entering discharge instructions jamie golden, msn student ucla school of nursing view presentation...
TRANSCRIPT
![Page 1: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/1.jpg)
ENTERING DISCHARGE INSTRUCTIONS
Discharge as a team sport
Jamie Golden, MSN StudentUCLA School of Nursing
![Page 2: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/2.jpg)
Objectives• Clarify or reinforce the unit expectation with respect to
initiating discharge instructions
• Describe the significance of starting instructions early
• Suggest elements of discharge instructions that may be started in advance of day of discharge
• Provide everyone a job aid that offers step-by-step instruction for entering discharge instructions in CS-Link, as well as other useful tips and suggestions.
![Page 3: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/3.jpg)
“Discharge planning starts at admission”
![Page 4: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/4.jpg)
The Unit Expectation
RNs on 7NW are expected to initiate discharge instructions
before the day of discharge.
![Page 5: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/5.jpg)
Whose Responsibility Is It?
It’s the shared responsibility of all RNs throughout a patient’s
hospital stay.
![Page 6: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/6.jpg)
Purpose of Discharge Instructions
Reinforce (not replace) discharge education performed throughout a
patient’s hospital stay.
(Krohn, 2008)
![Page 7: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/7.jpg)
Significance INSTITUTION-WIDE GOAL:
Discharge before 11 AM
• Numerous nursing tasks in the process of discharge Order DME Fax Paper Prescriptions Discontinue Lines Enter & Review Discharge Instructions Discharge Teaching Arrange Transportation Reconcile Patient Belongings Resolve Care Plan & Patient Education
• Helps expedite discharge and
supports the discharging RN to achieve to this goal
![Page 8: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/8.jpg)
Significance
THE BIG PICTURE
• Early discharge frees up beds for patient “parked” in recovery after surgery
• Improves patient flow
• Decreases patient wait time
(Institute for Health Improvement, 2008)
![Page 9: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/9.jpg)
Significance THE BIG PICTURE
• Press Ganey Associates found the following relationship relationship between hospital wait time and patient satisfaction:
(Based on 4,830,042 survey responses from 989 facilities received between Jan. 1 and Dec. 31, 2012)
• Financial implications now that hospital reimbursement is tied to HCAHPS scores
Hospital Wait Time
PatientSatisfaction
(Stempniak, 2013)
![Page 10: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/10.jpg)
Job Aid
• Step-by Step Instruction for Entering Discharge Instructions:
Entering & Navigating the SmartText Template
Editing Discharge Instructions
Adding & Editing Healthwise® Patient Care Instructions
Previewing & Printing the AVS
![Page 11: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/11.jpg)
Job Aid Features: Notes Margin
FYI Notes
• Navigation tips
• Suggestions where to find certain information for discharge instructions
• Ways to tailor instructions to the patient
• Cautionary points
![Page 12: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/12.jpg)
Before Day of Discharge
Suggestions
• Enter the SmartText Template
• Add in the Procedure/Condition
• Check Orders and Clinician Notes for insight into:Assistive devices (e.g. does PT recommend they go home with a
walker?)ActivityNew medications (e.g. Lovenox injections) Diet
![Page 13: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/13.jpg)
Before Day of Discharge
More Suggestions
• Attach relevant Healthwise® instructions about:New medications or vaccines orderedPrecautions (Hip precautions)Patient-specific condition(s)/procedure(s)
• To the Report the Following Symptoms to Your Physician field, add common symptoms of infection (e.g. fever, redness, foul odor) and reasons to seek emergency medical treatment.
![Page 14: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/14.jpg)
Before Day of Discharge
More Suggestions
• Check Additional Signed Discharge Orders in the Discharge activity, where other disciplines sometimes enter discharge orders in advance.
• If the patient is going to have home health, add the Home Health Care Coordinator’s contact information for his/her reference.
• Look-up/Add the Physician’s office phone number in the Follow-Up Appointment(s) field.
![Page 15: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/15.jpg)
Summary• It is possible to start discharge instructions early
• It is important for improving discharge efficiency and supporting one another in accomplishing the 11 AM Discharge Goal
• Implications for patient satisfaction and hospital reimbursement
• Refer to your job aid for tips or any questions you may have about entering quality discharge instructions
Thank you very much for your time
![Page 16: ENTERING DISCHARGE INSTRUCTIONS Jamie Golden, MSN Student UCLA School of Nursing View presentation in “Slide Show” mode to see animations](https://reader035.vdocument.in/reader035/viewer/2022062511/551b0bbf5503465e7d8b5d75/html5/thumbnails/16.jpg)
References
Institute for Healthcare Improvement. (2008). Transforming Care at the Bedside
how-to guide: Increasing nurses’ time in direct patient care. Retrieved from
http://www.ihi.org/resources/Pages/ToolsTCABHowToGuideIncreasing
NursesTimeinDirectPatientCare.aspx
Krohn, D. A. (2008). Discharge instructions in the outpatient setting: Nursing
considerations. Journal of Radiology Nursing, 27(1), 29-33. http://
dx.doi.org/10.1016/j.jradnu.2007.10.001
Stempniak, M. (2013). What, no wait? Health and Health Networks, 87(11), 30-35.
Retrieved from http://www.hhnmag.com/display/HHN-newsarticle.dhtml?
dcrPath=/templatedata/HF_Common/NewsArticle/data/HHN/Magazine/
/Nov/1113HHN_Coverstory