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Discharge Care Plan
| Date & Sign. |
Plan and Outcome [Check those that apply] |
Target Date: |
Nursing Interventions [Check those that apply] |
Date Achieved: |
| (_) The
patient/family's discharge planning will begin on day of
admission including preparation for education and/or
equipment. (_) On the day of discharge, patient/family will receive verbal and written instructions concerning:
(_) Other:
|
(_)
Assess needs of patient/family beginning on the day of
admission and continue assessment during hospitalization. (_) Anticipated needs/services:
(_) Involve the patient/family in the discharge process. (_)Discuss with physician the discharge plan and obtain orders if needed. (_) Contact appropraite personnel with orders. (_)Provide written and verbal instructions at the patient/family's level of understanding. (_) Verbally explain instructions to patient/family prior to discharge and provide patient/family with a written copy. (_) Ascertain that patient has follow-up care arranged at discharge. (_) Provide verbal and written information on what signs and symptoms to observe and when to contact the physician. (_) Assess if any community resources should be utilized (i.e.: Home Health Nurse), and contact appropriate personnel. (_) Document all discharge teaching on Discharge Instruction Sheet and Nursing notes. (_)
Other:________________ |
__________________________
Patient/Significant other signature
__________________________
RN signature
