Safe Discharge

[OldIsNew]

I am an old nurse returning back to ED after 25 years away ( ICU, PACU, Admin). I am so frustrated with myself at discharge. In the past year, I have had THREE HIPAA violations! It seems that I get wrapped up in what I'm doing and don't check EVERY sheet at discharge.

How do I make sure this doesn't happen? I typically discharge between 12 and 15 patients/shift after full work ups. I would love to spend more time, but we are also "dinged" on long times.

Any suggestions??? I am afraid I will lose my job if this happens again.

[Nalon1 RN/EMT-P, BSN, RN]

The only real answer is to check every sheet, every time. It is a PITA, but only way to make sure no extra sheets got in there.

Nothing worse than the wrong Rx on top of the discharge paperwork, or a stray sheet in the correct patient.

[skylark, BSN, RN]

Maybe its just about learning a new way of doing it?

When i get papers, I usually chat to the patient while I skim through, checking the name on each page.

Ask them how they are getting home, and ask to check their nameband once again, just to match it against the name on the papers. Nobody objects to that, it reassures them that you are making checks as you go along.

And you will find wrongly sorted papers too, I often find that the prescription for patient A is folded in with the papers for patient B. They come off the printer on different types of paper, so often the printer churns them out in a different order to the way they were requested when the doc pressed 'print'.

Or you can remove the angiocath first, and have then hold the gauze on it while you check the papers. That way you won't feel hurried, you can take as long as it takes for their puncture site bleeding to stop.

It doesn't take long to check through each page. and again they are usually reassured that you do that in front of them, kinda like proof-reading it for them. I have a highlighter pen that I use when I go through to highlight appointment details, and the pharmacy hours, and it still only takes a minute or so to have the papers ready to go.