Purpose for the Program
The discharge nurse (DN) position was presented to hospital administration in 2011 for permission to grant a trial as a strategy to improve patient satisfaction with the mother–baby unit (MBU) discharge process. We hoped to improve consistency of parent education before discharge and improve patient satisfaction with the process. We also felt this position would affect throughput between the labor and delivery unit and the MBU simply through facilitation of timely discharges. We projected an increase in our Press Ganey and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores as a result of this innovative program.
A DN would work five 8-hour shifts Monday through Friday. The DN would meet patients on their first day admitted to the MBU and begin their plan for discharge. Furthermore, the DN would review all prescriptions on the day of discharge, including the effects of medication and potential adverse effects, review and prepare necessary paperwork, review discharge instructions for the mom and infant, review all screening tests and results, and review follow-up appointments for the mom and infant. Patients discharged in the coming day or days would attend a daily parent education class taught by the DN. The final car seat check would also be executed by the DN. After the mom and infant were discharged, the DN would document the discharge and complete the process.
Implementation, Outcomes, and Evaluation
The position was trialed for 3 months and made permanent late spring 2012 after evaluation of outcomes were realized. Press Ganey as well as HCAHP scores validated an increase in patient satisfaction with the discharge process and patient education class time. The hospital administration recognized the positive outcomes and is presently using this best practice on another unit.
Implications for Nursing Practice
This innovative program can be used on any unit struggling with discharge-related patient satisfaction scores. The efficiency gained as a result of this process can be extrapolated for admission as well, and an admission and discharge team can be used to generate improved satisfaction in addition to improved throughput between units. Standardization ensures that the education surrounding discharge of mothers and newborns is consistent from one patient to the next. Nurse satisfaction was improved from this process and left more time for the staff nurse to monitor, care for, and teach patients with less fragmentation.