Title: Select one aspect of care which you have undertaken in children’s nursing practice in relation to the discharge process and critically analyse and discuss the key components of that care in relation to your experience, discharge planning and the specific research/literature you have reviewed.
The aspect of care to be discussed is pain management for a 4 year old boy after facial surgery, on a Nurse Controlled Analgesic morphine pump, being discharged from the recovery room to the ward
The need for discharge planning in optimising patient care has been identified in many recent studies and papers (viz. Mills M M et al. 2006). The basic rationale in all arguments for discharge planning is so that mechanisms to facilitate discharge can be put in place both before interdepartmental discharges and transfers, as well as before the eventual discharge, throughout the period of hospitalisation, so that they do not overwhelm healthcare professionals, the patient or parents at the end of the stay in the facility, department or the hospital.
A useful general tool for planning discharge is enunciated by Bruccoliere with identification of tasks and deadlines for transition tasks set shortly after admission and ideally incorporated into daily multidisciplinary ward rounds. This is specifically targeted at total hospital discharge, but has features aimed at departmental discharges or transfers. (Bruccoliere T 2000). This type of approach has been advocated by Halm who has expanded the tool to include a formal review by the responsible nurse (or team leader) for all paediatric patients whose discharge is anticipated within one week, to ensure that the discharge plan includes a projected day of discharge, a check on home equipment and medication, home health needs, home feeding plan, screening needs (e.g. car seat trial; hearing, developmental, or feeding assessment for the very young child), identification of a primary care doctor, and necessary follow-up plans in either primary care or the hospital outpatients. (Halm M A et al. 2003). Such measures may be appropriate for the patient in question at the end of their hospital stay. In this particular case however, one is considering a specific instance of interdepartmental transfer and the discharge planning mechanisms are therefore more specific.