Guidelines: Discharge Instructions for Covid-19 Patients

Abstract

Introduction/Objectives: Clinicians treating COVID-19 patients face a major challenge in providing an effective relationship with patients who are discharged to return to home in order to optimize patient self-management after discharge. The purpose of these discharge instructions is to assist and provide guidance for physicians, nurses, and other health care personnel involved in discharging COVID-19 patients to home after encounters at hospitals, emergency departments, urgent care settings, and medical offices. Methods: A systematic literature-search of studies evaluating both symptoms and signs of COVID-19 was performed in order to establish specific optimal performance criteria in monitoring a patient’s status with regard to disease safety. These optimal performance criteria parameters were considered with regard to the severity of morbidity and mortality. Strategies used to develop the discharge instructions included review of a broad spectrum of literature to develop the discharge criteria. Results: These guidelines are presented for patient education and should achieve the essential goals including: enabling patients to understand their medical situation, preventing complications, supporting patients by providing instructions, helping patients make more effective use of available health services, and managing patient stress by giving patients comfort through the knowledge of specific recommendations including how to respond to situations. Conclusion: The COVID-19 pandemic requires clinicians to efficiently teach their patients self-management strategies and to provide a safe educated response to the patient and the surrounding community environment. The primary goal of the patient education discharge-instructions (PEDI) is to provide self-management strategies for preventing complications and disease transmission.

Patients with COVID‐19 share their experiences of recovering at home following hospital care transitions and discharge preparation

“…Patients in this study suggested that there be follow‐up calls from either family doctors notified of their patients' COVID‐19 status or from AHS staff (e.g., discharging hospital transition coordinators). This aligns with other studies clearly indicating the need for regular monitoring of discharged patients to assess clinical status as well as the need for medical or rehabilitation care 12–15 . Approaches for follow‐up with those patients having other medical conditions were different.…”

“…This aligns with other studies clearly indicating the need for regular monitoring of discharged patients to assess clinical status as well as the need for medical or rehabilitation care. 12 , 13 , 14 , 15 Approaches for follow‐up with those patients having other medical conditions were different. They had virtual care and monitoring by their family doctors or specialty healthcare teams including ongoing assessment of their COVID‐19 status and additional supports or treatment as needed.…”

“…Most patients targeted the need for better verbal communication and even patient education by staff regardless of any written information or packages provided. 12 , 13 , 14 , 15 Informing patients about their time of discharge and making transportation arrangements were crucial to preventing confusion or delay. 10 Also important were the community or other contacts and information for recovery care or rehabilitation, which some or many patients would need to know how to access.…”

“…Patients in this study as in others made some clear suggestions for improvement around the discharge assessment, preparation and follow‐up process. Most patients targeted the need for better verbal communication and even patient education by staff regardless of any written information or packages provided 12–15 . Informing patients about their time of discharge and making transportation arrangements were crucial to preventing confusion or delay 10 .…”

“… 10 , 11 Many had not received any information about the discharge arrangements with family or caregivers, including arranging for transportation home, having contacts for further support or advice as needed, or what health advice or further treatments to follow‐up while recovering at home. 10 , 11 Having clear discharge protocols and communication with patients and their families/caregivers was viewed as critical, 12 particularly if there needed to be regular monitoring of patients to assess their clinical outcomes or the need for medical or rehabilitation care, 12 , 13 , 14 , 15 oxygen support or virtual or other types of care. 16 , 17 , 18 The intent of such monitoring during recovery was to address patient needs and reduce readmission to the hospital.…”