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In an attempt to review the critical discharge process, government plans highlighted the significance of the procedure of nurse-led discharge. it is recommended by the new guidelines that nurses in the case of general discharge may be competent by qualified medical professionals to perform this procedure, which is responsible for about 70% of discharge. It also advises nurses to be involved in the discharge of patients with more complex needs. Criteria-driven discharge is a general term that associates with the usage of discharge criteria and supports clinical decisions within agreed clinical parameters for supporting the discharge of patients from hospitals (Lambrinou, et al., 2012).
Nationally collected evidence suggests that a nurse-led discharge is usually interpreted as a transfer of responsibility for a doctor's decision to the discharge decision of a nurse. However, it may be justified that physicians never leave the patient - they ensure the permanence of the patient’s discharge treatment through accurate diagnosis and investigation. Also, the term “nurse-led discharge” means patient discharge is an exclusive activity of the nurse. Therefore, the structure of the discharge conducted by the nurse should be understood from an expert and organizational point of view, which is important.
Hospitalization and discharge led by the Chief Nursing Officer appointed by the Australian Chief Nursing Officer is one of the ten major roles shaping the future of nursing. Even as the role of nursing has improved, discharge planning rarely becomes a suitable field for new roles. However, there are obvious advantages to relying on patient, nurse, and nurse-led discharge development. Even as the role of nursing has improved, discharge planning has rarely become a suitable field for new roles. However, there are obvious benefits to nurse-led discharge development in patients, nurses, and confidence (Lees & Solihull, 2011).
In Australia, standard-led discharge is used. The parameters are good, but people (individuals) have to decide that they are down and very simple. The current concern is where and best organization has been created to integrate nurse-led discharge with the process. For example, an emissions plan may not have two (or ore) parallel processes. If the nurse leads the process, it should be a clear integrated approach. People are often invited to look at specific theories based on organizational change, such as normalized process theory and critical realism theory. The former argues that when an employee adopts an idea, it gradually becomes normal but it is important to understand the process that takes place. In that case it is reasonable to accept the situation or behavior according to the situation in which the employee works. Thus, if a nurse-led discharge is not appropriate or possible in a particular situation, it will not be accepted.
In the nurse-led discharge study, where satisfaction was measured, patients were asked "Do they not want to take nurse-led care again?" And 9% of patients answer "yes". The problem only occurs when the discharge care is interrupted and the patient has to wait for the discharge process to end. These two aspects are the same as the “normal discharge process”. Patients commented on "feelings about their care," "empowerment through collective decision-making," and "confidence."
The benefits of nurse-led discharge
Discharge of a Patient must be a prearranged portion of the overall care. Planning of Discharge with nurse-led discharge must be performed only by trained nurses or health care professionals to improve patient care. Although the idea is often found that the newly listed nurse is ready to discharge the patient, the guidelines emphasize that this should be the role of the senior nurse. Patient discharge is a type of skill that nurses acquire "in the workplace." These will not automatically appear in the first post with exposure and understanding related to the process (Lees-Deutsch 2018).
The amount in terms of which patients are discharge by the nurse reliant on the specific clinical environment they are in. For those nurses who are working in rehabilitation ward conversing the plans of discharge in multi-departmental meetings has been part of their role always. In contrast, those nurses who are working in day surgery have either little or no exposure to the discharge plan. However, in both clinical cases, the same amount may be needed to manage the nurse's discharge. District nurses can be leaders in this area. In contrast to rehabilitation and surgical function, they often manage both discharge for hospitalization and patient case loading. They are the gatekeepers of their services, unlike most hospital-based nurses. In the hospital environment, nurse-led discharge is now being developed as the norm in the field of surgery (Zhu, et al., 2015).
This is probably because treatment is related to emergency hospital admissions and therefore focuses primarily on electrotherapy with the help of surgery, so we cannot plan for this increased number of emergency hospital admissions. .. As a result, most alchemy surgeries can be planned, which can be arranged from the pre-primary stage. There are several ways to increase nurse-led discharge.
It is believed by some people believe that any kind of responsibility are not taken by the nurses when it comes to initiating the discharge process. Nevertheless, being a professional nurse one ought to be clear that the combination of education, training and practice must mean the role of any new, integrated, advanced or enhanced nursing as well as there is no exception for nurse-led discharge (Fox, 2016).
Cho, E. H., & Hwang, S. Y. (2011). Effects of the nurse-led discharge education on symptom experience and self-care compliance in patients with chronic obstructive pulmonary disease. Korean Journal of Adult Nursing, 23(6), 595-604.
Fox, M. (2016). Nurse-led early discharge planning for chronic disease reduces hospital readmission rates and all-cause mortality. Evidence-Based Nursing, 19(2), 62-62.
Jonasdottir, R. J., Jones, C., Sigurdsson, G. H., & Jonsdottir, H. (2018). Structured nurse‐led follow‐up for patients after discharge from the intensive care unit: Prospective quasi‐experimental study. Journal of Advanced Nursing, 74(3), 709-723.
Lambrinou, E., Kalogirou, F., Lamnisos, D., & Sourtzi, P. (2012). Effectiveness of heart failure management programmes with nurse-led discharge planning in reducing re-admissions: a systematic review and meta-analysis. International journal of nursing studies, 49(5), 610-624.
Lees, L., & Solihull, A. (2011). Implementing nurse-led discharge. Nursing times, 107(39), 18-20.
Lees-Deutsch, L. (2018). Dispelling myths around nurse-led and criteria-led discharge. Nursing Times, 114(4), 32-35.
Zhu, Q. M., Liu, J., Hu, H. Y., & Wang, S. (2015). Effectiveness of nurse‐led early discharge planning programmes for hospital inpatients with chronic disease or rehabilitation needs: a systematic review and meta‐analysis. Journal of clinical nursing, 24(19-20), 2993-3005.
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