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Discharge Planning

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Book cover Short Stay Management of Atrial Fibrillation

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Discharge planning is the process of evaluating and planning for the patient’s needs post-discharge and begins at the time of admission. All members of the healthcare team as well as the patient and his or her caregiver must contribute to the plan. The discharge plan must be individualized and provide the patient and caregivers with adequate information to sustain them to the next locus of care. Incorporation of the discharge planning process into the routine care and standard order sets will facilitate completion.

Atrial fibrillation (AF), the most common cardiac dysrhythmia seen in the ED, is often first diagnosed in the ED. The prevalence of AF increases with age and is often associated with multiple comorbidities, placing patients with AF in a higher risk category. Patients typically lack an adequate understanding of the disease, symptoms, medication management, stroke risks, and when to seek emergency care. Appropriate discharge plans reduce readmissions, save costs, decrease complications, and improve adherence.

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References

  1. Zavalla S, Shaffer C. Do patients understand discharge instructions? J Emerg Nurs. 2011;37(2):138–40.

    Article  Google Scholar 

  2. Han CY, Barnard A, Chapman H. Discharge planning in the emergency department: a comprehensive approach. J Emerg Nurs. 2009;35(6):525–7.

    Google Scholar 

  3. Agency for Healthcare Research and Quality (AHRQ) IDEAL Discharge.www.ahrq.gov/educatiion/curriculum-tools/susptoolkit/videios/11d_idealdischarte/index.html

  4. Naylor M, et al. Comprehensive discharge planning for the hospitalized elderly-a randomized clinical trial. Ann Intern Med. 1994;120:999–1006.

    Article  CAS  PubMed  Google Scholar 

  5. Kleinpell RM. Randomized trial of an intensive care unit-based early discharge planning intervention for critically ill elderly patient. Am J Crit Care. 2004;13:335–45.

    PubMed  Google Scholar 

  6. Russo V, et al. Management of atrial fibrillation in the emergency department: current approach and future expectations. Eur Rev Med Pharmacol Sci. 2013;17:3132–47.

    CAS  PubMed  Google Scholar 

  7. McDonald AJ, et al. Increasing US emergency department visit rates and subsequent hospital admissions for atrial fibrillation from 1993 to 2004. Ann Emerg Med. 2008;51(1):58–65.

    Article  PubMed  Google Scholar 

  8. Patel JN, et al. Contemporary trends for hospitalization for atrial fibrillation in the United States, 2000 through 2010: implication for healthcare planning. Circulation. 2014;129:2371–9.

    Article  PubMed  Google Scholar 

  9. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland Jr JC, Conti JB, Ellinor PT, Ezekowitz MD, Field ME, Murray KT, Sacco RL, Stevenson WG, Tchou PJ, Tracy CM, Yancy CW. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardio. 2014;64:2246–90.

    Article  Google Scholar 

  10. McMartin K. Discharge planning in chronic conditions: an evidence-based analysis. Ont Health Technol Ass Ser [Internet]. 2013;13(4):1–72. Available from: http://www.hqontario.ca/en/doucments/eds/2013/full-report-OCDM-discharge-planning.pdf.

  11. Besser KV, Mills AM. Is discharge home after emergency department cardioversion safe for the treatment of recent onset atrial fibrillation. Ann Emerg Med. 2011;58(6):517–20.

    Article  Google Scholar 

  12. Decker WW, et al. A prospective, randomized trial of an emergency department observation unit for acute onset atrial fibrillation. Ann Emerg Med. 2008;52(4):322–8.

    Article  PubMed  Google Scholar 

  13. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després, J-P, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Wiley JZ, Woo D, Yeh RW, Turner MB: on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2015 update: a report from the American heart Association. Circulation. 2015;131:e1–205.

    Google Scholar 

  14. Camm AJ, et al. Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology. Eur Heart J. 2010;31:2369–429.

    Article  PubMed  Google Scholar 

  15. McCabe PJ, et al. Knowledge and self-management behaviors of patients with recently detected atrial fibrillation. Heart Lung. 2008;37(2):79–90.

    Article  PubMed  Google Scholar 

  16. Eckman MH, et al. Integrating real-time clinical information to provide estimates of net clinical benefit of antithrombotic therapy for patients with atrial fibrillation. Circ Cardiovasc Qual Outcomes. 2014;7:680–6.

    Article  PubMed  Google Scholar 

  17. Sandy LP. Case management in the emergency room. Prof Case Manag. 2010;15(2):111–3.

    Article  PubMed  Google Scholar 

  18. Bayliss EA, et al. Descriptions of barriers to self-care by persons with comorbid chronic diseases. Ann Intern Med. 2003;1:15–21. doi:10.1370/afm.4.

    Google Scholar 

  19. Gozdzialski A, Schlutow M, Pittiglio L, Everson F. Patient and family education in the emergency department: How nurses can help. Nurse Educ. 2012;38(3):293–5.

    Google Scholar 

  20. Coleman EA, et al. The care transitions intervention. Arch Intern Med. 2006;166:1822–8.

    Article  PubMed  Google Scholar 

  21. Samuels-Kalow ME, Stack AM, Porter SC. Effective discharge communication in the emergency department. Ann Emerg Med. 2012;60(2):152–9.

    Article  PubMed  Google Scholar 

  22. Cleland JG, Ekman I. Enlisting the help of the largest health care workforce: patients. JAMA. 2010;304(12):1383–4.

    Article  CAS  PubMed  Google Scholar 

  23. Engel KG, et al. Communication amidst chaos: challenges to patient communication in the emergency department. JOCM. 2010;17(10):449–52.

    Google Scholar 

  24. Berkman ND, et al. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155:97–107.

    Article  PubMed  Google Scholar 

  25. McCarthy DM, et al. Emergency department discharge instructions: lessons learned through developing new patient education materials. Emerg Med Int. 2012;2012:306859. http://dx.doi.org/10.1155/2012/306859.

    Google Scholar 

  26. Fuster V, Rydén LE, Asinger RW, Cannom DS, Crijns HJ, Frye RL, Halperin JL, Kay GN, Klein WW, Lévy S, McNamara RL, Prystowsky EN, Wann LS, Wyse DG. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary; a report of the America College of Conferences (committee to develop guidelines for the management of patients with atrial fibrillation). Circulation. 2001;104:2118–50.

    CAS  PubMed  Google Scholar 

  27. Jack BW, et al. A reengineered hospital discharge program to decrease rehospitalization. Ann Intern Med. 2009;150(3):178–87.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kee CC, Borchers L. Reducing readmission rates through discharge interventions. Clin Nurs Spec. 1998;12:206–9.

    Article  CAS  Google Scholar 

  29. Anthony MK, Hudson-Barr D. A patient-centered model of care for hospital discharge. Clin Nurs Res. 2004;13:117–36.

    Article  PubMed  Google Scholar 

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Correspondence to Ginger Conway MSN or Barbara Bell MSN, ACNP .

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© 2016 Springer International Publishing Switzerland

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Conway, G., Bell, B. (2016). Discharge Planning. In: Peacock, W., Clark, C. (eds) Short Stay Management of Atrial Fibrillation. Contemporary Cardiology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-31386-3_17

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  • DOI: https://doi.org/10.1007/978-3-319-31386-3_17

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-31384-9

  • Online ISBN: 978-3-319-31386-3

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