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Journal articles on the topic 'Discharge education'

Author: Grafiati

Published: 4 June 2021

Last updated: 20 February 2023

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1

de los Reyes, Samantha, Dana Al-Khaled, Katherine Brito, Manizha Kholmatov, Brianna Farley, Melissa Kuriloff, Gayle Stamos, David Victorson, and Beth Plunkett. "AWHONN postpartum discharge education: patient knowledge and sustainability." BMJ Open Quality 11, no. 4 (November 2022): e001528. http://dx.doi.org/10.1136/bmjoq-2021-001528.

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ObjectiveThe objective is to evaluate whether the implementation of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) postpartum discharge educational initiative is associated with improved patient knowledge of warning signs of severe maternal morbidity (SMM) and if the initiative is self-sustaining.DesignA pre–post design was used to evaluate patient knowledge of warning signs of SMM (Plan–Do–Study–Act, PDSA cycle 1) and if the quality improvement initiative was self-sustaining (PDSA cycle 2). Patient understanding of warning signs of SMM prior to initiation of the AWHONN education (Usual Discharge) was compared with understanding of those who were discharged after implementation (POST-BIRTH discharge). The initiative was designed to be self-sustaining. The POST-BIRTH flyer describes nine warning signs of SMM. Eligible participants were English-speaking patients discharged with a live newborn who were able to be contacted within 2 weeks. Participants completed a telephone administered nine-item survey to assess knowledge of SMM. The primary outcome was the percentage of correct answers. To evaluate sustainability, whether the POST-BIRTH fliers and discharge checklist were still being used at 19 months postinitiative was planned.ResultsFor PDSA cycle 1, in the Usual Discharge group, 347 patients were discharged, 164 (44.7%) were eligible and 151 (92.1%) completed the survey. In the POST-BIRTH discharge group, 268 patients were discharged, 199 (74.3%) were eligible and 183 (92.0%) completed the survey. Compared with the Usual Discharge group, the POST-BIRTH group had significantly more correct responses (30% vs 60%, p<0.001). In PDSA cycle 2, POST-BIRTH flyers were still being used universally on one of the two floors from which postpartum patients are discharged, but not the other.ConclusionThe implementation of an educational initiative for postpartum patients is associated with improved knowledge of warning signs of SMM. The use of the education was self-sustaining on one discharge floor but not the other.

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Ackermann, Lily L., Emily A. Stewart, and Jeffrey M. Riggio. "Improved Supervision and Safety of Discharges Through Formal Discharge Education." American Journal of Medical Quality 34, no. 3 (August 30, 2018): 226–33. http://dx.doi.org/10.1177/1062860618794283.

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The goal of this study is to evaluate change in residents’ assessment of supervision and safety of the discharge process after formal discharge instruction education. An educational lecture and workshop addressing high-risk medications, medication reconciliation, follow-up, and handoffs were provided to internal medicine residents. Residents were given a longitudinal survey before and after the discharge education session. Significant improvement in perception was demonstrated in review of discharge instructions ( P < .001), review of new medications/side effects with patients ( P < .001), and review of discharge instructions with and receiving feedback from attending physicians ( P < .001). On review of 40 discharge instructions pre and post intervention, there was an improvement in completion of instructions for high-risk medications ( P < .05 [14 insulin, 26 anticoagulation]). This intervention was viewed positively by residents; more than two thirds of all residents favored a process of formal training over the current model of “training by doing.”

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Ivy, Jaclyn, Sharon Knauss, and Kimberly Platt. "Destress With Discharge Education." Journal of PeriAnesthesia Nursing 33, no. 4 (August 2018): e16. http://dx.doi.org/10.1016/j.jopan.2018.06.039.

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Reddick, Bobbie, and Cecil Holland. "Reinforcing discharge education and planning." Nursing Management (Springhouse) 46, no. 5 (May 2015): 10–14. http://dx.doi.org/10.1097/01.numa.0000463887.70222.50.

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Lees, Liz, Denise Price, and Amanda Andrews. "Developing discharge practice through education." Nurse Education in Practice 10, no. 4 (July 2010): 210–15. http://dx.doi.org/10.1016/j.nepr.2009.08.008.

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Polster, Debra. "Preventing readmissions with discharge education." Nursing Management (Springhouse) 46, no. 10 (October 2015): 30–37. http://dx.doi.org/10.1097/01.numa.0000471590.62056.77.

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Choi, Jeungok. "Improving Discharge Education Using Pictographs." Rehabilitation Nursing 38, no. 5 (May 23, 2013): 240–46. http://dx.doi.org/10.1002/rnj.101.

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Whitfield, Stephen J. "Discharge or incarcerate." Academic Questions 16, no. 2 (June 2003): 5–7. http://dx.doi.org/10.1007/s12129-003-1015-9.

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Sinha, Sanjai, John Dillon, Savira Kochhar Dargar, Alexi Archambault, Paul Martin, Brittney A. Frankel, Jennifer Inhae Lee, Amanda S. Carmel, and Monika Safford. "What to expect that you’re not expecting: A pilot video education intervention to improve patient self-efficacy surrounding discharge medication barriers." Health Informatics Journal 25, no. 4 (August 31, 2018): 1595–605. http://dx.doi.org/10.1177/1460458218796644.

