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#NURCHAT

#NurChat - What is most important to a patient? Getting home!

Did you miss the latest #NurChat twitter debate about discharging patients effectively? Let us sum it up for you …

Discharge is often the most important part of a hospital stay to the patient, making it a key issue for nurses. Safe, well-planned discharges that take into account a patient’s needs are a complex task, which is why this was an important issue for NurChat to tackle.

This was a lively and varied discussion (if you want to read the full transcript it can be found here, via the NurChat blog) with nursing opinions coming from those in the areas of general nursing, community nursing, learning disability nursing and mental health nursing.

The chat started by asking what constitutes a good discharge? Most participants were agreed on the main point being good communication between the MDT, the patient and any carers and community services.

@MrsCFlatt summed it up by saying “Timely, good continuity of care from the acute to primary sector, good effective communication and teamwork between MDT”.

@dmarsden49 added “A good discharge is coordinated and collaborative important to engage carers and care workers”.

Poor discharges were raised; @simonbrowes stated “Discharge should be negotiated between the individual, carers/ family and support. Many readmissions because things fall apart”.

@MrsCFlatt then added “Problems occur when hospital beds are short and patients are discharged too soon because the focus has been on creating new beds”.

NurChat asked if discharge was seen as less important than admission.

@alabcien tweeted “not in my place of work both are equally important”.

@l_ah_c added “good discharge planning should start on admission but this is often not the case”.

Discharge coordinators were discussed throughout the debate and it was mentioned that not only are discharge coordinators good resources, but so are LD liaison nurses.

@abrianpratt tweeted “we have now got a Learning Disability hosp liaison nurse to help make a difference”. Hospital passports for people with Learning Dissabilites were also identified as being a helpful tool for effective discharge.

Disharge in the mental health setting was also discussed. @MrsGracePoole tweeted “In some MH settings inpatient episode may last up to 2 years. Know people very well. Stay discharge focussed!”

@MrsGracePoole went on to add “For people who have been detained under some sections there is a legal requirement to manage discharge (section 117)”.

@raffthenurse added “CPA and care coordination so important when it comes to discharge plans for MH patients”.

One of the last points to be discussed was nurse led discharges. @PhilipRABall tweeted “Nurse led usually the best in my experience, where nurses lead everyone else, though lead not dictate”.

@l_ah_c tweeted “Its all about good communication and nurses have the most with patients”.

The important thing about this chat was that so many nurses from different branches came together to discuss a common problem - the discharge of patients. A lot of ideas were exchanged and some understanding of other areas of expertise were passed between the nurses taking part. For me, it was very interesting to hear about common problems that had been/were being tackled in different ways, and there were things that we could certainly learn from one other with regard to discharging our patients effectively. But fundamentally, what discharge comes down to is the patient. @cherylwilson2 summed it up by tweeting “What’s most important to a patient? Getting home!”

Teresa Chinn heads up NurChat for Newcross Healthcare Solutions - Nurchat is a fortnightly twitter chat for nurses exploring different topics that vary enormously.Anyone can suggest a NurChat discussion subject simply by tweeting @NurChat or by visiting the NurChat blog.

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