Example of goals for discharge-ready from medical, nursing, physiotherapy, and occupational perspectives
| Goals medicine | Goals physiotherapy | Goals occupational therapy | Goals nursing |
|---|---|---|---|
| The infection markers are decreasing | The patient must have a functioning locomotion | Assessment of the need for occupational therapy must be done and documented in the patient’s journal | Nursing actions have been started based on what is reasonable to achieve during the hospital stay |
| The hemoglobin level is increasing | The patient should have as independent locomotion as possible in relation to previous abilities and current preconditions | The patient should become as independent as possible in their everyday activities of daily living. A report is done to external caregivers according to the continued plan for everyday activities in daily life and the need of aid | A plan for the follow-up for the nursing actions after discharge must be ready |
| Afebrile | There should be an assessment and a plan for the external follow-up. The digital planning system for external caregivers must be updated | Adequate aid is safely prescribed or reported to external caregivers for follow-up | The patient and relatives must be informed and involved during the discharge process |
| The wound heals as expected | The nurses have the final responsibility to certain that the patients have all necessary papers, information, and drugs when being discharged | ||
| Test results and vital signs normalizes (expected) or are within the patient’s normal range. Not acute, remaining pathology, is referred further | |||
| The patient is symptom-free | |||
| The pharmaceutical prescription is updated |
| Goals medicine | Goals physiotherapy | Goals occupational therapy | Goals nursing |
|---|---|---|---|
| The infection markers are decreasing | The patient must have a functioning locomotion | Assessment of the need for occupational therapy must be done and documented in the patient’s journal | Nursing actions have been started based on what is reasonable to achieve during the hospital stay |
| The hemoglobin level is increasing | The patient should have as independent locomotion as possible in relation to previous abilities and current preconditions | The patient should become as independent as possible in their everyday activities of daily living. A report is done to external caregivers according to the continued plan for everyday activities in daily life and the need of aid | A plan for the follow-up for the nursing actions after discharge must be ready |
| Afebrile | There should be an assessment and a plan for the external follow-up. The digital planning system for external caregivers must be updated | Adequate aid is safely prescribed or reported to external caregivers for follow-up | The patient and relatives must be informed and involved during the discharge process |
| The wound heals as expected | The nurses have the final responsibility to certain that the patients have all necessary papers, information, and drugs when being discharged | ||
| Test results and vital signs normalizes (expected) or are within the patient’s normal range. Not acute, remaining pathology, is referred further | |||
| The patient is symptom-free | |||
| The pharmaceutical prescription is updated |
Source(s): Authors’ own work
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