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The objective of this study was to test the feasibility of video discharge education to improve self-efficacy in dealing with medication barriers around hospital discharge. We conducted a single-arm intervention feasibility trial to evaluate the use of video education in participants who were being discharged home from the hospital. The scores of pre- and post-intervention self-efficacy involving medication barriers were measured. We also assessed knowledge retention, patient and nursing feedback, follow-up barrier assessments, and hospital revisits. A total of 40 patients participated in this study. Self-efficacy scores ranged from 5 to 25. Median pre- and post-intervention scores were 21.5 and 23.5, respectively. We observed a median increase of 2.0 points from before to after the intervention (p = 0.046). In total, 95 percent of participants reported knowledge retention and 90 percent found the intervention to be helpful. Video discharge education improved patient self-efficacy surrounding discharge medication challenges among general medicine inpatients. Patients and nurses reported satisfaction with the video discharge education.

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Walter, Lora, and Meigan Robb. "Promoting Discharge Readiness Through Staff Education." Journal for Nurses in Professional Development 35, no. 3 (2019): 132–36. http://dx.doi.org/10.1097/nnd.0000000000000519.

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Bartolomei, Sonja, and Mary Lacy Grecco. "Transplant Discharge Education: Technology Versus People." Biology of Blood and Marrow Transplantation 25, no. 3 (March 2019): S441. http://dx.doi.org/10.1016/j.bbmt.2018.12.480.

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Wladkowski, Stephanie, Susan Enguidanos, Tracy Schroepfer, and Keegan Pabst. "Challenges in Implementing an Explicit Protocol for Live Discharge From Hospice." Innovation in Aging 5, Supplement_1 (December 1, 2021): 62. http://dx.doi.org/10.1093/geroni/igab046.238.

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Abstract A live discharge from hospice can occur when a patient stabilized under hospice care and no longer meets the life expectancy hospice eligibility criteria. In 2018, 220,000 hospice patients across the United States were discharged alive from hospice care, with 1 in 6 discharges due to stabilization, with a life expectancy exceeding hospice’s six-month criteria. Hospice practitioners prepare patients and their caregivers upon enrollment for the possibility of a live discharge should their condition stabilize, however, there is no explicit discharge process available within hospice to guide practitioners in transitioning patients (and caregivers) out of hospice care. This transition process largely falls within the domain of hospice social workers, yet there is no research documenting the challenges and facilitators to conducting a live discharge from hospice. This study aimed to understand social workers' perspectives on the live discharge process. To better understand challenges and facilitators to the live discharge process, we conducted focus group interviews with hospice social workers at four hospice agencies across the U.S. We asked participants to discuss specific tasks associated with the live discharge process for a patient and their caregiver including identifying concrete services needed post-discharge; assessing the psychosocial and grief risk of patient and caregiver; and developing a post-discharge follow-up plan. Using constant comparison analysis we identified several themes including the need for clear professional roles during a live discharge, interprofessional education, and the need for dedicated time for live discharge follow-up. Policy implications and opportunities also will be discussed.

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Edwards, Elisa, and Kristie Fox. "A Retrospective Study Evaluating the Effectiveness of an Asthma Clinical Pathway in Pediatric Inpatient Practice." Journal of Pediatric Pharmacology and Therapeutics 13, no. 4 (January 1, 2008): 233–41. http://dx.doi.org/10.5863/1551-6776-13.4.233.

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OBJECTIVE To determine if the asthma clinical pathway implemented at Wolfson Children's Hospital reduces the length of hospital stay. To determine if pathway use affected the use of asthma education, the use of appropriate discharge medications based on asthma classification, and readmission rates. METHODS A list of patients aged 2 to 18 years discharged from Wolfson Children's Hospital between September 1, 2004 and August 31, 2006 with the diagnosis of asthma was generated. Medical records of eligible patients were reviewed for demographic information, asthma pathway use, duration of hospital stay in days, readmission rates, receipt of asthma education, and medications prescribed upon discharge. Patients placed on the asthma clinical pathway were compared to a control group with asthma who were matched based on age and discharge date. Length of stay was averaged for each group. Asthma education, discharge medications, and readmission rates were compared between the two groups. RESULTS Forty-three patients placed on the asthma clinical pathway were compared to a 43 patients in the control group that were matched for age and discharge date. Use of the asthma clinical pathway reduced hospital stay by 0.372 days (P = .0373). Receipt of asthma education (P = .3864), the use of appropriate drug therapy prescribed upon discharge (P = .1398), and readmission rates (P = .5486) were unaffected by pathway use. CONCLUSIONS The asthma clinical pathway used at Wolfson Children's Hospital reduces length of hospital stay, but has no bearing on receipt of asthma education, use of appropriate drug therapy upon discharge, or readmission rates.

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Yamamoto-Mitani, Noriko, and Chieko Sugishita. "The Effectiveness of Nurses' Discharge Education and Post-Discharge Patient Problem Evaluation." Journal of Japan Academy of Nursing Science 20, no. 2 (2000): 21–28. http://dx.doi.org/10.5630/jans1981.20.2_21.

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15

Nightengale, Jane. "Discharge Planning." Social Work With Groups 13, no. 2 (September 21, 1990): 83–94. http://dx.doi.org/10.1300/j009v13n02_07.

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Synnott, Pádraig, Michelle Brennan, Shaun O'Keeffe, and Michelle Canavan. "279 Quality Improvement Audit on Bone Health Assessment and Secondary Prevention of Patients Discharged from an In-patient Rehabilitation Unit Post Fracture." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.175.

