Nursing Discharge Planning Checklist

Create a comprehensive discharge planning checklist for patient being discharged to [home/facility/rehab].

Discharge details:
- Discharge destination: [home/SNF/rehab/assisted living]
- Anticipated discharge date: [date]
- Diagnosis at discharge: [list]
- Functional status: [describe]
- Support at home: [family/alone/caregiver]

DISCHARGE PLANNING CHECKLIST

MEDICATIONS
☐ Discharge medication list reconciled
☐ New medications explained to patient
☐ Medication changes highlighted
☐ Patient demonstrates medication knowledge
☐ Prescription sent to pharmacy
☐ Medication assistance arranged if needed
☐ Medication schedule written in plain language

FOLLOW-UP APPOINTMENTS
☐ Primary care: [date/time/location]
☐ Specialist: [name/date/time]
☐ Lab work: [what/when/where]
☐ Patient has transportation: [yes/no]
☐ Appointment reminders given

EQUIPMENT AND SUPPLIES
☐ DME ordered: [list equipment]
☐ Delivery confirmed: [date]
☐ Patient trained on equipment
☐ Supplies sent home: [list]
☐ Vendor contact given

HOME SERVICES
☐ Home health ordered: [agency]
☐ PT/OT/ST home visits: [if needed]
☐ Home health aide: [frequency]
☐ Meals on Wheels: [if needed]
☐ Social work: [referral made]

PATIENT EDUCATION COMPLETED
☐ Diagnosis education
☐ Medication teaching
☐ Diet instructions
☐ Activity restrictions
☐ Wound care if applicable
☐ Warning signs to watch
☐ When to call doctor
☐ When to go to ER
☐ Patient verbalized understanding
☐ Written instructions provided in [language]

DISCHARGE TEACHING DOCUMENTED
☐ Teach-back completed
☐ Family included in teaching
☐ Questions answered
☐ Contact number provided

Note: Placeholder information only