Nursing, Effective Patient Transfer within the UK Hospital - Essay Example

Nursing; Effective patient transfer within UK hospital Discharge is a process. It has to be planned to the earliest opportunity between primary, hospital and social care organization to ensure that the patient and the carer understand and will be able to contribute to care planning decisions. The process of discharge planning should be well coordinated and collaborated. The process of discharge should be well coordinated, being led by a person who knows to answer and able to solve several problems that might arise. The people involve in the process should work within a framework of integrated multidisciplinary and multi- agency team. The multidisciplinary team (MDT) will be working in all aspects of the discharge process. Effective discharge of patients from hospital includes a successful transition of a patient from secondary to primary care. A good communication and planning is important in this process. There must be an effective coordination and collaboration between the PCT and all of the different partners in the care process so that services are seamless and responsive to changing need. The Primary Care Trust (PCT) is the leader in developing the care management in a hospital. Working together with other government companies to be able to achieve its aim to have The NHS plan, to be able to produce a modern, flexible and patient-centered NHS. The NHS is the one responsible in improving the policy in discharging patient. The Discharge Planning Team Source: Department of Health, 2003 (doh.gov.uk) Policy The government is continuing its aim to improve the policy and guidelines in discharging a patient. NHS has made several adjustments on its process . The aim of the policy in discharging patient is to ensure the effective patient care, the appropriate, timely placement of patients dependent on their individual needs and the wider effective management of the elective and emergency workload across the Trust. The discharge planning for patients will start at the admission or at pre-admission clinics for elective patients. The Clinical Team will be the one ensuring that the patient remains in the timely pathway to discharge. The ward managers will be the designated personnel in facilitating this process. Base on the policy done by the Luton and Dunstable Hospital NHS Trust, there are several principles that underpinned the discharge policy: Each patient discharge will be assessed by the multidisciplinary team with the help of the patient, relatives, and carer. The assessment will start on or before the patient will be admitted. A leader will be selected by the care team to take the responsibility in identifying the discharge date and make sure that the discharge process will be effective. Every patient will be treated with respect. If in any case the patient will reject the care being extended, his decision will be respected. In case of disabled patient all his needs will be given. The MDT will assess the case of each patient. They will classify it base on the severity of the patient. This will be treated first and will be given proper attention to avoid over staying in the hospital. All the discharge planned along with the dates and contact numbers will be clearly documented. The checklist will be available such as the one being used by the Nursing Assessment. The care providers will be informed instantly about the plan for discharge. Relatives and carers will be given proper attention. If necessary they will be assessed by the social services. Patients will be provided with proper health education and support relating to the discharge process. All the information given to patients, families and carers will be consistent with that given by community agencies. The patient will have access to information about the discharge arrangements. Any instruction given regarding the discharge arrangement will be provided in a written form. This include the following: leaflets, booklets, advice sheets following operations, relevant contact numbers should the patient or carer experience a problem following discharge. There are discharge that could be treated in a simple routine discharges. Others may be more complex discharges. There are some that does not follow any policy making it as an irregular discharge. The strategy used in discharging the patient is the nurse-led discharge. In the NHS plan the chief nursing officer identified 10 key roles for nurses, the important role for them is 'admit and discharge patients for specific conditions using agreed protocols. In this strategy, the senior nurses and medical staff are working closely collaborating and coordinating with each other. The nurse led discharge starts with straightforward surgical procedures and been underpinned by the development of local protocols agreed between the ward team. Case Study A case study of man having a hemi-colorectomy surgery shows the success and the effectivity of the process, with the leadership of a chosen person by the NHS and social services. At the start of this case the patient was oriented about his condition and about the treatment that may be offered. The core team will offer guidance and support regularly. The MDT will do the necessary protocols to facilitate the implementation of recommendations and improve the quality and co-ordination of care. The team includes clinicians who update the team regarding the diagnosis and treatment of colorectomy and a specialized