Standardization of the Discharge

Patient Education Process: an

Evidenced Based Practice Project
Toni Herrera, RN
Caroline Kim, RN
Objectives
Staff will verbalize understanding of the
patient discharge education process.
Staff will verbalize how to document the
patient education.


Current HCAHPS Scores on 5 East
3/2014 5/2014
Communication
with Nurses
77.1%, 37
th

percentile
80.1%, 63
rd

percentile
Discharge
Information
82.6%, 20
th

percentile
83.2%, 24
th

percentile
Care Transitions 54.7%, 66
th

percentile
52.5%, 46
th

percentile
HCAHPS Questions
This project is trying to change the way patients answer
the following questions:
During this hospital stay, how often did nurses
explain things in a way that you could
understand?
During your hospital stay, did you get
information in writing about what symptoms for
health problems to look for after you left the
hospital?
Before giving you any new medication, how often
did hospital staff tell you what it was for?



HCAHPS Questions (cont)
This project is trying to change the way patients answer
the following questions:
Before giving you any new medication, how often
did hospital staff describe side effects in a way
you could understand?
When I left the hospital, I had a good
understanding of the things I was responsible for
in managing my health.
When I left the hospital, I clearly understood the
purpose for taking each of my medications.


Planning My Discharge: A Patient
Discharge Worksheet (see handout)
Discharge Worksheet will be added to regular, stroke and care
partner admissions folders.
Explain to pt/family member/care partner that it is to help
organize their questions and for hospital staff to individualize
patient education.
When a question is answered, initial and date next to it.
Make sure that the worksheet is always visible with a pen
available. Dont let it get lost in the shuffle.
Patient has the right not to do it, unable to complete it, have
someone help them fill it out. That is wher ethe bedside script
comes in.
Planning My Discharge: A Patient
Discharge Worksheet (cont)
On the daily Ad Hoc Patient Education click off
the discharge categories you provide education on
during the shift. This will reflect the categories of the
discharge worksheet that you addressed.
On discharge, attach the worksheet to the front of
the admissions folder with the discharge information
inside the folder.
Use the questions the patient fills out as guidelines
for personalized patient daily goals Nursing Note
Goals.
Bedside Nursing Script
Encourage patients to ask questions and use a variety of teaching
resources like videos, printed materials and teach back,
depending on patient preference.

Diet:
Let me explain why you are on a fluid restriction/cardiac/ diabetic diet.
You will have to continue this when you are discharged. I encourage
you to ask any questions you have.
Medications:
I want to explain what your medication is for, side effects in a way that
you understand. Please feel free to ask me any questions about your
medications.
Nursing: use printed resources or videos depending on patients
preference.
Bedside Nursing Script (cont)

Diagnosis:
Lets make sure you understand what symptoms to look for after you
leave the hospital and what to do.
Nursing: Highlight signs/symptoms to look for and when to seek
immediate medical care in discharge instructions. Use printed
resources or videos too depending on what patients preference is.
Mobility/Care:
Lets make sure you understand how you should move safely/use
your walker or cane/spinal precautions/exercises done with
PT/OT/ST.
Follow-up appointments/care:
Dr. X is listed as your primary care doctor. Call the office tomorrow to
make an appointment to see him/her in a week. You will also see Dr.
Y, he/she is a X specialist. This is his/her office address and phone
number. Call the office tomorrow to make an appointment to see
him/her in a week.

Bedside Nursing Script (cont)
Discharge medications:
This is the list of medications you will be taking at home now.
(List medications pt was taking at the hospital, review side
effects, and the next time the medications will be taken. List
new medications that will be started at discharge. Review side
effects and the next time the medications will be taken.)
Nursing: Provide medication print outs and/or have pt watch
video on the medication.
Discharge diet:
Remember that you are going to continue your diet/restrictions
that we talked about while you were here.
Nursing: Provide diet explanation print outs.
Bedside Nursing Script (cont)
Discharge Follow-Up Phone Call
We would like to follow up with you on how you liked using the
Patient Discharge worksheet. If that is alright with you, can I
confirm a phone number that you can be reached in seven to
ten days?
Bedside Nursing Script (cont)
Keep explanations simple and short.
Be consistent and repetitive.
Utilize pts preferred method of learning.
Leader Daily Rounding Script
Our goal is to ensure your needs are met
during your stay in the hospital. We also
must make sure you feel prepared when you
leave the hospital. In your packet is a patient
discharge planning worksheet where you can
write down notes, questions and concerns to
discuss with your care team before you go
home.
Conclusion
Base patient education and patient goals on
what is written on the Patient Discharge
worksheet.
Click off the discharge categories you
educated on, on the patient education
section.
Use the bedside nurse script frequently and
consistently.
Leads use rounding script daily.