Responsibility of Registered Nurse Discharging the Patient
Patient discharged WITHOUT a referral
Print the following forms:
One (1) Face Sheet
One (1) Nursing Discharge Note
Two (2) Post Hospital Care Plans
One (1) Patient Discharge Medications List (PDML)
Distribute the forms as follows:
One (1) Face Sheet in the Patient’s Medical Record
One (1) Nursing Discharge Note in the Patient’s Medical Record
One (1) SIGNED Post Hospital Care Plan in the Patient’s Medical Record
One (1) SIGNED Post Hospital Care Plan to be given to the patient
One (1) Patient Discharge Medications List (PDML) to be given to the patient
Patient discharged WITH a referral
Print the following forms:
One (1) Face Sheet
Two (2) Patient Care Referrals
Two (2) Nursing Discharge Notes
Two (2) Post Hospital Care Plans
One (1) Patient Discharge Medications List (PDML)
If a summary from any of the Health Professions (Case Management, Dietary, PT, OT, Respiratory, Speech-Language Pathology and / or Social Services) is required at time of discharge and is not in the front of the chart, print two (2) copies of each form.
Distribute the forms as follows:
***For transfers to a facility print and include with discharge paperwork for EMTs/transport; for VNA, print and fax to agency
One (1) Face Sheet in the Patient’s Medical Record
One (1) Patient Care Referral in the Patient’s Medical Record
One (1) Patient Care Referral to the Referral Agency (e.g. VNA, rehab hospital, SNF)
One (1) Nursing Discharge Note in the Patient’s Medical Record
One (1) Nursing Discharge Note to the Referral Agency (e.g. VNA, rehab hospital, SNF)
One (1) SIGNED Post Hospital Care Plan in the Patient’s Medical Record
One (1) SIGNED Post Hospital Care Plan to be given to the patient
One (1) Patient Discharge Medications List (PDML) to be given to the patient
One (1) of each health care profession summary in the Patient’s Medical Record
One (1) of each health care profession summary to the Referral Agency (e.g. VNA, rehab hospital, SNF)