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Discharge Planning
出院计划

What is discharge
planning？

Lead-in
Background Information
New Words
Text
Useful Expressions

Dischargeplanningis the developmentof an individualized discharge （plan个体化出院计划）
for the patient prior to leaving the hospital, to ensure that patientsare dischargedat an appropriate time and with provision of adequate post-discharge services.

To help the patient leave safely and smoothly
To help the patient get the right care after discharge
To reduce adverse events and prevent readmissions （再入院）

When to discharge a patient?
Timely discharge（及时出院is ）when the patient is discharged homeor transferred to an appropriate level of care as soonas they are clinicallystable andfit for discharge.
ü Shorten the average length of hospital stay ü Reduce medical expenses
ü Makemedical resourcesmoreaccessible（可及的）
for clients
1
How is clinical stability defined?
Thepatientcan be definedas clinically or medicallystable（病情稳定）whentestssuch
as bloods and investigations are considered to be within the normal range（在正常范围内） for the patient.

Is the patient ‘fit for discharge’?
The patient ‘fitis fordischarge’ when physiological, social, functional, and psychologicalfactors or indicators havebeen taken into account（被考虑到）
following a multi-disciplinary（多学科的） assessment if appropriate.
The patientwho is ‘fit for discharge’ no longer requires the servicesof acute or specialiststaff within a secondary care setting, and where:

Is the patient ‘fit for discharge’?
review of the patient’s conditioncan be shared with the GP（general practitioner,全科医生） including adjustments to medication
ongoing general, nursing, and rehabilitationneeds
can bemet in another setting at home or through primary/ community care services
additionaltestsand interventionscan be carried
out in an outpatient ambulatoryor care setting（
流动护理站）.

Includethe patient and family as full partners in the discharge planning process
Question: who will be involved in the discharge process?

Include
Discuss
Educate
Assess
Listen

The processis usually taken care of by a multi-disciplinary team（多学科团队within） the hospital, including the doctor, nurse in charge or case manager（个案管理者, ）the nutritionist/dietician（营养师）, and the physicaltherapist（物理治疗师,） etc.
★ Engaging patients and families in the process is key to achieve an effective discharge planning.
2

Include the patient and family as full partners in the discharge planning process
Discuss with the patient and family key issues to prevent problems at home
Educate
Assess
Listen

1. Understandyour health; know what to watch out for and what to do if you have problems.
2. Know where and how you will receive treatment after you leave the facility.
Where you will be? Who will be your doctor?
Beforeyou leavethe facilityyou shouldhave
an appointmentwith the care providerwithin the next 7 days.
Five key elements of discharge instructions
Explain test results
Describe what life at home will be like
Review medications
Highlight warning signs and problems

Asa patient,what do you want to know before you leave the hospital?

3. Know what medications you need, how to take them, and what side effects to watch for.?
Have a list of your medications written down.
The primary caregivershould know how to operate any necessary medical equipment
4. Know the nameand personyou shouldcall if you have questions.

Include the patientand family as full partnersin the discharge planning process
Discuss with the patient and family five key areas to prevent problems at home
Educate the patient and family in plain language at
• Make follow-up appointments
every opportunity throughout the hospital stay
• Assess how well doctors and nurses explain the key
messages
Discharge Health Education
Teach back（反示教） is a techniqueby which the provider asks the patient or caregiverexplain to the recently taught concept inpa theient’s own words． This techniquepermitsthe providerto identifyand correct any misunderstandings in real time, with the intent of preventingadverse events related to inadequate comprehensionof discharge information.
Review
Listening to the dialogues of Chapter 11-Nursing
Diagnosis, and answering the following questions:
Did Mrs Chang follow the discharge teaching provided by the nurse of her first admission?
What was the main reasonfor Mrs Chang’s econd admission for the same symptom in only 2 weeks?
New Words
Word List
Chinese
Readmit v.
重新入院
Be readmitted

Develophypertension
得了高血压
Discharge teaching
出院指导
Dietician n.
Diet n.
营养师
开始特殊饮食
饮食
Start on a special diet
low-salt diet
Ona new medicine
低盐饮食
Generic name
吃一种新药
eg. furosemide
Trade name
属名
呋塞米
eg. Lasix
Contraindication
商品名
速尿
禁忌症

3

Include the patient and family as full partners in the discharge planning process
Discuss with the patient and family five key areas to prevent problems at home
Educate the patient and family in plain language at every opportunity throughout the hospital stay
Assess how well doctors and nurses explain the key messages
Listen to and honor the patient and family’s goals, preferences, observations, and concerns.

