Discharge procedure and its types in hospital .pptx

DISCHARGE PROCEDURE
MS. POOJA SEN
NURSING LECTURER ( MHN)

DEFINITION
• Discharge of patients from the hospital
means , relieving a person hospital
setting ,who admitted as an inpatient in the
hospital.
• Discharge from the hospital means the
departure from the hospital.
• Systematic process for preparing the client
to leave the health care agency and for
continuity of care.
MS. POOJA SEN

DEFINITION
Discharge is the termination of care
from a health care agency. Planning for
discharge actually begins on admission,
when information about the patient is
collected & documented.
Discharge from the hospital is the point
at which the patient leaves the hospital
& either return home or its transferred to
another facility such as one for
rehabilitation or to a nursing home.
MS. POOJA SEN

PURPOSES
•To prepare patient physically and psychologically for
transfer to the changes environment.
•Prepare the family emotionally and psychologically for
changing environment.
MS. POOJA SEN

DISCHARGE PLANNING
The key to successful
discharge planning is an
exchange of information
among the client, present
care givers and those
responsible for care after
release.
MS. POOJA SEN

TYPES OF DISCHARGE
2. L A M A
4. ABSCONDED
6. TRANSFER
1. PLANNED DISCHARGE
3. PAROLE
5. D O R
( DISCHARGE ON REQUEST)
7. REFERRAL
8. DEATH MS. POOJA SEN

1- PLANNED DISCHARGE
Planned discharge means
patients has completed the
initial & actual management of
diseases in the hospital. Now
patient does not need the
direct supervision. Planned
discharge is done when the
patients condition stabilize &
patient is ready to go home. MS. POOJA SEN

STEPS OF PLANNED DISCHARGE
Written order by doctor
Discharge card.
Informing other departments
Check payment of the bills.
Hospital glossaries taken back .
Returning of the personal belongings.
Arrangement for transport
documentation
MS. POOJA SEN

2- L A M A
(LEAVE AGAINST MEDICAL
ADVICE)
• When a client decide to leave the
hospital against medical advice.
• In this condition client must sign a
consent form for any legal
responsibility for health status.
• The client signature must be
witnessed and the form become part
of the client record.
When the client does not want to continuous his treatment and
want to leave against doctor advice, patients gone with LAMA,
Risk & complication explained to the patient & family members.
MS. POOJA SEN

3- PAROLE DISCHARGE
Parole is used in psychiatric
hospitals. The patient can be sent
to home for 2-3 days by the
approval of psychiatric charges. If
patient does not come or return
after the parole, the discharge
process should be done
according to the hospital protocol.
MS. POOJA SEN

4 – ABSCONDED DISCHARGE
When the client leave
hospital without any
information to hospital
authorities. During the
treatment process, the
client leaves hospital
without clearing his dues.
MS. POOJA SEN

5 – D O R (DISCHARGE
ON REQUEST )
The client is not willing
to take treatment from
hospital on his
personal request .
Doctor gives
discharge order while
describing his
condition.
MS. POOJA SEN

6 -TRANSFER DISCHARGE
Patient is referred to other
hospital where his medical
treatment can be
continued because of
better/specialized services.
Example – Client admitted
with cancer is referred to
cancer hospital
MS. POOJA SEN

8 - DEATH
The patients may die
during his /her stays in the
hospital. In this situation ,
it is nurses responsibility
to hand over the body of
the patients (decrease) to
relatives after doing all
formalities.
MS. POOJA SEN

7 - REFERRAL DISCHARGE
Referral means to the shift
the patients to other unit or
other hospital for further
management.
Example - From primary
health centre to district
hospital.
MS. POOJA SEN

DISCHARGE PROCEDURE
The patient , family members, medical
staff, nursing staff, social worker,
dietician all work together to coordinate
the discharge. The doctor plans the
discharge with the patients and leaves a
written order on patients charts.

The discharge planning should be ideal.
Involve the patients & family members in
discharge planning of the patients.
The ideal discharge planning approach
focus on the key points.
MS. POOJA SEN

DISCHARGE PROCEDURE
The ideal discharge planning approach focus on
the key points.
1. Includes – the patients & family members in the
process of discharge planning.
•Always include family members in group meeting.
•Recognize family members who will provide care to
the patients.
MS. POOJA SEN

DISCHARGE PROCEDURE
2. Discuss – the five main area to avoid problem at
home need to discuss with the patient & family.
• Discuss about home environment & activities.
•Discuss the warning signs.
•Explain test results to the family members.
•Discuss regarding follow up visit.
MS. POOJA SEN

DISCHARGE PROCEDURE
2. Discuss – the five main area to avoid problem at home
need to discuss with the patient & family.
• Discuss about home environment & activities.
•Discuss the medications.
•Discuss the warning signs.
•Explain test results to the family members.
•Discuss regarding follow up visit.
MS. POOJA SEN

DISCHARGE PROCEDURE
3.Educate – Educate the patient & family members
in simple language about the condition of the
patients regarding diet, exercise and medications.
MS. POOJA SEN

DISCHARGE PROCEDURE
4. Assess – Assess how well doctors & nurses has
explained the diagnosis , condition and steps in the
patient care.
5. Listen – Listen to the patient & family goals,
preferences observation & concern.
MS. POOJA SEN

STEPS FOR DISCHARGE PROCEDURE
♠ Do not discharge the patient without doctors procedure.
♠ Written consent/ instruction for discharge & take signature
of patient in release form with time & date.
♠Instruct the patients regarding care, medications & follow up.
♠ Make sure all instruction for care will be understand by
patients & relatives.
♠ If relative want LAMA have him sign LAMA. Assist the
patient to dress and hand over to belonginess with the sign
of witnesses.
MS. POOJA SEN

STEPS FOR DISCHARGE PROCEDURE
♠ Collect discharge slip & hand over to patient and relatives.
♠ Complete the patients records & discharge summary, &
confirm all documents are completed & sent to medical
record section.
♠ Hand over the personal belongings to the patient,
deposited at the time of admission with a written receipt.
♠ Care of unit after discharge & check the hospital property
during the discharge time.
♠ Nurses should inform the dietary department for discharge.
MS. POOJA SEN

ROLE OF NURSE IN DISCHARGE PROCEDURE
IN MLC CASES
 When a patient has to be discharged, inform the
police on duty in the hospital and to the CMO.
 If MLC patient abscond , inform nursing
supervisor, MO immediately & treating doctor.
 No MLC patients can leave the hospital with LAMA.
 The care given to the patients should be
documented timely, accurate & duly signs the
nurses notes.
MS. POOJA SEN

ROLE OF NURSE IN DISCHARGE PROCEDURE
IN MLC CASES
 Record related the treatment of patient has to be
stored safely & should be handover to the authorized
person as designated by the hospital authority.
 In case of death of an MLC, the body is not to be
handed over to the relatives. Label the body properly
& kept in mortuary.
 CMO/Police officer should be informed
simultaneously.
MS. POOJA SEN

CARE OF UNIT AFTER DISCHARGE
 Room is cleaned if discharge patient had communicable
diseases than fumigation should be done.
 Window and doors are opened.
 Then door window, Furniture is washed & cleaned if
need to sterilized send to CSSD or disinfect by chemical.
 All articles kept ready for next use.
 Used linens send to laundry.
 Mattress,pillow,blanket should be exposed to sunlight
according to hospital policy. MS. POOJA SEN

* THANK YOU *
MS. POOJA SEN

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Discharge procedure and its types in hospital .pptx