Safe Discharge from the Emergency Department Position Statement-Safe Discharge from the Emergency Department Position Statement

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Safe discharge from the emergency department is crucial for patients to properly manage their recovery. Patients who have a failed discharge often experience unfinished treatments and a worsening of their condition. The Agency for Healthcare Research and Quality (AHRQ) defines a high-quality ED discharge as including education on diagnosis, treatment plan, and expected course of illness, post-ED discharge care, and coordinated care within the healthcare system. However, there are many barriers to the discharge process and certain risk factors for discharge failure. Emergency nurses often provide discharge instructions in an environment that is not conducive to teaching and learning, and patients may have difficulty understanding the instructions. Studies have shown a clear relationship between patient understanding, the thoroughness of discharge instructions, and hospital readmission rates. Improving the discharge process can lead to better patient outcomes, fewer acute care visits, and higher patient satisfaction. There is limited research on safe discharge for at-risk patient populations, such as those who are impaired or have received sedative medications. Ethical and legal questions surrounding discharge responsibilities also need to be addressed. The Emergency Nurses Association (ENA) asserts that discharge instructions are an essential element of quality patient care and that accurate documentation and collaboration with the interprofessional team are crucial for safe patient transitions. Emergency nurses should use resources and established best practices for patient teaching and advocate for evidence-based research on safe discharge. The safe discharge process begins upon patient arrival in the ED and involves screening for potential issues, both medical and social. It also includes patient education using plain language and teach-back techniques, as recommended by The Joint Commission and the National Quality Forum. There are tools and interventions available to improve the discharge process, including follow-up phone calls and appointment assistance programs. Emergency nurses should also be aware of their legal responsibilities and state laws regarding discharge decisions. Each patient requires an individualized discharge process that ensures their safety and understanding of instructions.

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Keywords

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