Discharge Prep

can't really help with speeding up the process. We have a system though there are always kids who after 3 or 4 months of being there are ready for discharge with nothing done. Basically we have "baby-steps" home. Ten steps. I don't know the order of them now and they are frequently being revised as we often have to double chart stuff but its "supposed" to start on day of admission and starts with easy stuff like welcome to the nicu, how to call and get info, how to change your baby's diaper and progresses in a stepwise fashion to include car seat/temp taking/feeding/special equipment/pedi etc. Nurses are supposed to document when a step is done and in a perfect world they would all be done by discharge day. Sometimes it happens and sometimes it doesnt and the d/c nurse is left with it all.

It is a universal problem it seems. People don't document what they do with parent's, so the discharge nurse does it all. Happens all the time and is my biggest pet peeve ever. Different if the parents don't come in at all.

About 2 weeks before discharge we start really getting them prepped. We have a folder we give them with handouts on what we expect from them: An appropriate corificeat, a PCP, they have to come in and watch our videos for CPR and Corificeat safety, supplies they will need, etc. In the 2 weeks before we tell them to bring in the corificeat so that they can adjust the straps to fit the baby (we are not allowed to do this per our legal department), bring the name of a doc you want, or if they don't care we will select one for them from our peds clinic. Then from there we set up monitor training if they need it, med teaching after we send the prescriptions with them or to our pharmacy (our parents have to have the meds before discharge so that we can check them, esp from outside pharmacies that seem to mess up the concentrations of a lot of meds). We get immunization consents, circ consents, etc. I will say, our NNP's and docs are very good at calling parents and letting them know all this stuff, along with us. You mentioned consents...you can get phone consent for many things. We make sure we have a circ consent on the chart before the mom leaves and we have a sheet that has to be signed by the mom or by phone consent 24 hours before the circ is done. And for parents that don't visit much we make sure to tell them that they will be here for at least 3 hours prior to leaving the building so that we can do all the teaching, etc. It isn't a swoop and scoop.

We do have a bulletin board in the visitors area with a lot of discharge info on it. We also have a discharge check off sheet that we put on the front of the chart that is checked off when things are done (Hep B, corificeat challenge, sleep study, meds, appointments, VNA, WIC, etc)

We have made it pretty clear to all shifts that it starts on admission and ends with discharge. We have recently started holding the primary nurses responsible also. If you are a primary and work nights, you better have an associate that works days so things get done, or make sure you are passing on what needs done.