Patient Safety Tool: Medication History/Discharge Order/Patient Instructions Form From Kearney County Health Services

Kearney County Health Services, based in Minden, Neb., provided a medication history/discharge order/patient instructions form for use in a medication reconciliation toolkit developed by the Critical Access Hospital Network and available on the website of the Nebraska Hospital Association.

 

The two-page form addresses several critical components of a safe patient discharge, including medications to continue at home, new medications, restrictions on activities, restrictions on diet and guidelines for wound/incision care.

 

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Down the discharge form (doc) for adaptation and use in your facility.


Learn more about the Critical Access Hospital Network medication reconciliation toolkit.

 

Note: View our database providing 90-plus reports that link to free, downloadable and adaptable tools for use in surgery centers, hospitals and other organizations by clicking here.

 

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