Patients Understanding of Discharge Instructions in the Emergency Department of a Tertiary Care Hospital in Karachi, Pakistan
Good understanding of discharge instructions is an important part of patient care. It includes working diagnosis, treatment plan, self-care, follow up referrals and addressing any concerns. The objective of this study was to assess patients understanding of discharge instructions.
Methodology
A prospective, observational study conducted by telephonic interviews of randomly selected patients discharged from the emergency department of Aga Khan University Hospital from January 2013 to June 2013. Four independent emergency physicians listened to those recordings and scored patient understanding as no understanding, partial understanding or complete understanding.
Results
A total of 202 patients were interviewed out of which 179 (90.9 %) think they completely understand the discharge instructions. 101 patients (88.6 %) said that the verbal instructions were difficult to understand and only 59.6 % have read the discharge summary. Ninety patients (70.3 %) had complete understanding of their diagnosis however only one fourth knew the expected disease course. For medications instructions it was found that 89 patients (81.7 %) knew the dose, 84 (79.2 %) the duration and 76 (68.5 %) the purpose; however 84 patients (80.0 %) were unaware of side effects. Around half of the patients (47.9 %) were unaware of any self-care required and 44 patients (35.5 %) had no understanding regarding their follow up referral. Only 27 patients (21.6 %) knew return to emergency instructions.
Conclusion
Patients appear to be unaware of their lack of knowledge about discharge instructions. Deficits were more with medications side effects and return to emergency instructions.