nursing staff who can give support and advice to patients. The Multidisciplinary Team in this case involves the different staff of the hospital. The Team was divided into two teams: the core team and the associate team. The core team includes the Surgical Specialist, Oncologist, Physician gastroenterologist, Radiologist with gastrointestinal expertise, Hispatologist, Skilled colonoscopist, and nurse specialist. The associate team composes of the G/P primary health care team, Palliative care team, Dietician/nutritionist, clinical geneticist/genetics counselor and Social Worker. Each member of the team plays an important role in the process. As the patient was admitted, he was assessed and was concluded that the patient should be admitted. The team makes the necessary protocol and test needed. The patient was oriented as to what will happen upon admission and up to the time of discharge. A time frame was given which is usually 7 days. They meet regularly to be able to evaluate the severity of the case. Close coordination with the primary health care team, the treatment team, the palliative care team, and the patient's family and carer. Some team may discuss the management and treatment of the patient. The team must have adequate support to ensure that all decisions are recorded and communicated to patients and all those outside the core team. The team should do the research, data collection, adoption of and adherence to protocols, and participation in clinical trials. After several test and study the team does the necessary procedure. Early detection of the disease would lead to more appropriate management. The coordination and collaboration of the ideas presented by the teams would result in fewer negative results. If the proper procedure was done it may reduce the complication rate. The MDT has successfully treated the patient with hemi-colosectomy and was discharge in a timely manner. The implementation of the patient oriented process gives positive result to most patients. Proper leadership and dissemination of assignments lead this study into a discharged recovered patient. The time frame was followed perfectly, upon completion of the test needed such as psychological and social test the patient was found to be fit to discharge. The Multidisciplinary Team In the case stated above, the patient had a hemi-colectomy in the right. He was admitted and was placed in the Intensive Care Unit, because of the assessment that the patient is in serious condition. The MDT does the necessary action in analyzing the situation. The physician gastroenterologist wishes to be involved in the pre-surgical review process. Because of the possibility of pre-operative radiotherapy, the clinical oncologist should be involved in the decision about the management of patient undergoing hemi-colectomy surgery. The oncologist involved in the discussion of the management of al patients after surgery . Decisions about treatment should be discussed in relation to clinical practice guidelines and the team should follow the written protocol. In policy decisions and audit the members of the core team should be all involved. The team must have the adequate support from the associate team. For example, GPs and other professionals in the associate team - who requires, or may benefit from, information about decisions made by the team about the care of the patient. The benefit of a team working facilitates coordinated care. The patient who undergo the surgery received the treatment at appropriate time and receive seamless care through the stages of the disease. The complication rates and improve survival is reduced because of the managed care. The specialist nurses who is part of the palliative care team can reduce the distress during the later stages of illness, improve pain control, and increase satisfaction and information flow to patients. The patient where able to recovered from the surgery and was discharged. Before the patient was discharged, proper counseling and instruction was given. The Social Services discuss to patient the necessary medications needed for his full recovery. The operation was a success because of the coordination and collaboration of process. The MDT was able to perform its role in the case. Reference: 1) The Luton and Dunstable Hospital NHS Trust http://www.ldh.nhs.uk/freedom/keydocuments/policies/OperPols/Discharge%20policy%20February%2005.pdf 2) Discharge from Hospital: pathway,process and practice http://www.dh.gov.uk/assetRoot/04/11/65/25/04116525.pdf 3) Responsibilities of the Multidisciplinary Acute Pain Team, Carolyn Middleton http://media.wiley.com/product_data/excerpt/46/04700196/0470019646.pdf 4) The Strategic Leadership of Clinical Governance in PCTs http://www.cgsupport.nhs.uk/downloads/Board/strategic_leadership_CG_PCTs/cg2es.pdf 5) Health and Social Care Joint Unit and Change Agent Team (2003) Discharge from Hospital Pathways, process and practice, Department of Health: London, www.dischargeplanning.doh.gov.uk 6) Healthcare Commission (2004) Patient Survey Report, Healthcare Commission; London 7) NHS Modernization Agency (2002), Improvement leaders guide; process mapping, analysis and redesign. www.modern.nhs.uk/improvementguides. 8) Kumar, S. (2000), Multidisciplinary approach to rehabilitation, London: Butterworth-Heinemann. 9) Preston, C., Cheater, F., Baker, R. and Hearnshaw, H. (1999), Left in limbo: patients' views on care across the primary/secondary interface. Quality in Health Care 8: 16-21 Read More