discharge of the patient.

1. Prepared By
REENA YADAV
LECTURER
PUSHPANJALI SCHOOL OF
NURSING , AGRA

2. Discharge from the hospital means
the departure from the hospital.
It can be formal discharge of the
patient by attending doctor, when
the patient treatment is over, Left
Against Medical Advice (LAMA) due
to personal reasons, the patient may
abscond i.e leave the hospital
without any prior information or the
patient may expire during
hospitalization.

3.  systematic process for preparing the
client to leave the health care agency
and for continuity of care.
 The key to successful discharge
planning is an exchange of
information among the client,
present care givers and those
responsible for care after release.

4.  PURPOSE OF DISCHARGE PLANNING:-
1. patient has the information on his or her
condition, follow up schedule.
 2. provide for a safe and efficient return
of the patient clothing’s and other
valuables
 check that all the hospital equipments
back to hospital.
 3. avoid any misunderstanding or
difficulty for the patient or hospital in
relation to patient’s release; medicines,
bills, dues or referrals etc.

5. PURPOSE OF DISCHARGE PLANNING
 4. help the patient by making the safest
arrangement possible for patient at the
time of discharge.
 5. assist the patient to manage
successfully the change from hospital
environment to home environment.
 6. To provide continuity of care.

6. Exchange of information among-
 The client
 Patient care giver
 Those responsible after
discharge
KEYS TO SUCCESSFUL
DISCHARGE PLANNING

7. DISCHARGE PLANNING MUST BE
 Co-ordinate-
 Carefully planned
 Initiated as early as possible
 Involving the client, family or
significant care taker
KEYS TO SUCCESSFUL
DISCHARGE PLANNING

8. TYPES OF DISCHARGE

9. STEPS OF DISCHARGE PROCESS
ASSESSMENT
DIAGNOSIS
PLANNINGIMPLEMENTATION
EVALUATION

10.  ASSESSMENT:-
 l. HEALTH DATA
 ll. PERSONAL DATA
 lll. ENVIRONMENT
 lv. CLIENT OR FAMILY KNOWLEDGE
STEPS OF DISCHARGE PROCESS

11.  ASSESSMENT:-
 l. HEALTH DATA-
 Clients’ age, sex,
 height, weight,
 diagnosis,
 past medical history,
 current health problems,
 surgery,
 functional limitation such as
amputations, wheel chair or walker.
STEPS OF DISCHARGE PROCESS

12.  ASSESSMENT:-
 ll. PERSONAL DATA-
 Ascertain how the client feels about
discharge(as he anxious ?),
 expectations for recovery –are they
realistic ?
 what has been their coping ability in the
past- effective or ineffective?
 What are their attitude and beliefs about
health and illness.
STEPS OF DISCHARGE PROCESS

13.  lll. ENVIRONMENT
 Includes both home and community.
 Are there any structural barrier that
would inhibit function – narrow stairs for
a wheel chair –bound elderly client or
caregivers;
 Assistive device in bathroom,
 Hot water, heat, available space.

14.  iv. CLIENT OR FAMILY KNOWLEDGE
 Assess the understanding of treatment
plan and care regimen –
 medication,
 side effects,
 client diagnosis,
 prognosis,
 emergency measures,
 complications and symptoms of
impending problems

15.  Anxiety related to inability of self care
 -Deficient knowledge regarding home
care
 -Ineffective family coping related to
financial or personal support system.
 -Self care deficit {e.g.-feeding, toileting,
grooming, bathing etc) related to
inability to use right hand.
NURSING DIAGNOSIS

16.  -Impaired home maintaining
management related to
limited ability to shop for
food and clean the house
secondary to chronic
respiratory illness.
NURSING DIAGNOSIS

17. By METHOD approach we should plan
for care-
M: MEDICATION
The client will know
•Drug name
•What dosage to take and when to take.
•Purpose of drug
•Effect the drug should have
•Symptoms of possible adverse effect
and which ones to report.
PLANNING

