Glucose Monitoring and Discharge Planning
ÎTo ensure smooth transition to outpatient care, the Agency for Healthcare Research and Quality recommends that, at a minimum, discharge plans include:
> Medication reconciliation: The Patient's medications must be cross-checked to ensure that no chronic medications were stopped and to ensure the safety of new prescriptions.
> Whenever possible, fill prescriptions for new or changed medications and review with the patient and family at or before discharge.
> Structured discharge communication: Information on medication changes, pending tests and studies, and follow-up needs must be accurately and promptly communicated to outpatient physicians.
> Appointment-keeping behavior is enhanced when the inpatient team schedules outpatient medical follow up prior to discharge. Ideally the inpatient care providers or case managers/discharge planners will schedule follow-up visit(s) with the appropriate professionals, including the primary care provider, endocrinologist, and diabetes educator.
> Discharge summaries should be transmitted to the primary physician as soon as possible after discharge.
ÎIt is important that patients be provided with appropriate durable medical equipment, medication, supplies, and prescriptions at the time of discharge in order to avoid a potentially dangerous hiatus in care. These supplies/prescriptions should include:
> Insulin (vials or pens) if needed > Syringes or pen needles (if needed) > Oral medications (if needed) > Blood glucose meter and strips > Lancets and lancing device > Urine ketone strips (type 1) > Glucagon emergency kit (insulin-treated) > Medical alert application/charm
8
