Reflective accounts

Discharging patients

A CPD article improved Bing Raz’s knowledge of discharging patients from acute care

A CPD article improved Bing Raz’s knowledge of discharging patients from acute care

Proper planning is essential in ensuring timely discharge of inpatients  Photo: iStock

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

Delayed discharge from hospital can have significant effects on patients and healthcare organisations, for example, longer hospital stays, increased readmissions and financial cost. The CPD article provided information about effective discharge planning, to reduce delays and improve patient care.

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

The article outlined problems that can cause delays to discharge as a result of lack of planning. These include: transport difficulties, medications not prescribed or collected; referrals to community or other support services not completed, or the patient’s home arrangements not being considered.

I have learned that implementing a systematic discharge system could reduce delayed discharges and decrease the likelihood of patients being readmitted to hospital. This is important because longer hospital stays may result in complications, such as pressure ulcers, falls and deterioration in the patient’s health.

Having read the article, I now understand the importance of effective communication among all members of the multidisciplinary team in enabling patients to be discharged safely.

How did you change or improve your practice?

I work as a staff nurse in a stroke unit. Stroke is a life-changing event, and discharging patients who have had a stroke can be complex, because they might require specialist community services. Some patients have dysphagia and should be referred to the community nutrition nurse, or they may experience incontinence and should be referred to the community continence nurse. I will ensure I liaise with discharge coordinators, occupational therapists and community healthcare professionals so that appropriate referrals to these services are made, and that patients are discharged safely. 

In the stroke unit where I work, when a patient has completed their rehabilitation and the multidisciplinary team has determined the person is ready to be discharged, an occupational therapist will carry out a home visit. This is to assess the patient’s needs, for example whether they require a social services package of care, or additional equipment in the home.

I have experienced some of the issues that the article discussed when discharging patients, which have caused delays. These have included difficulties arranging transport, waiting for social services funding or for specialist equipment to arrive, and arranging the patient’s anticoagulation therapy. I intend to develop a discharge plan for each patient that considers these factors, to reduce delays.

How is this relevant to the Code? Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

Effective communication is a required as part of the theme of practising effectively. The article emphasised that communicating with patients, families and other members of the multidisciplinary team is essential to the safe and timely discharge of patients from hospital.

The Code states that nurses must prioritise people, by assessing and responding to their needs. The article discussed the importance of developing a discharge plan that is specific to the patient’s needs, and of identifying the support available in the community to meet these needs.

Bing Raz is a staff nurse at St George’s Hospital, London

This reflective account is based on NS830 Goodman H (2016) Discharging patients from acute care hospitals. Nursing Standard. 30, 24, 49-57. These questions are the same as those on the NMC templates that UK nurses and midwives must use
for revalidation

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You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a reflective account. To write a reflective account for Nursing Standard, use the NMC reflective accounts form 

Complete the four questions about the CPD article you have just read, writing about 800 words in total. How to submit your reflective account 

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