An audit of current discharge planning arrangements and their effectiveness on elderly care wards and community nursing services together with aspects of client satisfaction

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Abstract
This paper is a review of a clinical audit conducted on the elderly care wards of a National Health Service (NHS) Trust hospital in the East Midlands. The audit examined current discharge planning arrangements and their effectiveness on elderly care wards, community nursing services and client satisfaction. Sixty sets of nursing notes were examined, 27 community nurses received a questionnaire and 60 patients and 26 carers or significant others were interviewed in the patient's place of residence. The audit findings revealed that, of the 60 sets of notes examined, only 10% of patient discharge plans commenced on admission. Liaison between ward and community nursing staff to discuss the needs of patients being discharged was minimal. Only 50% of community nurses believed they were adequately informed about, and 40% adequately involved in, patient discharge. Little consultation between ward staff, patients and their carers occurred during the discharge planning phase. The majority of patients (63%) and carers (81%) interviewed said that the patient's needs were not discussed prior to discharge home. The report ended by formulating a list of 11 recommendations which includes a thorough review of current policies, procedures and standards. A multidisciplinary steering group has been formed to assist in the implementation of the recommendations.

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