Primary Care Experience of Hospital Discharge

1
Primary Care Experience of Hospital Discharge

• Ellen Hudson
• Assistant Director of Nursing - Primary Care
  Services, NHS Greater Glasgow

2
A Patients Journey Through the Health System

• The Start - referral processes
• How does it feel for them?
• Health intervention/s
• Going Home

3
Impact of Poor Discharge Planning

• Patient / Family Perspective
• Apprehension
• Fear / anxiety
• Distress
• Anger
• Frustration

4
Impact of Poor Discharge Planning

• Primary Care Colleagues Perspective
• Crisis Management
• Same Emotions as
• Patient / Family

5
What makes a good and effective discharge?

• Discharge planning from point of admission
• Assessment of needs
• Identification of key individuals to be involved
• Communication
• Information sharing
• Effective Team Working
• Equipment requirements / adaptations

6
Top Tips to Effective Discharge

• District Nursing Referral Criteria - Additional
  Requirements from Acute Hospitals
• Referrals for patients with complex care needs
  need to be referred to the district nursing
  service at the earliest possible stage of
  discharge planning and district nurses should be
  invited to case reviews.
• District Nursing must be advised of any referrals
  to Enhanced/ Augmented Home Care Service.
• On discharge patients should be provided with a 7
  day supply of all medication inclusive of
  dressings or continence aids.
• All patients who have been admitted with a
  pharmacy filled dossett box should be sent home
  with this service.
• .
• Referrals should be arranged at least 24
  hours before discharge if possible
• Referrals on a Friday or Public Holiday should
  be avoided except as part of a planned package of
  care.
• Risk assessment and safety issues for District
  Nursing Teams should be considered and the
  service alerted accordingly e.g. personal safety,
  clinical risk, moving and handling, Infection
  Control risk.
• N.B. Patients should be encouraged to attend the
  Treatment Room or their Practice Nurse where
  appropriate

7
Top Tips Continued

• Referrals on a Friday or Public Holiday should
  be avoided except as part of a planned package of
  care.
• Referrals should be arranged at least 24 hours
  before discharge if possible.
• Risk assessment and safety issues for District
  Nursing Teams should be considered and the
  service alerted accordingly e.g. personal safety,
  clinical risk, moving and handling, Infection
  Control risk.
• N.B. Patients should be encouraged to attend the
  Treatment Room or their Practice Nurse where
  appropriate

8
Key to Effective Discharge

• Good Communication