Discharge instructions for inpatients
- Go to Patient Station and choose patient. Do not access patient from the IR schedule or you will be in the wrong encounter and will have to do all your work over again.
- Once you have accessed the patient, you will see a list of encounters for him/her, all in green. Choose the encounter that says "Admitted". If you choose the wrong encounter, you will have to do everything again.
- Once you're in the correct encounter, go to the blue navigator column (on the left) and go down until you see the "Order Entry" button and select it. You want to write the Discharge Home and Discontinue IV orders. Type these in and sign them.
- Go back to the blue navigator column and go down until you see the "discharge" button. Select this button.
- You will now see a white column to the right of the blue one, and you will see, about halfway down, the section entitled "Discharge Documentation". Scroll down to the line titled "Order Reconciliation".
- Follow the prompts for this section. It is guiding you through her/his existing home and hospital meds and asking you to figure out what is needed and what isn't.
- Once that is done, go back to the white screen and choose "Discharge Summary". Then choose "Notewriter" (at the top of the screen) and choose "Discharge Summary". It will bring up a bunch of options; choose the Interventional Radiology one. Fill in the blanks.
The discharge instructions will have already be entered by Anne and Shari and will autopopulate the DC Summary, and you simply need to fill in the blanks.
Discharge instructions for same day patients
- Go to Order Entry and type in "Discharge"
- You will see many options, but you want the one that says "Same Day Discharge"
- Fill in the Hard Stop blanks, and the non-Hard Stop section ("Disposition")
- Below the Hard Stop boxes, there will be a section that says "Comments", and "click to add text". This is where you will type the following:
- VS per SDS protocol (this is typically Q15 min x 4, Q30 X 3, then Q1H, depending how long they are there) or more/less often if you wish.
- Any dressing/tube flushing instructions. Tell our nurses if there are tube flushing instructions so they can put it in their AVS, which the SDS nurses will give to the patient when they leave.
- DC IV
- Discharge home when patient meets SDS discharge criteria.
- To sign the order, and this is the kicker, you must select the correct Phase of Care (PACU Recovery) for the SDS nurses to see it. Please see the picture below which makes it pretty clear. OF NOTE, THE SNAPSHOT IS INCORRECT IN THAT IT SAYS "SIGN AND HOLD", AND OF COURSE IT SHOULD BE JUST "SIGN".