18. E: ENVIRONMENT
The client will be assured of:
Adequate instruction in necessary
homemaking skills.
Adequate emotional support.
Investigation of sources of economic
support.
PLANNING

19. T: TREATMENT
The client and family will able to
Know the purpose of any treatment to be
continued at home.
Be able to demonstrate correct
performance of the treatment.
PLANNING

20. H: HEALTH TEACHING
The client will
oDescribe how his or her disease condition
affects body function
oDescribe the means necessary to maintain
present level of health or achieve a higher
level of health.
PLANNING

21. O: OUTPATIENT REFERRAL
The client will able :
•Know when and where to keep clinical
appointments.
•Know where and whom to call for medical
help.
•Take home written discharge instructions.
PLANNING

22. D: DIET
The client will be able to
•Describe the purpose of his or her
prescribed diet.
•Plan several typical menus using the
prescribed diet.
PLANNING

23. IMPLEMENTATION
Before Day of Discharge
1. Suggest ways to change physical
arrangement of home.
2. information about community health care
resources.
3. Gives opportunity to practice new
readiness to learn,
4. conduct teaching session with client

24. Day of Discharge;-
1. Let the client and family ask question
or discuss issue
-Allow for final clarification of related to
home health care.
2. Check physician’s order for
prescription,
-Make sure that client receive all
medicines and know how to take.
3. Determine whether client or family has
arranged transportation.
-Prevent loss of personal items.

25. Day of Discharge;-
- If patient has financial problem for
arranging transport.
- Offer assistance
4. If patient has financial problem for
arranging transport at the time of
discharge, social worker may be
contacted to arrange financial assistance.
5. Offer assistance as a client dresses and
packs
-Prevent loss of personal items.
personal belongings. Provide privacy as
needed.

26. Day of Discharge
6. Check all closets and drawers for
belongings.
Obtain client’s sign verifies receipt of items
- copy of valuable list signed by client.
7.Make sure that all the hospital charges
are cleared i.e hospital bill, pharmacy bill
etc and bill receipt handed over to client or
family members.
-Any missing of the articles is belonging
are returned back to hospital before
handing responsibility of nurse attended
the over the discharge slip patient.

27. Day of Discharge
8. Explain detail about the diet, medication
and importance of follow up.
9. If patient is unable to walk, wheelchair
or trolley to carry him up to the transport.
10. As a courtesy, wish him early recovery
and good gives a sense of wellbeing.
11. After the discharge of patient, the bed
has to be to keep the unit ready for next
use.
12. Collect the patient records and
complete it and enter it into dispatch book.
-Complete the records.

28. E. EVALUATION:
1. Ask client or family member to describe
nature of illness treatment regimen and
physical sign or symptom to be reported to
a physician.
2. Have client or family member perform
any treatment to be continued at home.

29. WRITE DATE AND TIME OF
DISCHARGE ON THE FOLLOWING
RECORD
• Nurse’s record.
•Admission and Discharge register.
•Treatment book.
•Report book.

30. VARIOUS HOSPITAL PROCEDURES FOR
DICHARGE:
PRIVATE SECTOR:
care taker is informed to clear the medical
bills and on producing the bill receipt the
discharge slip.
GOVT SECTOR:
discharge slip is handed over to the
patientcare giver as soon as discharge
summary is prepared. Special Cases: In
case of MLC, the hospital security is
informed and the local police are informed
about the discharge.

31. ELEMENTS OF WRITTEN
DISCHARGE SUMMARY FORM

32. FUMIGATION
•Total surface exposure to formaldehyde gas under
the condition of controlled humidity temperature
and time exposure will destroy all vegetative forms
of bacteria, viruses, and most of the spores.
•The best result can be obtained with high
concentration of gas , humidity above 60 and
temperature of not less than 18 degree centigrade.
• The exposure time varies from 1 to 16 hours.
• The agent commonly used for the fumigation
are formalin tablets, ethylene oxide liquids etc.

33. BIBLIOGRAPHY
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34. BIBLIOGRAPHY
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