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Abstract Background Osteoporosis accounts for more disability-adjusted life years than many non-communicable diseases. Identification and treatment is important to reduce morbidity and mortality associated with further fracture.(1) National Osteoporosis Guideline Group recommends all patients with a fragility fracture should undergo a bone health assessment and commence pharmacological therapy if indicated.(2) Methods Electronic discharge summaries of all patients with a diagnosis of fracture discharged from an off-site rehabilitation unit from 1st January 2018 to 31st December 2018 were reviewed. Patient details, location and mechanism of fracture, bone health assessment and discharge prescription were assessed. Following data collection, an education session directed at NCHDs was performed and a discharge checklist prompting bone health review and consideration of pharmacological therapy was introduced. A re-audit was performed at 4 months to assess change following this intervention. Results 74 patients had a diagnosis of fracture. 4 were excluded as fracture resulted from high impact trauma. 100% had corrected calcium measured. 93%(n=65) had Vitamin D(OH) measured. 91%(n=64) had PTH measured. 55%(n=39) were discharged on calcium/vitamin D(OH) supplementation. 33%(n=23) were discharged on Vitamin D(OH) alone. 66%(n=46) were discharged on antiresorptive therapy: 28%(n=13) bisphosphonate, 67% (n=31) denosumab, 4% others. 33%(n=23) were not prescribed any bone protection on discharge. 4 had advanced chronic kidney disease. 6%(n=4) were discharged without calcium/Vitamin D or antiresorptive therapy. A re-audit from January to April 2019 of 15 patients post NCHD education has shown an increase in antiresorptive therapy prescription 86%(n=13) Conclusion Bone health assessment and prescribing practices of antiresorptive therapy in patients undergoing rehabilitation post fracture is sub-optimal. Education of non-consultant hospital doctors can substantially improve rates of antiresorptive therapy prescription.

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Eloi, Hildreth. "Implementing teach‐back during patient discharge education." Nursing Forum 56, no. 3 (April 30, 2021): 766–71. http://dx.doi.org/10.1111/nuf.12585.

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ROMANG, LARRY. "Patient Education Before Discharge From the Hospital." Southern Medical Journal 79, no. 8 (August 1986): 998–1001. http://dx.doi.org/10.1097/00007611-198608000-00019.

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Manning, D. M., J. G. O'Meara, A. R. Williams, A. Rahman, D. Myhre, K. J. Tammel, and L. C. Carter. "3D: a tool for medication discharge education." Quality and Safety in Health Care 16, no. 1 (February 1, 2007): 71–76. http://dx.doi.org/10.1136/qshc.2006.018564.

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Lynch, Martha. "Continuing Education Bronchopulmonary Dysplasia: Management After Discharge." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 7, no. 2 (March 1989): 34–40. http://dx.doi.org/10.1097/00004045-198903000-00007.

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McCarter-Spaulding, Deborah, and Stephen Shea. "Effectiveness of Discharge Education on Postpartum Depression." MCN, The American Journal of Maternal/Child Nursing 41, no. 3 (2016): 168–72. http://dx.doi.org/10.1097/nmc.0000000000000236.

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Fox, Brent I., and Bill G. Felkey. "Take-Home HIT: The New Discharge Education?" Hospital Pharmacy 49, no. 2 (February 2014): 206–7. http://dx.doi.org/10.1310/hpj4902-206.

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Ohman, Kathleen, and Diane Spaniol. "Halo Immobilization: Discharge Planning and Patient Education." Journal of Neuroscience Nursing 22, no. 6 (December 1990): 351–57. http://dx.doi.org/10.1097/01376517-199012000-00004.

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Carroll, Áine, and Maura Dowling. "Discharge planning: communication, education and patient participation." British Journal of Nursing 16, no. 14 (July 2007): 882–86. http://dx.doi.org/10.12968/bjon.2007.16.14.24328.

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FOSTER, SUSAN D. "The Role Of Education In Discharge Planning." MCN, The American Journal of Maternal/Child Nursing 11, no. 6 (November 1988): 403. http://dx.doi.org/10.1097/00005721-198811000-00003.

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Shah, Nandi, and Kristen Kulasa. "Diabetes Medication Reconciliation at Hospital Discharge." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A424. http://dx.doi.org/10.1210/jendso/bvab048.866.

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Abstract Background: During hospital discharge, patients are at high risk for medication discrepancies as they transition from hospital to home. This study aims to evaluate the prevalence of medication errors at hospital discharge for diabetes medications in patients who received an endocrinology consultation for diabetes and explore interventions to improve the accuracy of discharge medication reconciliation. Methods: All patients (n=3018) who received an endocrinology consultation for diabetes at a tertiary care medical center from October 2017 to December 2019 were included. A retrospective chart review was performed to collect the following information on each patient: primary service from which the patient was discharged, hospital site, month and year of discharge date, and whether each patient’s medication reconciliation for diabetes medications at hospital discharge was in agreement with the inpatient diabetes team’s recommendations. Patients who were discharged on medications discordant from those recommended by the inpatient diabetes service were subcategorized into three groups: 1) one medication incorrect 2) more than one medication incorrect and 3) the primary service did not notify the consult team of patient’s discharge or request final recommendations for diabetes medications prior to discharge. Based on the findings of this study, an educational intervention was implemented in November 2019 to the Hospital Medicine services regarding diabetes discharge medication reconciliation. Results: Of the 3018 patients who received an endocrinology consultation for diabetes at a tertiary university medical center, 2279 patients (76%) were discharged on correct medications, 165 patients (5%) were discharged with one incorrect medication, 443 patients (15%) were discharged with more than one incorrect medication, and 121 patients (4%) were discharged without final discharge recommendations from the diabetes service. There was no significant variation based on discharging service or month of the year. After an educational intervention was implemented in November 2019 to the Hospital Medicine service on the existence and use of a comprehensive diabetes discharge order set, the percentage of patients discharged on correct medications improved to 92% (11/12 patients) compared to prior 81% (44/54 patients). Conclusion: Despite detailed discharge medication recommendations including patient education detailing the recommended regimen by the endocrinology diabetes service, a significant number of patients were discharged by providers across all services on diabetes medications discrepant with the diabetes service’s recommendations. Educational efforts improved the rate of correct medications at discharge on the Hospital Medicine service, and additional educational interventions with other services may be helpful in improving medication reconciliation accuracy.

