ABSTRACT
In our hospital, we have appointed some nurses to full time support and adjust patient discharges since May 2009. We have an electronic “Discharge Support Protocol”, which is a tool that includes discharge adjustment screening, discharge support assessment, discharge adjustment planning, and discharge support planning. However, only a few ward nurses have used the tool. We performed a survey of nurses in the acute care ward, where 32% of the inpatients require discharge support input to consider how the “Discharge Support Protocol” could be fully utilized. The main reasons given for the low input rate were the difficulty in finding time from routine ward duties, and the vagueness of the protocol. We, therefore, made it part of the routine ward duty to fill out the discharge support protocol, and also made the work flow clearer. As a result, we found an increase in input rate of the first part of the protocol which deals with discharge adjustment screening, but did not find any change in input rate from the second part onwards. The challenge from now on will be to take further measures to improve the overall input rate. In addition, we have suggested the usability of the “Discharge Support Protocol” to educate ward nurses, and to share information about patients between nurses and other departments.
ABSTRACT
Our hospital has a nutrition support team (NST) serving inpatients of all department. Two years ago, the team started activities with the motto “Apt nutritional management for inpatients”. It is an interdepartmental unit consisting of physicians, nurses, dietitians, pharmacists and speech therapists. Initially we found it difficult to make time to join forces, but now it has become possible to screen patients for undernourishment on a weekly basis while making nutritional assessment and planning, and holding consultations. The main purpose of the consultations is to improve the nutritional status of patients according to plans formulated after nutritional assessment made at the request of physicians and nurses in charge of the patients. To achieve the objective, we are expected to concentrate all our efforts and brains. This paper presents some consultation cases we have handled. In addition, the nutritional assessment and nutritional intervention activities of our hospital are described.