Do you do assessments after a patient is discharged?

loriangel14, RN · Dec 13, 2012

I would still do it.If there was any question about their condition on the day they left the charting would show an assessment was done that day before they left.Just becasue they are leaving soon doesn't mean you shouldn't assess.What if there was a change in their comndition before they left?

KelRN215, BSN, RN · Dec 13, 2012

How can you do an assessment after the patient is discharged? Discharged patients aren't there to assess, are they?

When I worked in the hospital, if I had a patient who I "knew" was being discharged soon, everything was still done per usual. I've seen many patients with one foot out the door who ended up staying for whatever reason. If the discharge papers are signed at 9am and the patient is still waiting for a ride when it's time for their next assessment then, no.

dudette10, MSN, RN · Dec 13, 2012

Yes. Twice in my short career my assessment findings reported to the MD have delayed or canceled discharge. I am responsible for confirming the stability of the patient at discharge, so yes, I do an assessment.

turnforthenurse, MSN, NP · Dec 13, 2012

I always do an assessment.

melmarie23, MSN, RN · Dec 13, 2012

yes of course. If you know they are an early discharge, then I would priortize my assessment on them (provided the rest of my pt's are stable for the time being).

It may not get charted until AFTER they've left, but at least the assessment had been done and I am charting accurate and relevant pt status information. And as others which as other's have pointed out...that assessment could delay or cancel their d/c all together if they for example took a turn for the worse.

chorkle · Dec 13, 2012

OP--

Since you asked for (our) opinion, here is mine.

Your post is unclear, thus it is impossible to respond appropriately, despite the above 5 responses.

"Your" patient was discharged at 9 a.m. (your example) but is still "there . . for hours."

Was the patient discharged, or not? Or, what exactly did you mean (but not explain) by "discharged"?

Anna Flaxis, BSN, RN · Dec 13, 2012

I think the OP means that the discharge order was written at 9am, but for whatever reason, the actual discharge process took hours to accomplish. This happens a lot, like if outpatient services are being arranged, or for obtaining transportation, or if the destination isn't prepared to receive them yet.

To answer the question, yes, I would do it. Just because the patient has a discharge order written does not mean they are discharged. They aren't discharged until they have physically left the hospital, and until that time, if you are the nurse assigned to care for them, you are still responsible for their nursing care. Also, no matter how stable they appear, there could be a change in condition between the time the order to discharge is written and the time they actually leave. Additionally, it is important to document their condition upon discharge.

When I was a CNA, I was transporting a patient who had been discharged. I had just gotten him into the wheelchair and had taken maybe three steps toward the elevator, when he slumped over and became unresponsive. Needless to say, he was not discharged.

~PedsRN~, BSN, RN · Dec 13, 2012

We assess at the start of our shift and then PRN (of course) - if a patient already has discharge orders written, I will do a quick assessment prior to their discharge. If they have been discharged and are waiting on a prescription/ride/etc, then no - I do not perform an assessment. They are on their way out the door! :)

NurseOnAMotorcycle, ASN, RN · Dec 13, 2012

This happens a lot where I work. The patient has their discharge papers and is dressed to go, but they don't have a ride home until 1600. So they sit around until their ride comes.

I don't usually document reassessments after they have been officially discharged, but I do check on them and see if they need snacks, etc while they are waiting. The elderly are especially checked on. I will still turn/position right up until they go.

pgotm · Dec 13, 2012

Always assess, pt's can change at any time. You would rather know that you charted an accurate view of the patient's condition whether it be positive or negative. And of course if you ever have to go to court, your documentation will paint a pciture of the patient's condition. Remember each minute is promised to no one. Here now, gone the next. :yes:

Twinmom06, ASN, APN · Dec 13, 2012

so then to those of you that assess the discharged patient waiting for their ride (or whatever the delay is) do still give them their medications? As in they are officially discharged at 0900 but their ride isn't coming until 1100 and they have a 1000 med - do you still give them the med?