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Joseph, Rachel A. "Tracheostomy in Infants: Parent Education for Home Care." Neonatal Network 30, no. 4 (2011): 231–42. http://dx.doi.org/10.1891/0730-0832.30.4.231.

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Children with tracheostomies are increasingly discharged home for continued care by their parents. Nurses are responsible for providing these parents with the extensive education required for a smooth and successful transition to home care. This article is intended to help neonatal and pediatric nurses to effectively prepare the parents of an infant with a tracheostomy to provide safe, quality care to their child after being discharged from an acute care setting to their home. This article discusses the knowledge, attitudes, and skills the parents are required to acquire prior to the infant’s discharge. Home ventilation, airway management, suctioning, tracheostomy care, emergency management, safe home environment, equipment for continuous or intermittent ventilation, and supplies necessary for care are some of the topics discussed.

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Gao, Michael C., Paul B. Martin, Julius Motal, Laura F. Gingras, Christina Chai, Megan E. Maikoff, Alex M. Sarkisian, Nadine Rosenthal, and Brian M. Eiss. "A Multidisciplinary Discharge Timeout Checklist Improves Patient Education and Captures Discharge Process Errors." Quality Management in Health Care 27, no. 2 (2018): 63–68. http://dx.doi.org/10.1097/qmh.0000000000000168.

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Walston, Bobbi Jo, Lisa A. Fletcher, William Wilson, Renae A. Boerneke, Ashley H. Marx, John D. Vargas, and Claire E. Farel. "747. Implementation of a Pharmacist-led Intervention for Infectious Diseases Patients Discharged on Antimicrobials: the Infectious Diseases Discharge Outreach and Retention (ID DOOR) Program." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S333—S334. http://dx.doi.org/10.1093/ofid/ofz360.815.

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Abstract Background Hospitalized patients who require Infectious Diseases (ID) consultative services and are discharged on antimicrobials (AM) are medically complex and at high risk of readmission. Complications related to AM toxicity, suboptimal regimen completion, or lack of AM access are prevalent. Our ID clinic pharmacist contacted patients affiliated with ID services within 72 hours of discharge to identify and intervene on needs such as AM access and management, toxicity monitoring, AM administration teaching, and to assess discharge care progression. The goal of this intervention was to leverage the subject matter expertise of an ID-trained pharmacist to create a protocolized intervention to improve the inpatient-to-outpatient transition for ID patients. Methods During a 12 week time period, 173 patients were identified and enrolled in the ID DOOR intervention. Patients who received consultative care by an ID physician were tracked and automatically referred to ID DOOR; those discharged on antimicrobials were included in the intervention group. Phone-based assessment of discharge AM access, education, and administration was initiated by the ID pharmacist within 72 hours of discharge (Table 1). Results Of the 173 patients, 155 (90%) were successfully contacted post-discharge. The majority of needs identified were AM education, access, and coordination of care (Table 2). In addition, discrepancies between discharge orders, summary content, and patient instructions were prevalent. Based on the medication-related assessment performed by the ID-trained pharmacists, they were able to resolve AM-related issues and identify, triage, and link patients to appropriate multidisciplinary providers to coordinate care plans. Conclusion The data highlight the prevalence of immediate post-discharge needs related to antimicrobial for patients and the critical role of ID-trained pharmacists in addressing these needs. In a large public academic medical center with uninsured and underinsured patients, additional support for AM access, education, and navigation of care plans is needed. For medically and socially complex ID patients, an ID-trained pharmacist plays a critical role in reducing risk inherent in the transition from inpatient to outpatient care. Disclosures All authors: No reported disclosures.

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Gouge, Catherine C. "Improving Patient Discharge Communication." Journal of Technical Writing and Communication 47, no. 4 (May 4, 2016): 419–39. http://dx.doi.org/10.1177/0047281616646749.

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Transitional care communication events—such as discharge from hospital—are complex and dynamic: impromptu questions are asked and answered, documents are discussed and signed, and health-care professionals and patients with different knowledge must work together to establish understanding. This article examines a set of patient discharge instructions that bear substantial traces of impromptu conversation in the patient discharge communication process and argues that we need to do more to account for such exchanges as a part of the complex information our documentation must coordinate and make accessible for end users.

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Coates, Martha, Patricia Shewokis, and Rose Ann DiMaria-Ghalili. "TRENDS IN ADVERSE DRUG EVENT ADMISSIONS AMONG OLDER ADULTS IN THE UNITED STATES." Innovation in Aging 6, Supplement_1 (November 1, 2022): 412–13. http://dx.doi.org/10.1093/geroni/igac059.1619.

