how do i know when someone is ready for discharge?

[pear8]

Hi,

i was wondering how do i know when someone is ready for discharge or not? what should i be looking for? is there some type of criteria? its either to discharge them or to continue their visits in home health. how about in a general hospital environment? often i feel that patients aren't even readdy to get discharged but we are forced to due to insurance limitations.

[KateRN1]

With home health, you need to be constantly referring to your 485 plan of care which contains your interventions and goals. Patients are ready for discharge when all interventions have been carried out and all goals have been met--and it's all been documented. At times, we discharge for non-compliance but that pattern of non-compliance must be well documented by all disciplines.

[annaedRN, RN]

Remember too with home health that the goal may not be total healing...it could be independence with wound care or remaining infection free. Some times teaching may not be able to be completed due to language, environmental, cognitive or compliance issues - just document each thing you do and the response of the patient to that intervention. Just remember if a patient has a chronic disease process that we are to assist them in becoming independent and safe in management at home using whatever support system they have in place ( or helping them find one). So once those goals have been accomplished, it is time to discharge. With insurance - if you can justify the need at each visit for a future visit, then they will usually pay for more. With Medicare - just document the skilled need each and every time.