Lama & Abscond - it is a legal procedure where patient is willing to go from hospital without medical advice.

Lama and abscond in detail

1. LESSON PLAN
ON
LAMA AND ABSCOND



SUBMITTED TO
SUBMITTED BY
REGNO: 21501401002
MSC (N) 1st YEAR
NURSING

INTERNAL EXAMINER

2. LESSON PLAN
ON
LAMA AND ABSCOND



SUBMITTED TO
SUBMITTED BY
REGNO: 21501401002
MSC (N) 1st YEAR
NURSING

EXTERNAL EXAMINER

3. IDENTIFICATION DATA

Name of the student Teacher = Eslavath Swathi
Name of the course = MSC (N) 1
st
year
Year of the study = 2021 to 2023
Name of the subject = Nursing Education
Unit No. =
Group =
Method of teaching = Lecture method
Previous knowledge =
Date = 9/2/24
venue =
Av – aids = Black board, PPT, pamphlets, chart, OHP
Time duration = 15min

4. GENERAL OBJECTIVES:
At the end of the session students will be able to understand about LAMA and ABSCOND
modalities and they will be able to apply this knowledge in the clinical practice.

SPECIFIC OBJECTIVES: At the end of this teaching session students will be able to:
➢ Define LAMA and ABSCOND
➢ Type of discharge
➢ Definition of LAMA and ABSCOND
➢ Consent of LAMA and ABSCOND
➢ Summarize about LAMA and ABSCOND
➢ Conclusion about LAMA and ABSCOND
➢ Assignment about LAMA and ABSCOND
➢ References about LAMA and ABSCOND

5. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVALUATIO
N
1. 1
Min









1
Min







Introduct
ion










Explain
about
discharg
e
definitio
n
Introduction on Discharging the patient

This is the stage when patient is shifted from
hospital to home. Discharging means per
milling the patient to let go from the hospital
to his home.

Discharge is the preparation of patient
to leave the hospital. A formal statement in
written form is given from the hospital in
which he has been undergoing treatment.

Discharge Definition

“Discharge of patient from the hospital means,
relieving a patient from the hospital setting,
who admitted as an inpatient in that hospital”



LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS

p
p
T


ASSIGNMENT,
ESSAY
TYPE&SHORT
ANSWER
QUESTIONS

6. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVAL
UATI
ON











2
min










Explain
about
objective
of
discharg
e
“Discharge or dismissal from the
hospital means the departure of patient
from the hospital”

“Discharge from the hospital is the point
at which the patient leaves the hospital
and either return home or is transferred
to another facility such as one for
rehabilitation or to a nursing home”


Objectives of discharge:

• To complete obligations to
hospital.
• To ensure proper medical care
after discharge.
• To motivate the patient and
relatives
LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS

OHP


ASSIGN
MENT,
ESSAY
TYPE&S
HORT
ANSWE
R
QUESTI
ONS

7. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIES
LEARNING
ACTIVITIES
AV
AIDS
EVALUATI
ON





2
min






Explain
type of
discharg
e
• To promote independence and self-
reliance throughout illness.
• To promote good public relations.



Type of discharge

The patient is discharged from the
hospital in one of the following ways.

➢ Cured and discharge/ planned
discharge
➢ Discharge to another hospital or
another unit within the hospital
(referral)
➢ LAMA/ DAMA: left against
medical advice/ Discharged against
medical advice.

LECTURE&
DEMONSTRATI
ON METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE TO
THE
QUESTIONS

CHAR
T


ASSIGNMENT,
ESSAY
TYPE&SHORT
ANSWER
QUESTIONS

8. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVAL
UATI
ON







2
min
s






Explain
about
definitio
n

➢ ABSCOND
➢ Death discharge
➢ Planned
➢ Transfer


Definition

LAMA/DAMA (Left against medical advice/
discharge against medical advice): in LAMA/
DAMA, patient choose to leave the hospital
before the treating physician recommends
discharge

LAMA : The patient will leave the hospital
against the doctor’s advice even though after
explains patient condition.
LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS

OHP


ASSIGN
MENT,
ESSAY
TYPE&S
HORT
ANSWE
R
QUESTI
ONS

9. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVALUATI
ON
2
min
Explain
about
consent
for lama
CONSENT FOR LAMA

• I am leaving the hospital ward against
medical advice.
• Doctor explained me about my disease
condition and ill effects of discharge
against medical advice.
• Doctors and nursing staffs will not be
responsible for any ill effects happing
after my departure.


Name of the patient:
Relation
Signature
Date
Time


LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS

p
p
T


ASSIGNMENT,
ESSAY
TYPE&SHORT
ANSWER
QUESTIONS

10. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVALUATIO
N
2
min
Explain
about
abscond

ABSCOND

Definition:
Patient leaves the hospital
without prior information
Patient went out of the hospital
without doctors or other staff
knowledge. Or patient may abscond or
leave the hospital without and prior
information.