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Abstract Older adults experience adverse drug events (ADEs) putting them at risk for increased morbidity and mortality. Utilizing the 2018 Healthcare Cost and Utilization Project’s National Inpatient Sample, we identified the prevalence of ADE admissions among adults 65 and older and examined the differences in characteristics and discharge outcomes in those with and without a primary diagnosis of an ADE (n=2,647,673). ADEs accounted for 7.4% of discharges and had higher odds of needing post-discharge care including transfer to a skilled nursing facility (OR=1.08, 95% CI [1.07, 1.09]) and home-health care (OR=1.1, 95% CI [1.09,1.1]). In the ADE group, hospital charges were higher ($39,609 vs. $38,649, p< .01) and length of stay (6+ days) longer (OR=1.53, 95% CI [1.52,1.55]). Opiates, diabetic agents, benzodiazepines and narcotics were frequently associated with ADEs. Older adults discharged after an ADE have increased healthcare utilization. Education on medication self-management is needed to prevent ADEs in older adults.

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Clark, Nicholas A., Julia Simmons, Angela Etzenhouser, and Eugenia K. Pallotto. "Improving Outpatient Provider Communication for High-Risk Discharges From the Hospitalist Service." Hospital Pediatrics 11, no. 10 (October 1, 2021): 1033–48. http://dx.doi.org/10.1542/hpeds.2020-005421.

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BACKGROUND Patients are at risk for adverse events during inpatient-to-outpatient transitions of care. Previous improvement work has been targeted at this care transition, but gaps in discharge communication still exist. We aimed to increase documentation of 2-way communication between hospitalists and primary care providers (PCPs) for high-risk discharges from pediatric hospital medicine (PHM) services from 7% to 60% within 30 months. METHODS A3 improvement methodology was used. A list of high-risk discharge communication criteria was developed through engagement of PCPs and hospitalists. A driver diagram guided interventions. The outcome measure was documentation of successful 2-way communication with the PCP. Any documented 2-way discharge communication attempt was the process measure. Via a survey, hospitalist satisfaction with the discharge communication expectation served as the balancing measure. All patients discharged from PHM services meeting ≥1 high-risk criterion were included. Statistical process control charts were used to assess changes over time. RESULTS There were 3241 high-risk discharges (442 baseline: November 2017 to January 2018; 2799 intervention and sustain: February 2018 to June 2020). The outcome measure displayed iterative special cause variation from a mean baseline of 7% to peak of 39% but regressed and was sustained at 27%. The process measure displayed iterative special cause variation from a 13% baseline mean to a 64% peak, with regression to 41%. The balancing measure worsened from baseline of 5% dissatisfaction to 13%. Interventions temporally related to special cause improvements were education, division-level performance feedback, standardization of documentation, and offloading the task of communication coordination from hospitalists to support staff. CONCLUSIONS Improvement methodology resulted in modestly sustained improvements in PCP communication for high-risk discharges from the PHM services.

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Bonk, Nicole, Alexander Milsap, Amanda Goplen, Krista McElray, and David Rabago. "Reducing Discharge Delay Through Resident-Pharmacist Colocation: A Pilot Study." Family Medicine 52, no. 9 (October 1, 2020): 665–67. http://dx.doi.org/10.22454/fammed.2020.708034.

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Background and Objectives: Discharge delay of hospitalized patients is costly, inefficient, and can impede care of pending admissions. Through pharmacist colocation and daily discharge medication reconciliation meetings, we aimed to improve discharge efficiency and decrease the number of electronic pages. Methods: We conducted a quality improvement initiative on the family medicine inpatient teaching service at a large academic medical center using two interventions: colocation and daily discharge medication reconciliation meetings of pharmacist and family medicine residents. We assessed: (1) discharge delay, defined as the time between discharge order and pharmacist’s completion of discharge medication reconciliation and patient education; (2) the number of electronic messages between the pharmacist and family medicine team, assessed 1 month before and 1 month after implementation of the interventions. We also assessed team members’ postinitiative views on collaboration, discharge safety, and timeliness, and knowledge acquisition using three 5-point Likert statements. Results: Ninety-five preintervention and 54 postintervention patients met eligibility criteria. Discharge delay prior to intervention was 72.7±58.4 minutes and 47.6±37.4 minutes postintervention. The number of electronic messages between pharmacist and family medicine team pager decreased from 118 to 14 during the months studied. Team members felt collaboration, safe and timely discharges, and acquisition of new knowledge improved. Conclusions: Colocation of workspaces and daily medication reconciliation meetings were associated with decreased discharge delay and decreased pages between team members. Further study is needed to assess its reproducibility, impact on resident education and patient satisfaction, cost-effectiveness, and ability to scale to other services.

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Acosta, Aline Marques, Maria Alice Dias da Silva Lima, Giselda Quintana Marques, Amanda Pinto Abreu, Amanda Xavier Sanseverino, and Nelly Oelke. "Health interventions for the reduction of hospital readmission within 30 days in clinical patients: An integrative review." Research, Society and Development 11, no. 2 (January 17, 2022): e2011225273. http://dx.doi.org/10.33448/rsd-v11i2.25273.

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Study with the objective of analysing the evidence available in the scientific literature on the interventions used to reduce hospital readmissions within 30 days in clinical patients who were discharged from the hospital to the home. An integrative review was carried out on the online Medical Literature Analysis and Retrieval System and Latin American and Caribbean Literature in Health Sciences databases. Intervention research, published between January 2009 and April 2020, in Portuguese, English and Spanish, was included. The sample consisted of 71 articles. The most frequently performed interventions were telephone contact after discharge (73.2%), health education after discharge (71.8%) and health education during hospitalization (67.6%). Identification of readmission risk (12.9%), home visits after discharge (26.8%) and discharge planning (28.2%) were the least mentioned. The interventions were performed predominantly by a multidisciplinary team (39.5%). There was a significant reduction in readmissions in 50.7% of the studies. It was found that the interventions are aimed at preparing the patient during hospitalization for the return home and post-discharge monitoring to reinforce the care plans and clarify doubts, this important combination of different actions by the multiprofessional team impacts readmission rates.

