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Nurses able to discharge patients at North Staffs hospital


Nurses working at a major acute hospital in the Midlands are being allowed to discharge patients out of hospital in a move managers claim is better for patients and is freeing up beds quicker.

The process is now being rolled out across wards at the University Hospital of North Staffordshire after being successfully piloted on one ward during June and July.

The trust said 30% of patients are now being sent home sooner thanks to the Criteria Led Discharge (CLD) plan.

Under the protocol, medical plans are pre-agreed by a multidisciplinary team of doctors and nurses. Providing all the criteria in the medical plan are subsequently met, nurses have the authority to discharge patients home without waiting for a doctor to sign it off.

On one ward 65 patients were discharged this way in June and July.

Jenny McLatchie, ward manager for Ward 122 where the CLD was piloted, said: “In the past we’ve had to wait for doctors to start their shifts before being able to discharge patients from the ward, but we’re now in a position where we can discharge some patients ourselves, which is great.

“The CLD system has given us much more autonomy within our positions and has streamlined the patient journey and enhanced patient satisfaction,” she said.

“Patient discharge is much quicker and patient length of stay is significantly reduced,” she added. “With doctors releasing some of the ownership of the discharge to the staff nurses we believe more patients will benefit.” 

The ward currently has three nurses trained to discharge patients with two more planned. It is hoping to have one CLD trained nurse per shift.

Dr Ananth Nayak, consultant in diabetes and endocrinology, said: “The doctors on Ward 122 would like to commend sister McLatchie, deputy ward manager nurse Carter and the entire nursing team on the ward for all their hard work and initiative which has made this project a huge success.”

The CLD system is now being rolled out on other wards across the hospital.

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Readers' comments (4)

  • Nurse-led discharges are nothing new and generally work pretty well; as long as a 'one-size fits all approach' is not employed and they are not used as a means, under pressure, ' to 'free up beds'.

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  • I know of several hospitals who use nurse-led discharges, if a patient is deemed fit enough to be dischaged shouldn't this be sorted out so they can go home, presumably the doctor has already signed them off as being fit. What do the nurses have to wait for?

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  • sounds great as it must force medical teams to make clear plans in advance so the patient and the whole team know what the criteria for, and likely date of discharge is.

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  • As long as nursing plans are also dealt with - Being "fit for discharge" may not be enough. Nurses themselves, because it is the focus of every board round, focus on the patient being medically fit without addressing their nursing or social issues .

    For example; I have seen nurses discharging older patients without assessing incontinence issues and just sending them home with pads with referral to community for further pads. The patient is then labelled as incontinent and no attempt is made to find the cause and treat.

    Patients are sent home with catheters without a thought being made to who, if not the patient, will empty the bags or change bags. Also with no thought to how at risk a patient may be at home with a catheter

    Have DNs and GPs been asked to address the quality of the discharges?

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