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IOIGN 65 CLEU\/\ufb01'NO . \u2019 Signature of Nurse Responsible for Care \nName of Discharge Nurse: S. &y KN 7\u2018_\u2018__:[_)_?,55_\u201d_.5\u2018\u201c Time ; \n- gl.\u00e9nature ) &Q\/\\\/\\ am: P ; : \ne 1] 310 \n. night: i\/ | [3 (IO \\ \nPatlent handlmg- risk assessed \nCorrect techniques for moving patient adopted and specified on Handling Assessment Form \nPatient is safely recovered from procedure as evidenced by stable vital signs and'is awake 10 \nand orientated CD S \n. \nT L T P B OO X YRS I P T TR Pt ewpeeys o g \nPatient does not appear to distressed by pain i \n(level of pain recorded on MEWS chart & record as variance if pain score > 4) Q) CS \nPatient does not appear to distressed by nausea \nB - {Record a variance nausea score > 1(0-2 score) on 2 or more occasions in 4 hour period) QQ \n1:-) [ L) - Colour, warmth, sensation and movement to operative limb satisfactory (if applicable) QO \nPatient is tolerating fluids and diet without nausea . &) t\u00a7 ; \n. Cannula \/ electrodes are removed (document time of cannula removal) To = \n: I3 \nPatient has passed urine 1(6 i \nOperative site is clean and dry and ,does not appear to be excessively swollen QO ILVS & \nAnti-embolic devices commenced (For VTE Prophylaxis) 5 \nPlease tick if applicable: Anti-embolism stockings ___\\___(._Not Appllcable _______ @ ro'j . \nPatient has returned to usual levels of independence \nPatient seen by Consultant post operatively \nPatient demonstrates understanding of written \/ verbal discharge advice \n(including instructions for removal .of skin closure) \nDischarge drugs given to patient \n(own medication returned and recorded where appropnate on page 8) \ns \n- .| Dressings and \/or equipment supplied (please specify): \nGP letter (clinical summary) produced from PIMS and give to patient \n~+1 Clinical coding summary of discharge completed (NHS \/ ECN patients only) \nConsent obtained to forward clinical summary to GP \u2018 \u2018 \nFollow-up appointment given to patient (if applicable) \nInformation about patient reported outcome meaures given (if applicable) \n* Valuables returned to patient \nX-Rays returned to patient \nEREB6]) 515 |6 ) 616 [klslslblele el 6\u2018 \nDate \/ Time . Multidisciplinary Evaluation Signature \/ Designation \n+ \nab + \nDate \/ Time \" Variance'\/ Action taken \/ Outcome Signatdre\u2018 \/ Designation \nNuffield Health Day and Overnight Stay Care Record . -17 - T w2 January 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