Discharge Counselling PDF

DISCHARGE COUNSELLING WHAT IS DISCHARGE COUNSELLING? A system for providing medication counseling to all patients discharged from a hospital. After the patient's discharge, regimen is reviewed by the pharmacist, the prescriptions' are filled, and the pharmacist counsels the patient at the bed...

DISCHARGE COUNSELLING WHAT IS DISCHARGE COUNSELLING? A system for providing medication counseling to all patients discharged from a hospital. After the patient's discharge, regimen is reviewed by the pharmacist, the prescriptions' are filled, and the pharmacist counsels the patient at the bedside. Goals Help patients understand the role of medication in their recovery process Medication adherence Maintenance of sustained illness remission Possible side effects and its management To achieve long term treatment success and positive outcomes A. Principles of patient counselling are the same Hospital Community Not always possible to counsel every patient Prioritise patients B. Counselling area | time Quiet place No distractions or interruptions Sufficient – time for all points to be made and, Questions answered  C. Advantages of counselling in hospitals Access to the patient’s notes Doctor and nursing staff involved in their care available Indications for drugs are known Reasons for their selection Patient’s response to the drugs Avoiding duplication of unnecessary information Reinforce important points Repeated sessions can be organized D. Plan for counselling Timing of patient counselling should be planned Starting well before the date of discharge Avoid the situation where patients are eager to leave and no time to listen or think Obtain all medication prior to discharge E. Patient counselling checklist Check list of all the points you wish to make Example, 1. Disease state; what brought patient to hospital. 2. Name and appearance of drug (s); generic | trade names, other names more meaningful to the patient e.g. water tablet, colours, appearance of different brands. 3. How to use; inhaler technique, cream and ointment, drops etc. You may have a leaflet – use this to show the patient 4. When to use; relate times to daily routine. Explain what p.r.n means. Counselling checklist. cont. 5. How long to use; antibiotics, long medications 6. Side effects; only mention common ones. How to deal with them e.g. take NSAIDS with food or milk. 7. Anything to avoid; drinks (alcohol) 8. Missed doses; what to do if dose is missed whether dosage can safely be altered without consulting doctor. 9. storage; any special instructions e.g. refrigerator, GTN tablets Patient counselling checklist. Cont. The most pressing problem The problem that brought patient into hospital Therapy geared to resolution of that problem Emphasize need for long term monitoring, including labs,eg BUN creatinine F. How much information Different ways of organizing information about several drugs Grouping drugs according to indications, times of administration, similar formulation together Most appropriate to discuss the most recently prescribed drugs first Most important points selected and emphasised G. Confirming understanding Use open questions Ask patient to explain how long they will take their medication Give patient an opportunity to ask questions Discuss any problem they think they may encounter BENEFITS OF DISCHARGE COUNSELLING Findings suggest that the addition of these key points to medication discharge counseling, coupled with providing the patient with filled prescriptions immediately at discharge can decrease 30 day rapid readmission between 35% and 50%. Encourage medication adherence in the initial acute phase of treatment following hospitalization Give patients the opportunity to be treated in a less intrusive outpatient setting. Improve patient quality of life Increase hospital bed availability, leading to better stewardship of precious acute care resources. Conclusion The pharmacist is frequently the last person to see a patient before they leave hospital, so be prepared for any type of question from “ when do I have come back to clinic” to “which is the way out”,etc References ▪John R. Tomko (2013) Tips for patient discharge counseling from the hospital setting: Improving adherence. Mental Health Clinician: February 2013, Vol. 2, No. 8, pp. 240-242 ▪http://www.lopioidrems.com/IwgUI/rems/pdf /patient_counseling_document.pdf R