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Carran, Deborah, Marie Kerins, and Susan Murray. "Three-Year Outcomes for Positively and Negatively Discharged EBD Students from Nonpublic Special Education Facilities." Behavioral Disorders 30, no. 2 (February 2005): 119–34. http://dx.doi.org/10.1177/019874290503000201.

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This paper presents results from a study initiated by a consortium of non-public special education facilities to respond to issues of accountability. Research questions were (a) How do students from the most restrictive therapeutic non-public special education facilities compare with other nationally published studies?; and (b) How do positive and negative discharge students differ in transition experiences after leaving a restrictive therapeutic nonpublic special education facility? Three cohorts of EBD students discharged 1994–1997 from seven non-public special education facilities in Maryland were tracked for three years using a longitudinal panel design with telephone interview surveys. Descriptive results are presented, which indicated that students who received intensive and specialized services in non-public education centers completed/graduated (positive discharges) at a much higher rate than national and regional averages and had lower arrest rates at the end of three years. This sample was most independent at Year 2 (employment, living situation, and related outcomes), but by Year 3, level of independence was lower than Year 1. Limitations and implications of findings are discussed.

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Ellsworth, Brandon L., Daniel Settecerri, Ahmad M. Hider, Nicole Mott, Lesly A. Dossett, and Tasha M. Hughes. "204 Identifying Barriers to and Strategies for Implementing Same-Day Discharge after Mastectomy." Journal of Clinical and Translational Science 6, s1 (April 2022): 30. http://dx.doi.org/10.1017/cts.2022.106.

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OBJECTIVES/GOALS: Same-day discharge (SDS) after mastectomy without reconstruction (MwoR) is cost-effective with equivalent complications rates when compared to patients discharged the day after surgery. Despite this, facilities SDS rates after MwoR vary from <10%-80% (20% overall). We aimed to explore barriers to and strategies for implementing SDS after MwoR. METHODS/STUDY POPULATION: We conducted semi-structured interviews with surgeons currently performing MwoR and practicing in the state of Michigan. Recruitment was done through purposeful and snowball sampling methods. Interviews ranged from 40-60 minutes in length. The interview guide was based on the Tailored Implementation of Chronic Disease framework. Interviews were transcribed then analyzed by 3 independent reviewers. A framework matrix was created to identify common themes. RESULTS/ANTICIPATED RESULTS: Participants (n=15) included general surgeons, breast surgeons, surgical oncologists, and both university and non-university affiliated practices were represented. Surgeons either discharged patients the same-day or the day after MwoR. All surgeons who didnt routinely discharge patients the day of surgery (n=9) believed their facility had the resources to implement this practice and it would be safe for most patients. Identified barriers to same-day discharges included provider preoperative expectation setting, patient anxiety about managing their wound drain, and practice standards at their facility. Potential strategies for implementation included incorporating drain teachings with patients before surgery and explaining the benefits of same-day discharge with other providers at your facility. DISCUSSION/SIGNIFICANCE: We identified novel barriers to same-day discharge after MwoR. These barriers are potentially targetable with interventions addressing patient anxiety surrounding drain management, and education of providers across the care continuum.

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St. John, Isabelle J., and Heather M. Englund. "Improving Patient Discharge Education Through Daily Educational Bursts." Journal for Nurses in Professional Development 36, no. 5 (March 18, 2020): 283–87. http://dx.doi.org/10.1097/nnd.0000000000000627.

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Robertson, Bethany, Carrie McDermott, Jessica Star, Linda Orkin Lewin, and Nathan Spell. "Synchronous virtual interprofessional education focused on discharge planning." Journal of Interprofessional Education & Practice 22 (March 2021): 100388. http://dx.doi.org/10.1016/j.xjep.2020.100388.

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Van Royen, P., D. Avonts, and R. Van der Stichele. "Health education on vaginal discharge in general practice." Patient Education and Counseling 34 (May 1998): S63. http://dx.doi.org/10.1016/s0738-3991(98)90150-1.

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Slevin, Amy P. "A Model for Discharge Planning in Nursing Education." Journal of Community Health Nursing 3, no. 1 (March 1986): 35–42. http://dx.doi.org/10.1207/s15327655jchn0301_5.

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Schultz, Alyce A., Patricia A. Geary, Frances S. Casey, and Margaret A. Fournier. "Joining Education and Service in Exploring Discharge Needs." Journal of Community Health Nursing 14, no. 3 (September 1997): 141–53. http://dx.doi.org/10.1207/s15327655jchn1403_2.

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Frank-Bader, Margaret, Karen Beltran, and Dorothy Dojlidko. "Improving Transplant Discharge Education Using a Structured Teaching Approach." Progress in Transplantation 21, no. 4 (December 2011): 332–39. http://dx.doi.org/10.1177/152692481102100413.

