Hospital and Nursing - Discharging the patient

DISCHARGING THE PATIENT

Discharge is a preparation of a patient and discharge records to leave the hospital.

Purpose

To ensure continuity of care to the patient after discharge

To assist the patient in discharge process

Guidelines

The patient are discharged from the hospital in one of the following ways

Discharge to home. The discharge to home or another hospital or another unit within the hospital is initiated by the doctor who advises the patient that he is well enough to leave the hospital or requires treatment in another unit within the hospital or in an another hospital

Discharge to another hospital or another unit within the hospital (referral). When a patient or family is not satisfied with the treatment or care given and wants to leave the hospital against the medical advice, in such cases the patient or the relative is asked to sign a statement that he is going or taking the patient on his own will and responsibility.

Discharge against medical advice (AMA).

Patient leaves the hospital against the medical officer' s advice. When a patient escapes from the hospital without the knowledge of the hospital staff and without signing the said statement he is treated as absconded in the records.

Nurses Responsibility

Inform the patient and the relatives a day or two before the discharge

Get the discharge slip prepared after checking the vital signs and examining the patient.

The nurses should see that the patients personnel hygiene is maintained, he is dressed in home clothes and has taken meals.

Hand   over   the   patient' s   belongings and any valuables, which have been kept safely, to the patient or the relative under proper receipt.

Complete the unit admission and discharge registers, case sheet and other records.

Hand over the case sheet and other records to medical record department under proper receipt.

Inform the hospital authorities about the discharge if the patient is medico-legal.

Hand over the discharge slip to the patient or relative and explain about

the treatment and the diet to be taken at home

follow-up visits and inform to bring the discharge slip on every visits

any special advices pertaining to condition

See that the patient receives all the medicines as per discharge slip.

Check the hospital things before the patient leaves the ward.

Place  the  patient  in  the  wheel  chair  or  stretcher

according to the patient' s condition until he leaves the hospital.

Immediately after the patient leaves, reorganise the patient unit.

Summary

Hospitals are institutions, which are designed to care the sick, injured and the well.

The basic functions of a hospital are care of the sick and injured, diagnosis, treatment and rehabilitative services.

Many hospitals undertake education of doctors, nurses and technicians and also undertake research works.

There are various departments in a hospital like medical, nursing, pharmacy and dietary department.

Every hospital has its own policies and rules, which govern their various activities.

The main aim of a hospital is patient care and comfort.

Every nurse should know how to keep her ward clean.

Proper disinfection should be done for infected articles by immersing in 1:20 carbolic lotion for 2 hours.

Stock taking should be done periodically of all kitchen utensils, instruments, linen and drugs.

Economy of time, money and men power should be kept in mind in ward management.

The entrance of a patient into a health care agency is termed as admission.

The patient who is admitted need good reception, orientation to place and people, safeguarding his personal belongings, physical assessment, prompt personal hygiene and observation to identify deviations from normal.

Recording of the observations is called charting.

The nurse provides a safe and comfortable environment to the patient by using the mechanical devices.

Discharge is a preparation of a patient and discharge records to leave the hospital.