Lead-in
Background Information
New Words
Text
Useful Expressions
New Words
Word List
Chinese
Hazardous adj.
危险的
Adverse adj. 不利的，有害的，相反的
Adverse effect
= side effect
Storage n.
反作用
储存
Interaction n.
交互作用
Drug-food interaction-
药物食品相互作用
Salt-preserved food
腌制食品
Garlic n.
Canned adj.
大蒜
can n.
Diuretic a.
罐装的；
罐子
Tingling n.
利尿剂

Tremor n.
发麻，麻刺感，麻感

震颤；战栗
New Words
Word List
Chinese
anuria n.
Follow-up visit
无尿
随访
OTC (over the counter) 非处方药
Drowsy adj.
drowsiness n.
昏昏欲睡的
/
催眠发困
Sore
adj.
痛的

4
New Words
Word List
Chinese
Regimen n.
制度、规则
treatment regimen
治疗方案
Potassium n.
钾高钾食品
Potassium-rich food
Sodium n.
钠高钠食品
Food high in sodium
7. Please come to the Emergency Room straight away if …
• Wound breaks open.
• Wound is oozing（伤口渗出）.
• Pain comes back.
• Having chest pain.
• Breathless.
Sore throat
Citrus n.
嗓子痛
柑橘
Apricot n.
杏
Cantaloupe n.
香瓜，哈密瓜
Fowl n. 鸡，家禽
Listening
Listening to the dialogues of Chapter 12, and answering the following questions:
What informationshouldyou give to the patientif she/he goes home on a new medicine?
After class activity:Practicethe skill of low-saltdiet instructionand use Teach Back techniqueto assess patient’s understanding of your instruction.

Lunch meat
Smoked meat
午餐肉
熏肉
MSG
monosodium glutamate
Sun-block
味精
防晒乳
Photosensitivity
光敏性，感光性
Sentences Commonly Used
The doctor is goingdischarge to you today/this morning.
The doctor hasprescribed some medication for you; you will needtake to one(pill) twice a. day
You will need cometo back for a check on …up
You will need keepto the dressingfor on…days .
Pleasedo not lift anything heavyfor a few weeks.
If there are any problems/complications, please contact us immediately.
Sentences Commonly Used
Sentences Commonly Used
8. Avoid any mental stress and have a good rest.
9. keep off alcoholgreasy and（油腻的） food.
10. Do you have any questions you would like to ask?
11. Pleaserememberto settleyour account/payour bill（结账） before you leave the hospital. 12. Are you sure that you haven’t left anything
behind?
Healthdeteriorates（恶化）.
Medication doesn’t seem to be working.
5
Situational Conversation
Situational Conversation
Discharging a patient after heart surgery
Patient: Ok, do I need to come back for a check up?
Patient:The doctor says that the tests were OK, does that mean
I can go home?
Nurse:you will needto comeback for a checkup in 2
weeks.
Nurse:Yes, you will be discharged tomorrow morning.
Patient:wherewill I have to go for the check up, in
Patient:Oh,that’s great.
Outpatients?
Nurse:You will need to take some medication home with you,
Nurse:Yes, you will need to register first, like the last time
the doctor has prescribed some tablets to control your blood
pressure and you needtake oneto twice a day morning and
and then go and see the doctor in OutpatientsI’ll writ .
（舌下的）
thedoctor’s name down for you, so you can give it to the
evening. He hasalsoprescribeda sub-lingual
tabletwhich you shouldtake when the pain comes in your
registration nurse.
chest. Put one tablet under your tonguedissolve and, let it
Patient:That will be really helpful, thanks a lot.
you must onlytake a maximum of two tablets.
a day
Situational Conversation
Situational Conversation
Nurse:Before you leave,I’d like to give you some suggestions. Patient: Ok, I will.
Firstly, you will have to rest when youjust go gentle home,
Nurse:Have you any questions you would like to ask?
exercise at first time and do not lift anything heavy for a few
weeks. Secondly,avoidany mentalstressand spicyfood.
Patient:No, Idon’think soI’ll. wait till I see the doctor,
and ask him some questions. Thank a lot.
（空腹
And most importantly,examinations of fasting sugar
Nurse:Ok. The doctor will write a letter for you to give to
血糖）
（心电图）
and an ECG
should be done regularly.
your GP, explaining the treatment you have had a