Discharge from hospital and early supported discharge

2020 ◽  
pp. 345-352
Author(s):  
Catherine Gaynor
Keyword(s):  
Discharge Planning ◽  
Models Of Care ◽  
Effective Discharge ◽  
The United Kingdom ◽  
Early Supported Discharge ◽  
Hospital To Home ◽  
Discharge From Hospital ◽  
Applied Health Research

‘Discharge from hospital and early supported discharge’ provides some useful guidance and outlines the issues that we encounter in facilitating effective discharge from hospital following a stroke. Hospital discharge is an important milestone in a stroke patient’s journey. It marks the end of the acute hospital episode, and the start of a new life living with and adjusting to their stroke and its sequelae. It can be a stressful time for patients and their carers, but careful and thorough discharge planning can help to ease the transition from hospital to home. The chapter explores the timing of discharge, models of care after discharge, early supported discharge, the evidence from SSNAP (Sentinel Stroke National Audit Programme) in the United Kingdom, the initiative of CLAHRC (Collaborative for Leadership in Applied Health Research and Care), guidance from the National Institute for Health and Care Excellence (NICE), institutionalization, role of capacity, role of IMCA (independent mental capacity advocate), communication with primary care, and follow-up after discharge from hospital.

scholarly journals Improving nutritional discharge planning and follow up in older medical inpatients: Hospital to Home Outreach for Malnourished Elders

2018 ◽  
Vol 75 (3) ◽  
pp. 283-290 ◽  
Author(s):  
Adrienne M. Young ◽  
Alison M. Mudge ◽  
Merrilyn D. Banks ◽  
Lauren Rogers ◽  
Kristen Demedio ◽  
...  
Keyword(s):  
Discharge Planning ◽  
Medical Inpatients ◽  
Hospital To Home

Discharge planning for the patient with a new tracheostomy

1990 ◽  
Vol 10 (7) ◽  
pp. 73-79 ◽  
Author(s):  
EB Wilson ◽  
N Malley
Keyword(s):  
Critical Care ◽  
Planning Process ◽  
Discharge Planning ◽  
Signs And Symptoms ◽  
Critical Care Nurses ◽  
Care Plan ◽  
Discharge Care ◽  
Increased Risk ◽  
Hospital To Home ◽  
Discharge From Hospital

A patient with a new tracheostomy will face threatening changes upon discharge from hospital support. Nurses, particularly in the critical care unit, frequently and closely support a patient and family through new and often difficult situations during hospitalization. The patient leaving the hospital with a new tracheostomy will face problems with secretion management, increased risk of infections, alterations in body image, and impaired vocalization. To ensure a safe transition from the hospital to home, the patient and family must demonstrate competence in all aspects of tracheostomy care, must be able to recognize signs and symptoms that should be reported to the physician, and must have adequate support at home (such as homecare nurses, properly functioning equipment, and access to necessary supplies). These "musts" form the basis of the discharge care plan. Nurses can help a patient successfully manage these problems through comprehensive discharge planning. Although the critical care nurses who initiate the multidisciplinary discharge planning process may not remain involved in that process throughout the patient's hospitalization, their early efforts can provide an orderly, comprehensive discharge plan optimally suited to ensure that the patient and family acquire the necessary skills, confidence, supplies, and support for the eventual transition home. The information, encouragement, skills demonstrations, and referrals to other resources that critical care nurses provide help the patient adjust to a new tracheostomy.

Improving patient care after a suicide attempt

2018 ◽  
Vol 26 (2) ◽  
pp. 145-148 ◽  
Author(s):  
Fiona Shand ◽  
Laura Vogl ◽  
Jo Robinson
Keyword(s):  
Suicide Attempt ◽  
Discharge Planning ◽  
Psychosocial Assessment ◽  
Coordinated Care ◽  
Effective Discharge ◽  
Effective Care ◽  
Increased Risk ◽  
Discharge From Hospital ◽  
Improving Patient Care ◽  
Risky Patients

Objectives: Improving the care that patients receive after a suicide attempt will reduce the risk of a subsequent suicide attempt. We described how care for these patients can be improved and identified the available guidelines. Methods: We reviewed the literature on crisis and aftercare, psychosocial assessment, risk assessment, brief contact interventions, and brief interventions. Results: People who have made a suicide attempt are at increased risk of suicide, and the period immediately after discharge from hospital is particularly risky. Patients require an empathic response at their first point of contact, comprehensive psychosocial assessment, effective discharge planning, rapid and assertive follow-up, and coordinated care in the subsequent months. Conclusions: Empathic and effective care that begins in the emergency department and extends through to community care is imperative. Enough is known about the risks of inadequate care and the key ingredients of effective care to proceed with changes to Australia’s healthcare response to a suicide attempt.

