What should be included in concise discharge instructions for parents?

Effective Discharge Instructions for Parents

Concise discharge instructions for parents should include diagnosis, treatment plan, follow-up instructions, return precautions, and medication details, delivered through both standardized verbal and written formats with teach-back verification of understanding. 1

Essential Components of Discharge Instructions

1. Diagnosis Information

• Clear explanation of the child's condition in simple language
• Brief summary of relevant hospital course or emergency department findings
• Avoid medical jargon and provide patient-centered explanations 1

2. Treatment Plan

• Specific medication instructions with name, dose, frequency, and duration 1
• Patient-centered medication instructions (e.g., "Give 5 mL of medicine three times a day" rather than general directions) 1
• Clear instructions for any home care procedures or treatments
• Any activity restrictions or special care needs 1

3. Follow-up Instructions

• Specific appointment details with date, time, and location when possible
• Clear guidance on when follow-up should occur if specific appointment not scheduled
• Contact information for follow-up providers 1

4. Return Precautions

• Explicit warning signs that require immediate medical attention
• Specific symptoms that indicate worsening condition
• Clear guidance on when and where to seek additional care 2
• This category is particularly important as 63.3% of essential discharge content items identified by experts relate to when parents should return to the emergency department 2

5. Medication Information

• Detailed instructions for medication administration
• Side effects to monitor
• Instructions for measuring liquid medications correctly
• Recommendation to use calibrated measuring devices for liquid medications 3

Delivery Methods for Maximum Effectiveness

Structured Verbal Instructions

• Use standardized verbal instructions to improve comprehension 1
• Include diagnosis, treatment plan, and follow-up instructions in verbal discharge process 1
• Verbal reinforcement in the parent's preferred language significantly improves recall, especially for non-English speakers 1

Written Instructions

• Provide diagnosis-specific written instructions to supplement verbal information 4
• Written materials significantly improve understanding of treatment instructions (92% vs 82% understanding) 4
• Use "patient-centered" instructions with specific details rather than general information 1, 5

Verification of Understanding

• Implement "teach-back" methods where parents repeat key instructions to verify understanding 1
• Request return demonstrations of skills needed for home care 1
• Have parents verbalize understanding of medication dosing and administration 6

Special Considerations

High-Risk Situations

• For complex discharge plans (multiple medications or appointments), provide additional support and verification 6
• Parents with limited English proficiency may need additional resources such as translated materials or interpreter services 6
• Families with public insurance or no insurance may benefit from additional discharge support 6

Common Pitfalls to Avoid

• Medication dosing and adherence errors are common parental mistakes 6
• Parents frequently miss follow-up appointments and misunderstand return precaution instructions 6
• Overreliance on written materials alone may not be effective for all parents, especially those with limited health literacy 1
• Pictograms alone may decrease correct interpretation compared to patient-centered written instructions 1

Implementation Strategies

• Begin discharge planning early in the hospital course 1
• Involve parents in care from admission to build confidence 1
• Develop individualized teaching plans with checklists of specific tasks to master 1
• When possible, identify at least two responsible caregivers who can learn necessary care 1
• Consider parent rooming-in and telephone follow-up to facilitate education 1

By following these guidelines for discharge instructions, healthcare providers can significantly improve parental understanding, adherence to treatment plans, and ultimately patient outcomes.