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The Implementation of the Discharge Nurse On a Mother Baby Unit; A Conduit to Increased Patient Satisfaction
Title: The Implementation of the Discharge Nurse On a Mother Baby Unit; A Conduit to Increased Patient Satisfaction
- Identify key elements of the discharge nurse's job responsibilities which impact the discharge process and patient satisfaction survey scores.
- Describe how the discharge nurse position is an integral part of the Mother-Baby Team
- Discuss how a discharge nurse can be implemented on their Mother-Baby Unit
The Discharge Nurse Position(DN) was presented to hospital administration in 2011 for permission to grant a trial as a strategy to improve patient satisfaction with the discharge process from the Mother baby Unit (MBU). We hoped to improve consistency of parent education prior to discharge impacting patient satisfaction with the process. We also felt this position would impact throughput between labor and delivery and MBU simply through facilitation of timely discharges. We projected an increase in our Press Ganey and HCAHPS scores as a result of this innovative program.
Proposed change: A DN would work five eight hour shifts Monday through Friday. She would meet patients on their first day admitted to the MBU and begin their plan for discharge. The DN would review all prescriptions on day of discharge including effects of medication and potential side effects, review and prepare necessary paperwork, review discharge instructions for mom and baby, review all screening tests with results, and review follow up appointments for mom and baby. The final car seat check would be done. Both Mom and baby would be discharged to home and the DN would complete the process through documentation. The daily parent education class would be taught by the DN every day. Those who would be discharged in the coming day or days would attend this class. Car seat checks were facilitated by the DN as well.
Implementation, outcomes and evaluation: The position was trialed for three months and made permanent late spring 2012 once evaluation of outcomes were realized. Press Ganey as well as HCAHP scores validated an increase in patient satisfaction with the discharge process and teaching surrounding that period of time.Hospital administration saw the outcomes and is using this best practice on another unit at present.
Implications for nursing practice: This innovative program can be utilized on any unit struggling with patient satisfaction scores related to discharge. The efficiency gained as a result of this position can be extrapolated for admission as well, and an admission/discharge team can be utilized to generate improved satisfaction as well as improved throughput between units. Standardization ensures that education surrounding discharge of mothers and newborns is consistent from one patient to the next. Impacting nurse satisfaction was a win from this position as well leaving more time for the staff nurse to monitor, care for, and teach patients with less fragmentation.
Keywords: Discharge Nurse, patient satisfaction, HCAHPS scores, standardization, nurse satisfaction