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Context Nonadherence to posttransplant regimens is common in transplant patients and has the potential for devastating consequences, including acute rejection, graft loss, decreased quality of life, and even death. Comprehensive education of patients and families that improves their understanding of posttransplant regimens and selfcare techniques can increase adherence and improve outcomes. Transplant recipients have to learn a vast amount of complex information in a short period as they recover from major surgery and cope with the emotional stress of transplantation. It is not surprising that many patients report that they do not feel ready for discharge. Objective To describe the development, implementation, and outcomes of a comprehensive interdisciplinary patient education program. Design A quality improvement project. Setting A solid organ transplant unit of a large academic medical center. Participants In-hospital transplant patients and their families and the interdisciplinary team. Interventions A comprehensive discharge education program that integrated written materials, patient and clinical pathways, and discharge instructions. Main Outcome Measure Improved patient satisfaction with readiness for discharge and medication teaching. Results A postimplementation patient discharge survey using a 5-point Likert scale showed an increase in patients' understanding of medication dosage (3.6 to 4.6) and side effects (3.6 to 4.7), and satisfaction with the discharge teaching process (3.4 to 5.0).

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Cai, Wei, Xiaofen Zheng, Runping Wang, Huifen Zhu, Xinxin Xu, Xiaowen Shen, and Chunmei Zhang. "Factors of Parents-Reported Readiness for Hospital Discharge in Children with Acute Leukemia: A Cross-Sectional Study." Journal of Healthcare Engineering 2022 (April 22, 2022): 1–7. http://dx.doi.org/10.1155/2022/4082196.

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Aim. The aim of this study is to investigate the existing status and to explore the influencing factors of parents-reported readiness for hospital discharge in children with acute leukemia (AL) in China and to propose optimizing pathways and recommendations of discharge readiness for clinical reference. Methods. A cross-sectional survey was conducted for the 122 children with AL who were discharged from the Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University; their parents were investigated by using the modified Chinese version of Readiness for Hospital Discharge Scale (RHDS) and Quality of Discharge Teaching Scale (QDTS). Data were collected between September 2020 and May 2021.Univariate analysis and multivariate logistic regression analysis were performed to explore the influencing factors of readiness for hospital discharge. Results. The 122 children with AL included 52 females and 70 males with mean age 6.08 years. The total RHDS score was 7.7 ± 1.2, and 68.9% of the participants had high readiness for hospital discharge (RHDS score >7). The total QDTS score was 7.6 ± 2.0. Parent marital status (OR = 4.86, 95% CI: 1.31–18.05), education status (OR = 3.86, 95% CI: 1.18–12.55), family per capita monthly income (OR = 1.08, 95% CI: 1.01–2.99), and high QDTS (OR = 1.56, 95% CI: 1.11–2.68) were risk factors for high RHDS. Conclusions. Our data suggest parents of children with AL had high readiness for hospital discharge and had the ability to take care of their children after discharge. Parental marital status, education status, QDTS score, and family per capita monthly income were independently associated with high RHDS.

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Lenert, Leslie A., Farrant H. Sakaguchi, and Charlene R. Weir. "Rethinking the Discharge Summary." Academic Medicine 89, no. 3 (March 2014): 393–98. http://dx.doi.org/10.1097/acm.0000000000000145.

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Songwathana, Praneed, and Nurhayati Nurhayati. "Discharge Education for Mild Traumatic Brain Injury Patients at Emergency Department." JOSING: Journal of Nursing and Health 1, no. 2 (June 30, 2021): 65–74. http://dx.doi.org/10.31539/josing.v1i2.2122.

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This study aims to review the literature on educational interventions for the discharge of mild traumatic brain injury (mTBI) patients in the Emergency Room (IGD). Database searches were performed based on PICO queries and keywords. using ProQuest, ScienceDirect, Scopus, and PubMed for the period 2012-2019. Ten studies were reviewed. The findings revealed the contents of discharge information for mTBI patients including diagnosis, signs and symptoms, treatment and medication, pain management, home care, and ED return instructions. Four methods of discharge intervention are commonly used in the ED; written, spoken, animated and moving videos, and printed instructions measured over two time periods, either pre-discharge in the ED or follow-up 1-2 weeks post-discharge at home. In conclusion, combined teaching was more effective in terms of level of knowledge, understanding, and ED repeat visits. Keywords: Discharge education, Emergency, Minor Traumatic Brain Injury

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Gardner, Lara, and Sharmila Vishwasrao. "The Effects of Physician Characteristics on Patients’ Hospital Discharge Destination and Length of Stay." Research in Applied Economics 14, no. 1 (March 23, 2022): 1. http://dx.doi.org/10.5296/rae.v14i1.19667.

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We study the effects of physician, hospital, and market characteristics on length of stay and discharge destinations for cardiac inpatients in Florida hospitals in 2004, while controlling for patient characteristics. Using a competing risks hazard model, we analyze the determinants of whether patients are discharged home, to a skilled nursing facility, home under the supervision of a home health agency, or die within the hospital. Our study is unique in that we estimate a competing risks hazard model to identify the impact of physician education and training on hospital length-of-stay and post-hospital discharge destination. We find that physician characteristics are significantly related to transition rates to home discharge and that hospital and county characteristics impact the hazard rates for discharge to home health agencies and skilled nursing facilities.

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Hamilton, Kree. "Family Education: Development of a Formal Education Process to Ensure Quality Education Prior to Discharge." Journal of Pediatric Nursing 26, no. 2 (April 2011): e3. http://dx.doi.org/10.1016/j.pedn.2010.12.022.

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Sulistyowati, Arlina Dhian. "CONTINUING NURSING EDUCATION : PENTINGNYA PERAN PERAWAT DALAM DISCHARGE PLANNING DI RSIA ‘AISYIYAH KLATEN." Jurnal Pengabdian Masyarakat Kebidanan 4, no. 1 (January 13, 2022): 37. http://dx.doi.org/10.26714/jpmk.v4i1.8904.

