Day Surgery Nurses Develop Discharge Instructions

Nurses involved in the project include, from left, Nancy Brooks, RN, Susan Skahan, RN, Sandra Torrisi, RN, Marie Courtney, RN, and Nicole Engel, RN. Barbara McCarthy, RN, is not pictured.

In an ambitious undertaking during the last three years, Day Surgery nurses have developed more than 100 sets of standardized discharge instructions in English and Spanish for all Day Surgery procedures. Through countless meetings, reviews and revisions, the group has remained focused on patients’ needs.

“The nurses created a standard template for all discharge instructions,” said Ann Furey, MBA, RN, Patient Education program manager, who worked with the group. “This project really captures another way that the expertise of our nurses contributes to the good of the patients.”

Prior to this project, discharge instructions varied, depending on the physician and nurse responsible for the discharge. “The instructions weren’t uniform or consistent,” said project leader Sandra Torrisi, RN, of Day Surgery.

It was challenging for nurses and physicians to provide discharge instructions reflective of the plan of care.

Nancy Brooks, RN, nurse in-charge in Day Surgery, reached out to Furey, and they formed a small core committee, adding new members as they tackled each specialty area within Day Surgery.

Now available online, the discharge instructions are in standardized templates, with copious information broken down into readable sections. Once the initial drafts were complete, the committee shared them with attending physicians, residents, physician assistants, nurses and others in each area for additional review. Each template can be customized to personalized instructions as needed for a particular patient.

“It took a lot of revisions and was tedious at times, but well worth the effort to provide quality patient instructions to every patient,” Furey said. “These instructions represent the collective wisdom of the team.”

The instructions are easy to read, with information broken out into bullets and written at a sixth- to seventh-grade reading level.

“Patients find these detailed instructions very beneficial,” said Nicole Engel, RN, of Day Surgery. “We review the instructions verbally with the patients, and they can keep the printed instructions to refer to when they have a question.”

Nurses, residents and other staff appreciate having standardized instructions available online. “It makes our work easier as well,” Engel said. “Everything is pre-printed.”

This is echoed by PACU nurses, who discharge Day Surgery patients on weekends. “This is a great resource for the PACU,” said Marie Courtney, RN, of the PACU, who previously worked in Day Surgery. “This helps the patients and it helps the nurses feel more assured that we are better preparing the patients for discharge.”

The committee also made the instructions available for Day Surgery patients at the Brigham and Women’s/Mass General Health Care Center at Foxborough and Faulkner Hospital.

“The staff here epitomize professional practice,” said Jeanne Lanchester, RN, nurse manager of PACU/Pre-Op/Day Surgery Unit. “This was a grassroots effort to provide our patients with better instructions—our focus is always to meet patients’ needs.”