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Discharge Planning Nursing - Essay Example

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Discharge planning provides a critical link between the treatment received by a hospitalized patient and the care provided to the patient after discharge. A patient's discharge is not an instantaneous event; rather it is a process which starts right from the moment a patient gets admitted to the hospital…
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Discharge planning provides a critical link between the treatment received by a hospitalized patient and the care provided to the patient after discharge. A patient's discharge is not an instantaneous event; rather it is a process which starts right from the moment a patient gets admitted to the hospital. It is generally accepted that discharge planning should start prior to admission (for planned admissions) or at the time of admission (for unplanned admissions). Medicare defines discharge planning as "A process used to decide what a patient needs for a smooth move from one level of care to another." The discharge plan takes multiple factors into account based on which it is decided whether to send the patient home, a rehabilitation facility or a nursing home. key factors involved are medication, symptom management, diet, activity, sleep, medical follow-up, and the emotional status of patients and their caregivers. Only a physician can authorize a patient's discharge but there many other people involved in the process like the nurse, the patients family members and the discharge planner who may be the patient's primary nurse, a case manager, a dedicated discharge planner, or an inter-disciplinary team. A patient's health prognosis depends significantly on careful discharge planning and good follow-up contact along with decreasing healthcare and social costs.
"With discharge planning, patients can maintain a level of health and improve it," says Castiglia. "It also helps people assume more responsibility for their own health."
An ideal discharge planning strategy should include assessment of the patient's physiological, psychological, social and cultural needs; development of a care plan that identifies and documents discharge strategies; and arranging for the provision of services, including patient/family education and referrals. The complexity of the plan is determined by the patient's medical condition, needs, and goals. Members of the discharge planning team and their responsibilities should be identified and a coordinator specified. Implementation of the discharge plan is done to assure the safety and efficacy of the continuing care of an intensive care patient.
The physical environment must be evaluated for safety and suitability. It should be free of fire, health, and safety hazards; provide adequate heating, cooling, and ventilation; provide adequate electrical service; provide for patient access and mobility with adequate patient space (room to house medical and adaptive equipment) and storage facilities.
Financial resources must be identified at the beginning of the discharge process. Lack of funding or inadequate funding impacts the entire discharge plan and can determine the care site
A multidisciplinary plan of care is developed based upon the evaluation of the patient's needs and goals. The plan should be consistent with recommended practices and guidelines for the patient's condition
The discharge plan coordinator and the physician should monitor the progress of the discharge plan. Each team member should participate in regularly scheduled team conferences to assess the progress of the discharge plan. Modifications may be made according to the individual patient's goals and needs.

Undesirable and/or unexpected outcomes may occur if the patient is discharged prior to the full implementation of the discharge plan. An undesirable and unexpected patient outcome may be a hazard or complication of the discharge plan or a result of the natural course of the disease or other factors beyond the control of the discharge planning process.





Primary Source: IS YOUR DISCHARGE PLANNING EFFECTIVE
By: Patrice L. Spath
Reprinted from Respiratory Care [Respir Care 1995;40(12):1308-1312] Read More
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