Hospital to Home: A Geriatric Educational Program on Effective Discharge Planning

2014 ◽  
Vol 35 (4) ◽  
pp. 369-379 ◽  
Author(s):  
Lauren N. DeCaporale-Ryan ◽  
Ann Cornell ◽  
Robert M. McCann ◽  
Kevin McCormick ◽  
Jenny Speice
Keyword(s):  
Educational Program ◽  
Discharge Planning ◽  
Effective Discharge ◽  
Hospital To Home

Developmentally Supportive Care in the Neonatal Intensive Care Unit: An Occupational Therapist’s Role

2011 ◽  
Vol 30 (4) ◽  
pp. 243-248 ◽  
Author(s):  
Kathleen Nightlinger
Keyword(s):  
Supportive Care ◽  
Neonatal Intensive Care ◽  
Discharge Planning ◽  
Team Members ◽  
Early Intervention Services ◽  
Developmentally Supportive Care ◽  
Education Decision ◽  
Treatment Education

The role of a pediatric occupational therapist (OT) in the NICU is to provide comprehensive services, including evaluation, treatment, education, decision making, family support, and discharge planning. It may also include early intervention services or outpatient pediatric rehabilitation services. This article will address the need for developmentally supportive care in the NICU, and specifically addresses the role of an OT in this setting. It will explain how crucial collaboration between team members can be in providing quality, comprehensive care for these neonates. In addition, it will address the important role of the parent in this setting for developmentally supportive care while in the NICU and follow-up intervention upon discharge.

scholarly journals The Role of Effective Discharge Planning in Preventing Homelessness

2007 ◽  
Vol 28 (3-4) ◽  
pp. 229-243 ◽  
Author(s):  
Thomas E. Backer ◽  
Elizabeth A. Howard ◽  
Garrett E. Moran
Keyword(s):  
Discharge Planning ◽  
Effective Discharge

A Scheme of Early Supported Discharge for Elderly Trauma Patients: The Views of Patients, Carers and Community Staff

1995 ◽  
Vol 58 (9) ◽  
pp. 373-376 ◽  
Author(s):  
S J Closs ◽  
L S P Stewart ◽  
E Brand ◽  
C T Currie
Keyword(s):  
Hospital Stay ◽  
Discharge Planning ◽  
Length Of Hospital Stay ◽  
Royal Infirmary ◽  
Trauma Patients ◽  
Post Discharge ◽  
Early Supported Discharge ◽  
Community Staff ◽  
Elderly Trauma Patients

This collaborative scheme of Early Supported Discharge, involving hospital and community staff and based in the Orthopaedic Directorate, Royal Infirmary of Edinburgh NHS Trust, has improved early rehabilitation, discharge planning and follow-up for trauma patients aged over 70 and admitted from home and has produced substantial reductions in length of hospital stay. Central to the scheme is a dedicated occupational therapist who coordinates discharge arrangements for eligible patients. An evaluation of the experiences of patients, carers, general practitioners and other community staff indicated that shorter stays in hospital have been achieved without undue problems for patients during the immediate post-discharge period.

Home nutritional support

2011 ◽  
Author(s):  
R. Mark Beattie ◽  
Anil Dhawan ◽  
John W.L. Puntis
Keyword(s):  
Social Services ◽  
Healthcare Professionals ◽  
Discharge Planning ◽  
Tube Feeding ◽  
Continuing Care ◽  
Good Communication ◽  
Enteral Tube Feeding ◽  
Effective Discharge ◽  
Hospital To Home ◽  
Care Company

Home enteral tube feeding (HETF) 106Home parenteral nutrition (HPN) 108Equipment supply is usually arranged through a home care company. Good communication between patient, family, and healthcare professionals is a prerequisite for effective discharge planning. The needs of the child and family must be clearly identified in order to prepare transfer from hospital to home. It is also essential that continuing care arrangements are in place with coordinated action from all involved (family, healthcare professionals, social services, education, voluntary bodies, etc.)....

Implications of the Ankle Injury Management (AIM) trial

2019 ◽  
Vol 101-B (12) ◽  
pp. 1472-1475 ◽  
Author(s):  
David J. Keene ◽  
Keith Willett
Keyword(s):  
Care Pathway ◽  
Close Contact ◽  
Controlled Trial ◽  
Ankle Injury ◽  
Early Management ◽  
Injury Management ◽  
The United Kingdom ◽  
Key Issues

The Ankle Injury Management (AIM) trial was a pragmatic equivalence randomized controlled trial conducted at 24 hospitals in the United Kingdom that recruited 620 patients aged more than 60 years with an unstable ankle fracture. The trial compared the usual care pathway of early management with open reduction and internal fixation with initially attempting non-surgical management using close contact casting (CCC). CCC is a minimally padded cast applied by an orthopaedic surgeon after closed reduction in the operating theatre. The intervention groups had equivalent functional outcomes at six months and longer-term follow-up. However, potential barriers to using CCC as an initial form of treatment for these patients have been identified. In this report, the results of the AIM trial are summarized and the key issues are discussed in order to further the debate about the role of CCC. Evidence from the AIM trial supports surgeons considering conservative management by CCC as a treatment option for these patients. The longer-term follow-up emphasized that patients treated with CCC need careful monitoring in the weeks after its application to monitor maintenance of reduction. Cite this article: Bone Joint J 2019;101-B:1472–1475.

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