DISCHARGE IN ANOTHER
CONDITION

Lama: if the patient leaves against medical
advice the nurse is responsible to
LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS

OH
P







P
A
M
P
H
L
E
T
S
ASSIGNMENT,
ESSAY
TYPE&SHORT
ANSWER
QUESTIONS

11. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVALUATIO
N
a) Follow the institutional polices for
patient discharge do not force the
patient to stay in the hospital.
b) Explain about the critical condition
of the patient
c) Inform the medical officer.
d) Signature of the relatives, in which
that she writes that there is full
responsibility on the part of
relatives about the risk of taking
away the patient with them.
e) Hospital equipment (given to
patient during admission) and the
clearance of bills, should be
checked before the discharge.
f) Records should be kept safe.
LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS

PP
T
ASSIGNMENT,
ESSAY
TYPE&SHORT
ANSWER
QUESTIONS

12. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVALUATI
ON
2
min
Explain
about
abscond
ABSCOND:
If the patient runs from the ward-
hospital to avoid these problem the nurse
must


a) Check the no. of patients admitted,
discharged of the shifts.
b) Inform immediately the CMO in
writing of get it signed.
c) Record of the patient should be
kept under lock and key.
LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS

O
H
P
ASSIGNMENT,
ESSAY
TYPE&SHORT
ANSWER
QUESTIONS

13. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVALUATIO
N
ROLES & RESPONSIBILITIES OF
NURSE DURING DISCHARGE
PROCEDURE
• 1. See doctor’s written order for discharge: no
client should be discharged without doctor’s
written order
• 2. Explanation of discharge procedure
• 3. Hand over personal belongings: clothing,
jewelry or other valuables that were entrusted
with hospital at the time of admission should be
returned to client.
• 4. Check and receive any hospital property:
any of the hospital property that was given to
client for his/her use in hospital should be
checked and received back before he/she leaves
• 5. Teach nursing procedures to be continued at
home, get it’s practice done: Provide
instructions regarding medication, follow-up
visit
LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS

E
X
P
L
A
N
A
T
I
O
N
ASSIGNMENT,
ESSAY
TYPE&SHORT
ANSWER
QUESTIONS

14. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVALUATIO
N
• 6. bill paid: Before client leaves, nurse
should confirm that the client has paid the
hospital bill
• • 7. Inform other departments regarding
discharge.
• • 8. Documentation: the nurse should check
that the charts &
• 9 . if the client is not able to walk, then the
nurse should see that he/she is transferred
either on a wheel chair or stretcher
• • 10. If DAMA: -check consent, the form
should state that the person is leaving against
medical advice of doctor and that neither
doctor nor the hospital can be held
responsible for any ill effect happening after
the departure
• • 11. Care of patient’s room and articles
after discharge.

LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS

E
X
P
L
A
N
A
T
I
O
N
ASSIGNMENT,
ESSAY
TYPE&SHORT
ANSWER
QUESTIONS

15. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVAL
UATI
ON


SUMMARY

such discharge is called LAMA or left
against medical advice of DAMA,
discharged against medical advice and
doctor should be taken in writing that all
case history, treatment and
investigations done were provided to
attendants and it full payments not done
then it should be also mentioned







LECTURE&
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ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS


ASSIGN
MENT,
ESSAY
TYPE&S
HORT
ANSWE
R
QUESTI
ONS

16. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
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LEARNIN
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ACTIVITI
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CONCLUSION

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.it
could be when attendings doctor
advice to leave the health care
facility or patients himself wishes to
leave.
LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS


ASSIGN
MENT,
ESSAY
TYPE&S
HORT
ANSWE
R
QUESTI
ONS

17. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVAL
UATI
ON
ASSIGNMENT

This study was supported by Tehran
heart center affiliated to Tehran
university medical science. We wish to
thank the surgery data base group at
Tehran heart for it support

REFERENCE

Albert HD, Kornfeld DS (1973) The
threat to sign out against medical
advice. Ann Intern Med 79(6): 888-891.

Long JP, Marin A (1982) Profile of
patients signing against medical
advice. J Fam Pract 15(3): 551-556.
LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS


ASSIGN
MENT,
ESSAY
TYPE&S
HORT
ANSWE
R
QUESTI
ONS

18. SL
NO.
TIME SPECIFIC
OBJECTIV
E
CONTENT TEACHING
ACTIVITIE
S
LEARNIN
G
ACTIVITI
ES
AV
AID
S
EVAL
UATI
ON
Onukwugha E, Saunders E, Mullins CD,
Pradel FG, Zuckerman M et al.
(2010) Reasons for discharges against
medical advice: a qualitative
study. Qual Saf Health Care 19(5): 420-
424.


BIBLIOGRAPHY

Author: suresh k sharma
Text book: fundamental of nursing
Edition: 2
Page no. 300 to 306






LECTURE&
DEMONSTRAT
ION METHOD
STUDENT
TAKE DONE
THE NOTES


GIVE
RESPONSE
TO THE
QUESTIONS


ASSIGN
MENT,
ESSAY
TYPE&S
HORT
ANSWE
R
QUESTI
ONS