Refer to the Hospital Discharge Summary Form Instructions for Information on How to Complete This Form
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People also ask
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What should be included in a hospital discharge summary?
To continue to paraphrase the APTA's description: All discharge summaries should include patient response to treatment at the time of discharge and any follow-up plan, including recommendations and instructions regarding the home program if there is one, equipment provided, and so on. -
How do you complete a discharge summary?
6 Components of a Hospital Discharge Summary Reason for hospitalization: description of the patient's primary presenting condition; and/or. ... signNow findings: ... Procedures and treatment provided: ... Patient's discharge condition: ... Patient and family instructions (as appropriate): ... Attending physician's signature: -
What is a summary of a hospital discharge?
The discharge summary is a narrative document for communicating clinical information about what happened to the patient in the hospital. It's extremely important for telling primary care doctors and other outpatient providers which follow-ups are needed for the patient. -
What are the components of discharge report?
Conclusion The key components to include in a discharge summary are the discharge diagnosis, treatment received, results of investigations and the follow up required. The limited evidence pertaining to ED discharges was consistent with this. -
Who is responsible for completing the discharge summary?
Regardless of the reason, when at all possible, the patient and caregiver must be given the reason and advanced notice of the discharge. It is the responsibility of the Nurse Care Coordinator or the RN managing the patients' care to coordinate and document the discharge summary. -
What must a discharge summary include?
The discharge summary must outline the complete list of recommended actions that were provided to the patient and/or carer. This informs primary care providers of follow-up care information that the patient and/or carer was provided. -
How do you write discharge instructions?
Provide Clear Discharge Instructions All instructions for care at home, including medications, diet, therapy, and follow-up appointments, must be explained in detail to all patients and then presented in written form to take home upon discharge. Exact dates and times of follow-up appointments need to be included.
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