Literature review on patient discharge instructions

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Understanding discharge instruction is crucial to optimal healing but can be compromised in the hectic environment in the emergency room. Waisman, Siegal, CHemo (2003) completed a study in which the objective was to determine the parents understanding of ED discharge instruction and factors that may affect home care. …


A convenience sample was used of 287 patients. In this particular ER, full understanding was found in 72% of the parents that had children discharge from the ER. The results showed that overall, there was a fair understanding in this case while 20% still showed very little understanding post discharge. Supporting the results of that study but getting poorer results, Gilroy noted in a study done in 2009 that patients who are discharged from the emergency room have a difficult time remembering the instructions, especially those that are given about such things as wound care and medications. In a study performed in an emergency room, doing call back 1 week after discharge, 68% could not tell the call back nurse what the instructions that were given were.
In a study performed by the University of Michigan Health System (2008), it is noted that around the nation there are 115 million patients that visit the emergency room. Of those patients, 3/4 leave with an impression of what happened or what should happen next. Most ER care teams including University of Michigan would like to see much better than 75% remember what to do next. What they found to be even more upsetting was that 80% of those that understood what to do next were "pretty sure what to do". Northwestern Hospital of Chicago (2008), performed a similar study, reviewing making post ER calls over a 6 month period and collecting data from those calls. Researchers at Northwestern, led by Engel, reported more than 75% of ED patients interviewed after discharge had deficient comprehension or less than complete memory. ...
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