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Discharge planning merupakan proses berkisnambungan yang dilakukan seorang perawat untuk mempersiapkan perawatan mandiri pasien pasca rawat inap. Pada kenyataanya pelaksanaan disharge planning belum dapat dilaksanakan optimal oleh perawat. Tujuan utama dari discharge planning yaitu menurunkan perawatan kembali di Rumah Sakit. Discharge Planning dilaksanakan dengan menitikberatkan pada keinginan dan kebutuhan pasien. Perawat memiliki andil yang cukup besar dalam keberhasilan discharge planning diantaranya sebagai edukator, collaborator, post-discharge care coordinator dan family conselor. Kegiatan pengabdian kepada masyarakat dilaksanakan untuk meningkatkan pengetahuan dan kemampuan perawat dalam melaksanakan discharge planning di Rumah Sakit. Kegiatan ini dilaksanakan melalui beberapa tahap yaitu pengkajian, implementasi dan evaluasi. Kegiatan ini diikuti oleh 25 peserta. Hasil dari kegiatan ini peserta antusias mengikuti kegiatan dari awal sampai akhir, dengan rata-rata pengetahuan perawat meningkat dari 72,85 menjadi 84,73. Keberhasilan discharge planning tidak terlepas dari peran seorang perawat dalam melaksanakan standar operasional prosedur yang telah ditetapkan di Rumah Sakit. Kegiatan berjalan dengan lacar, seluruh peserta mengikuti kegiatan dari awal sampai akhir. Berdasarkan hasil pretest dan postest maka diperoleh hasil bahwa terdapat peningkatan pengetahuan perawat terhadap pelaksanaan discharge planning.

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Mannarino, Candace N., Kelly Michelson, Lindsay Jackson, Erin Paquette, and Mary E. McBride. "Post-operative discharge education for parent caregivers of children with congenital heart disease: a needs assessment." Cardiology in the Young 30, no. 12 (September 22, 2020): 1788–96. http://dx.doi.org/10.1017/s1047951120002759.

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AbstractObjective:Children with congenital heart disease (CHD) have complex unique post-operative care needs. Limited data assess parents’ hospital discharge preparedness and education quality following cardiac surgery. The goals were to identify knowledge gaps in discharge preparedness after congenital heart surgery and to assess the acceptability of an educational mobile application to improve discharge preparedness.Methods:Telephonic interviews with parents of children with two-ventricle physiology who underwent cardiac surgery 5–7 days post-discharge and in-person interviews with clinicians were conducted. We collected parent and clinician demographics, parent health literacy information and patient clinical data. We analysed interview transcripts using summative content analysis.Results:We interviewed 26 parents and 6 clinicians. Twenty-two of the 26 (85%) parents felt ready for discharge; 4 of the 6 (67%) clinicians did not feel most parents were ready for discharge. Fifteen of the 26 parents (58%) reported receiving the majority of discharge teaching on the day of discharge. Eight parents did not feel like all of their questions were answered. Most parents (14/26, 54%) preferred visual educational learning aids and could accurately describe important aspects of care. Most parents (23/26, 88%) and all 6 clinicians felt a mobile application for post-operative care education would be helpful.Conclusions:Most parents received education on the day of discharge and could describe the information they received prior to discharge, although there were some preparedness gaps identified after discharge. Clinicians and parents varied in their perceptions of the readiness for discharge. Most responses suggest that a mobile application for discharge education may be helpful for transition to home.

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Hall, J. N., J. P. Graham, M. McGowan, and A. H. Cheng. "MP08: What’s the plan?: Improving ED patient discharge communication through patient-centred discharge handouts." CJEM 19, S1 (May 2017): S67—S68. http://dx.doi.org/10.1017/cem.2017.174.

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Introduction: Discharge from the Emergency Department (ED) is a high-risk period for communication failures. Clear verbal and written discharge instructions at patient-level health literacy are fundamental to a safe discharge process. As part of a hospital-wide quality initiative to measure and improve discharge processes, and in response to patient feedback, the St. Michael’s Hospital ED and patient advisors co-designed and implemented patient-centred discharge handouts. Methods: The design and implementation of discharge handouts was based on a collaborative and iterative approach, including stakeholder engagement and patient co-design. Discharge topics were based on the 10 most common historical ED diagnoses. ED patient advisors and the hospital’s plain language review team co-designed and edited materials for readability and comprehension. Process mapping of ED workflow identified opportunities for interventions. Multidisciplinary ED stakeholders co-led implementation, including staff education, training and huddles for feedback. Patient telephone surveys to every 25th patient presenting to the ED meeting the study inclusion criteria (16 years of age or older, directly discharged from the ED, speaks English, has a valid telephone number, and has capacity to consent) were conducted both pre- (June-Sept 2016) and post- (Oct-Dec 2016) implementation. Results: Stakeholder engagement and co-design took place over 10 months. Education was provided across one MD staff meeting, four RN inservices, and at monthly learner orientation. 44846 patients presented to the ED and 25600 met the study inclusion criteria. 935 surveys (response rate=97%; declined n=30) were completed to date. Pre-implementation (n=467), 9.2% (n=43) of patients received printed discharge materials and 71% (n=330) understood symptoms to look for after leaving the ED. Post-implementation (n=468), 44% (n=207) of patients received printed discharge materials with 97% (n=200) finding the handouts helpful and 82% (n=385) understanding symptoms to look for after leaving the ED. Conclusion: Through the introduction of patient co-designed and patient-centred discharge handouts, we have found a marked improvement in patient understanding, and consequently safer discharge practices. Future efforts will focus on optimizing discharge communication, both verbal and written, tailored to individual patient preferences.

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