i have just started up a discharge task team in my nicu and am asking for ideas to help speed along discharges. we have identified many barriers to discharge and they are as follows:
1) nurse assignment load, high census
2) parents not visiting, or live far away. this delays a) obtaining consents, b) bringing in carseat, c) teaching, d) pediatrician consent etc...
3) float pool from picu/peds do not do discharge prep items, so this piles up for the next shift/day
4) does the discharge prep list involve too much paperwork?
5) not getting started on admit
6) stepdown unit vs icu and days vs. nights (icu thinks it can start on the stepdown unit, nights thinks it can start on days) or vice versa
7) not starting on dc prep items because there is no order for it (pedi consents, hep b consent etc)
8) unknown exact dc date
9) only one place to watch dc videos (we require 2 videos to be watched by families: cpr and carseat safety but only have one place for them to be watched which is in a very small family lounge)
10)parents don't think to ask questions about discharge prep other than "when is my baby going home"
11)no resources other than nurses and admit folder are available to parents
12)chorio admits go home after 48 hours and discharge prep is started on late
we have discussed placing a cork board in the family lounge with information all about discharge encouraging parents to bring it up with the nurse. on the cork board will be a checklist for the families to ask themselves...do i have a carseat? have i chose a pedi? etc. we will attach flyers and information on discharge prep to allow parents to take with them. we have also discussed placing a very simple discharge list in the admit folder in the front of all other papers for parents to read.
any ideas or suggestions on ways to get discharges speeded along so it doesn't fall on the discharge nurses.