Research
Do Patients Understand Discharge Instructions?

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Introduction

Adherence to aftercare instructions following an emergency department visit may be essential for facilitating recovery and avoiding complications, but conditions for teaching and learning are less than ideal in the ED. The objective of this study was to identify and describe areas of patient confusion about ED discharge instructions.

Methods

Follow-up telephone calls were made to 50 ED patients on the day after discharge to inquire how they were doing and whether they had any questions about their instructions.

Results

Fifteen subjects (31%) requested information about their aftercare instructions that required further clarification by the investigator, and 15 subjects (31%) described a diagnosis-related concern that revealed poor comprehension of instructions.

Discussion

This study demonstrated that patients commonly remain confused about aftercare information following treatment in an ED. Follow-up telephone calls may be useful for identifying and addressing ongoing learning needs.

Section snippets

Methods

This prospective, randomized, descriptive study used follow-up telephone calls placed to patients 1 day after ED discharge in order to assess their understanding of aftercare instructions. The study site was the emergency department of Reston Hospital Center, located in Reston, Virginia. The Reston Hospital Emergency Department treats about 40,000 patients annually and discharges 82% back into the community without hospital admission. Subjects consisted of adult patients, aged 18 years or

Results

Thirty-three percent of the subjects were male and 66% were female. Ages ranged from 22 to 91 years with a mean age of 48 years (SD = 18 years). The most common medical problems were musculoskeletal complaints (n = 10), followed by gastrointestinal symptoms (n = 7), chest pain (n = 6), minor wounds (n = 6), and headache (n = 5). Fifteen of the 49 subjects contacted (31%) requested information about discharge instructions that required further clarification on the part of the investigator. In

Discussion

In the emergency department where this study was conducted, nurses value patient education, and established procedures and resources exist to support formalized discharge teaching for every patient. In spite of these efforts, nearly one third of subjects had substantive questions or areas of confusion that required additional explanation within 1 day of ED discharge. Some patients experienced unnecessary discomfort because they did not understand they had prescriptions for analgesic

Sandra Zavala, Member, Northern Virginia Chapter, is Emergency Nurse, Reston Hospital Center, Reston, VA, and Graduate Student, George Mason University, Fairfax, VA.

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There are more references available in the full text version of this article.

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Sandra Zavala, Member, Northern Virginia Chapter, is Emergency Nurse, Reston Hospital Center, Reston, VA, and Graduate Student, George Mason University, Fairfax, VA.

Carol Shaffer is Research Coordinator, Reston Hospital Center, Reston, VA, and Adjunct Faculty Member, George Mason University, Fairfax, VA.

Earn Up to 8.5 CE Hours. See page 211.

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