharge summary, & confirm all documents are completed & sent to medical record section. Hand over the personal belongings to the patient, deposited at the time of admission with a written receipt. Care of unit after discharge & check the hospital property during the discharge time. Nurses should inform the dietary department for discharge. MS. POOJA SEN NURSING LECTURER ( MHN)

24. ROLE OF NURSE IN DISCHARGE PROCEDURE IN MLC CASES When a patient has to be discharged, inform the police on duty in the hospital and to the CMO. If MLC patient abscond , inform nursing supervisor, MO immediately & treating doctor. No MLC patients can leave the hospital with LAMA. The care given to the patients should be documented timely, accurate & duly signs the nurses notes. MS. POOJA SEN NURSING LECTURER ( MHN)

25. ROLE OF NURSE IN DISCHARGE PROCEDURE IN MLC CASES Record related the treatment of patient has to be stored safely & should be handover to the authorized person as designated by the hospital authority. In case of death of an MLC, the body is not to be handed over to the relatives. Label the body properly & kept in mortuary. CMO/Police officer should be informed simultaneously. MS. POOJA SEN NURSING LECTURER ( MHN)

26. CARE OF UNIT AFTER DISCHARGE Room is cleaned if discharge patient had communicable diseases than fumigation should be done. Window and doors are opened. Then door window, Furniture is washed & cleaned if need to sterilized send to CSSD or disinfect by chemical. All articles kept ready for next use. Used linens send to laundry. Mattress,pillow,blanket should be exposed to sunlight according to hospital policy. MS. POOJA SEN NURSING LECTURER ( MHN)

27. * THANK YOU * MS. POOJA SEN NURSING LECTURER ( MHN)