Wendera Cooper – 000-08-7248

Clinical Log Assignment

NUPR 108-04

Due Date: October 11th, 2022

Instructor: Mrs Justina Toote-Knowles

 a) Describe the discharge procedures  for the assigned ward under the following

headings

1. Doctor

2. Ward Clerk

There should be a strategy in place for the patient's speedy and secure discharge when doctors

determine that they no longer require inpatient care. The role of a ward clerk is to ensure that

an elderly patient is ready to depart, that they will be safe wherever they go, and that any

further support is put in place. A discharge assessment is the initial phase, which the doctor

will evaluate whether additional care is required after the patient leaves the hospital. This is

developed in consultation with the patient and, with their consent, any family members or

caregivers. It is referred to as a "minimum discharge" if the patient requires little or no care.

If additional care is required, the discharge is considered "difficult," and a care plan is

implemented. The doctor also, prescribes the medication and informs the family. The guide

on what happens following hospital discharge has more information on this. Long before the

actual day of departure, the ward clerk will examine a patient's needs in order to determine

how best to proceed. When the doctor provides the all-clear for medical discharge, the goal is

to have everything ready.

a) Discuss  the role of the  nurse with rationales  performed  by the nurse during a patient

discharge procedure.

Discharge planning aims to shorten hospital stays, prevent unscheduled readmissions, and

enhance service coordination once a patient leaves the hospital. To coordinate follow-up

services, tools, and supplies as well as to reiterate patient instructions and discharge
preparations, the nurse will make calls and connections. The following are a few aspects to

considered by nurse during a patient discharge procedure:

 Referrals: A patient can need additional care from another physician after receiving

initial treatment in a hospital or other facility. Home care, general healthcare, physical

therapy, and other treatments may be arranged for patients by a discharge planning

nurse.

 Understand the procedures: The patient may not have had direct contact with the

discharge planning nurses during their hospital stay. To ensure that there is a

discharge plan and that everyone involved is aware of it, this nurse must collaborate

closely with the patient's doctors and other nurses. They must also share these plans

with the patient's family, especially if they will be involved in the patient's further

recovery.

 Teaching: Family members frequently need to step in to assist when a patient requires

additional care or treatment after being discharged. In these situations, it is the

discharge planning nurse's duty to instruct the family in several straightforward tasks

that are vital to the patient's wellbeing. This can include information on how to use a

glucometer or how to appropriately wrap a wound.

 Post-Treatment Preparation: The discharge nurse is in responsibility of making sure

the patient receives referrals for further healthcare professionals whose services may

be required following initial treatment, as was previously noted. Nurses must make

sure the patient has all the tools and information they may require after being
 discharged at this period. Additionally, they must confirm that the patient is aware of

the date, time, and location of any scheduled follow-up appointments.

 Teamwork: In order to provide the greatest care possible, a discharge nurse cannot

operate alone in the hospital; she needs to collaborate closely with the rest of the

team. The nurse may delegate some tasks related to discharge preparation to the

patient's designated nurse, particularly if many discharges are taking place

concurrently. The patient's doctor and the nurse might also need to talk about the

patient's care and subsequent therapy.

b) Identify the essential  requirements necessary for the patients discharge.

Pre-discharge procedure:

 A physician’s order is required prior to discharge.

 Discharge guidelines established while extended care facilities shall be

followed and discharging patients to those types of facilities.

 The patient shall be assessed prior to discharge to determine and document the
nursing diagnosis that have been resolved on the nursing care plan.

 An RN shall complete discharge assessments within eight hours of discharge

of the patient.

 The assigned nurse or team leader shall notify security department to return to
the patient any valuables placed in the hospital safe.

 Discharge instructions ordered by the physician shall be completed.

 The hospital is responsible for the patient until discharge.

 If there's any condition changed, the discharge shall be held, and the attending
physician notified.
  All patients shall be discharged at the entrance in a wheelchair. If the patient
refuses, a nursing staff member or a volunteer must accompany the patient to
his slash her car.

 A minor shall be discharged only to the custody of his or her parent, legal
guardian or custodian, unless such parent or guardian shall otherwise direct
and writing.

 This provision shall not apply to a minor legally capable of contracting

medical care and assuming responsibilities for him/herself upon discharge.

 No mental competent adults shall be detained in the hospital against his or her
will.

 A minor under the age of 18 shall not be detained in a hospital against his will.

 A miner shall not be detained against the will of his parent or legal guardian.

 In those cases where law permits a minor to obtain medical care without the
consent of his parent or guardian, he/she shall not be detained in the hospital
against his/her will.

 The provision does not prevent attempts to persuade a patient to remain in the
hospital in his/her own entrance nor the detention of a mentally disordered
patient for the protection of himself or others.

 The discharge procedure shall be explained to the patient on the family

member or significant although once the discharge order has been completed.

Discharge Procedure:

 Identify the patient

 Provide privacy while dressing

 Collect personal belongings

 Collect medicals and prescriptions for instruction and self-administration.

 Assist patient to pack all personal belongings

 Disconnect all tubes and unchanged dressings as needed

 Reinforce and teach procedures, medications and appointments for home care.

 Explain and write activity restrictions, diet and when to call physician.
 Collect valuables and inventory lists and check with the patient.

 Assist as needed.

 Determine if patients’ medications were sent to pharmacy. If they were, obtain them.

 Accompany patient to the first security gate and ensure that security signs and collect
gate pass. close medical record and send unused medications to pharmacy and
equipment to departments.

c) Explain  one document used at this time.

Medical Notes is the document used when discharging a patient.

d) State and explain one recommendation that may be necessary to improve  the

discharge process.

One recommendation would be to prioritize early discharges. nurses should be proficient

in the art of timely discharge of stable patients since it is one technique to increase bed

turnover. Although there are frequently challenges to overcome, discharging patients can

be simple, particularly for elderly patients with multiple diseases and disabilities who

may have complex demands. Timely discharge planning also improves patient outcomes

by decreasing unexpected readmissions and elevating patient and caregiver satisfaction

with the healthcare process.