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Patient Discharge and Support

Every patient should be seen following their operation by the anaesthetist and surgeon involved in their care. However in many countries the final assessment of when the patient is ‘street fit’ or ready for discharge is performed by nursing staff. Each day unit needs to identify clear discharge criteria as part of a written policy for staff to follow. These need to consider social factors as well as a medical assessment of sufficient recovery for discharge. The following table gives the areas to be covered
  • Vital signs should be stable for at least one hour
  • Oriented to time, place and person
  • Adequate pain control and has a supply of oral analgesics
  • Understand how to use oral analgesia supplied and has been given written information about these
  • Ability to dress and walk where appropriate
  • Minimal nausea, vomiting or dizziness
  • Has at least taken oral fluids
  • Minimal bleeding or wound drainage
  • Has passed urine (only if appropriate to surgery)
  • Has a responsible adult to take them home
  • Has agreed to have a carer at home for next 24 hours
  • Written and oral instructions given about postoperative care
  • Knows when to come back for follow up (if appropriate)
  • Emergency contact number supplied.
All patients should receive verbal and written instructions on discharge which should include details about any symptoms that they might experience during the first 24 hours after surgery. Guidance should be given about not driving for at least 24 hours though this will vary according to the operation performed. Further information about the use of machinery, signing legal documents, returning to work and when sutures should be removed should also be provided. All patients should also be supplied with information about what to do in an emergency and be provided with a contact number for use when they need urgent advice.
Attention to these details helps ensure that the patient feels supported and the provision of a contact number helps reduce the number of patients visiting their Primary Care Doctor (General Practitioner).