Lecture 10.2 Hepatic Case Discharge Planning

Flashcards covering key concepts from Year 2 Hepatic Case Discharge Planning notes, including timing of discharge planning, literature findings on discharge risks, discharge letter contents, continuity of care, and pharmacist considerations.

What are the key time points for effective discharge planning?

On admission, during admission, at least 48 hours before discharge is planned, day of discharge, and follow up care.

According to Lankshear et al., what are the identified risks and causes related to anticoagulant discharge?

Risks: non-compliance with anticoagulant medication, polypharmacy, lack of monitoring. Causes: poor documentation and communication between acute and primary care, and accessibility of clinics.

What did Hansen et al. find about the relationship between discharge documentation quality and rehospitalisation?

No direct association overall; an association was seen in patients with follow-up and a larger number of medications.

What safety risk related to transitional care did Laugaland et al. identify for older people?

Lack of discharge planning and post-discharge support.

Which factors did Hagino et al. identify as risk factors for readmission among hip fracture patients?

Age over 85 years, chronic disease, dementia, and mobility (walking) disability prior to fall.

What did Howard et al. report as major contributors to drug-related readmissions?

Four groups of medicines account for 50% of drug-related readmissions; three underlying causes are patient adherence, monitoring, and prescribing errors.

What unmet information and communication needs were identified by Romagnoli et al. for discharged patients?

Limited medication information; non-medication issues about care/safety/follow-up; functional limitations; severity of condition; communication problems.

What risks were reported by Clarke et al. regarding the ESD scheme?

Lack of patient consent, patients not ready for discharge, feeling unsafe, medication supply problems, transport home problems, lack of home nursing.

What did Goulding et al. find about patients on clinically inappropriate wards?

Placement on inappropriate wards poses a latent threat to safe discharge planning; patients are more likely to be deemed medically fit before they actually are.

What eight risk factors did Härlein et al. identify for falls in older people with dementia on discharge?

Eight risk factors for falls in older people with dementia; these can be used prospectively on admission.

What were the findings of Courtney et al. regarding a 24-week post-discharge rehabilitation and telephone support program?

Intervention group had lower readmission rates, fewer emergency GP contacts, and improved quality-of-life indices.

What topic does Coffrey summarize in relation to discharge planning?

Discharging older people and risks; summary of discharge risks among older people.

What is the purpose of a discharge letter?

To communicate key information to other care providers (GP), update patient records, update changed medications, chase test results, arrange further investigations, and continue monitoring and titration.

What should a discharge letter include as a minimum contents?

Reason for hospitalisation; significant findings; procedure and treatment provided; patient’s discharge condition including medication changes; patient and family instruction including follow up; sign off.

What is meant by continuity of care between sectors?

Not an end point but a transfer of care from one sector to another within the patient’s journey; continue safe and effective treatment.

What concerns should pharmacists have regarding discharge?

Consultation; needs/concerns; list of discharge medicines; summary of changes to medicines; medications to be reviewed; monitoring of therapy (efficacy/side effects).