AKH / NABH /NSG/ 03
APOLLO KH Doc. No.
HOSPITAL Issue No. 03
Date 21-05-2019
NURSING MANUAL
Page Page 1 of 5
DISCHARGE PROCEDURE
1. Purpose:
This procedure describes for discharge and the need for planning discharge at the
time of admission.
2. Scope:
This procedure is applicable for all discharge happening at Wards / units of
Apollo KH Hospital
3. Responsibility:
3.1 Physician: Admitting Physicians shall plan discharge at the initial episode of patient
admission. They shall notify nurse in charge about discharge and prepare discharge
summary.
3.2 Nurses: The nursing staff shall send file to Medical Transcription Department and return
medicine for pharmacy. Explain about discharge medications.
3.3 Floor Incharge: Co-ordinate with all departments for the smooth functioning of
discharge.
3.4 Medical Transcription: Typing of discharge summary.
3.5 Pharmacist: Issue discharge medication to the patient. Double-check the medicines with
the prescription.
AKH / NABH /NSG/ 03
APOLLO KH Doc. No.
HOSPITAL Issue No. 03
Date 21-05-2019
NURSING MANUAL
Page Page 2 of 5
3.6 Billing and Insurance dept.: Generate the final bill and submits the bill to the patient’s
relatives
4. Procedure:
4.1 A written doctor’s order is required prior to discharge a patient and the nurse confirm the
time at which patient is to be discharged.
4.2 Discharge intimation to be given to other department by HIS.
4.3 The patient or their relatives are notified of the discharge and the time processes.
4.4 Inform Resident to co-ordinate with all referal doctors to get dischage advise medicines
and to write discharge summary.
4.5 Patient’s un-used medicines are returned to pharmacy and place indent for discharge
advise to pharmacy before sending the file for discharge.
4.6 Give priority to the Insurance patient.
4.7 For self pay patient, billing counter informs the patient on final bill and bill is handed
over to the patient attender for payment after collecting the amount patient is given the
discharge slip and discharge slip will be handed over to the nurse in the ward.
4.6 The nurse should collect the discharge slip and hand over the discharge medicines
to the patient after proper counseling. Patient / bystanders can clear their queries
regarding medications. They also double-check the medicines with the prescription.
Diet advice is given by the Dietician on Discharge.
AKH / NABH /NSG/ 03
APOLLO KH Doc. No.
HOSPITAL Issue No. 03
Date 21-05-2019
NURSING MANUAL
Page Page 3 of 5
4.7 The original discharge summary and the lab reports are handed over to the patient /
relative by nurses and get name and signature from the patient or relatives. A copy of
summary is retained in the Medical Records department in the respective patient case file.
4.8 On submitting the discharge slip the Nurse explains about the follow-up, diet (which
is included in discharge summary) hand over the original summary and feedback is taken
from the patient and documented.
4.7.1 Discharge summary incorporates instructions about when and how to obtain
urgent care.
4.7.2 Remove the ID Band and the IV line and the patient is allowed to leave.
4.7.3 If the patient is discharged with the IV Line/Catheter/Ryles tube based on the
Doctor’s order
4.7.4 Send the patient home via wheel chair or stretcher to the vehicle.
4.7.5 Once the patient is left the ward, discharge the patient in the system.
4.7.6 Enter the discharge date and time in the Nominal Register.
4.8 Discharge at Request:
4.8.1 If the patient is stable and wish to leave the hospital earlier than the discharge date
prescribed by the doctor, then the patient shall be discharged on request.
AKH / NABH /NSG/ 03
APOLLO KH Doc. No.
HOSPITAL Issue No. 03
Date 21-05-2019
NURSING MANUAL
Page Page 4 of 5
4.8.2 In such cases the patient/ relative shall be informed by the physician about the
medical consequences of leaving the hospital, but still wishes to leave, the
physician shall ask the patient to sign the consent form. The patient’s discharge
may be effective immediately.
4.8.3 The physician shall record in the medical record that the patient is being
discharged against medical advice and the medical consequences of the patient’s
action were explained to him in detail (consequences should be listed).
4.8.4 The physician shall record the witness’ name and title in the discharge summary.
5 Records:
Nominal Register
6 Annexures:
Nil
7 References:
Guide Book to NABH Standards for hospitals, Fourth Edition, December 2015
AKH / NABH /NSG/ 03
APOLLO KH Doc. No.
HOSPITAL Issue No. 03
Date 21-05-2019
NURSING MANUAL
Page Page 5 of 5
