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INFECTION PREVENTION AND CONTROL DISCHARGE / TRANSFER COMMUNICATION FORM To be completed on discharge/transfer to other care or shared housing facilities, including care homes and sheltered housingPatient
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How to fill out discharge transfer home version

01
To fill out the discharge transfer home version, follow these steps:
02
Gather all relevant information such as patient's personal details, medical history, current medications, and treatment received during the hospital stay.
03
Begin by providing the patient's full name, date of birth, and contact information in the designated fields.
04
Specify the date of admission and discharge from the hospital.
05
Write down the primary diagnosis or reason for hospitalization.
06
Include any secondary diagnoses or conditions that were identified during the hospital stay.
07
Document all procedures, surgeries, or treatments received along with their dates, duration, and outcomes.
08
List all prescribed medications, including dosage instructions, frequency, and duration.
09
Mention any allergies or adverse drug reactions experienced by the patient.
10
Provide details of any follow-up appointments or recommended care instructions upon discharge.
11
Sign and date the discharge transfer form to validate the information provided.
12
Make copies of the completed form for the patient, the primary care physician, and any other healthcare providers involved in the patient's care.
13
Submit the original form to the appropriate medical records department for filing and documentation.

Who needs discharge transfer home version?

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The discharge transfer home version is needed by patients who have completed their hospital stay and are preparing to go home.
02
It is also required for patients who are transferring to another healthcare facility or transitioning to a different level of care.
03
Additionally, this form is necessary for medical professionals involved in the patient's care, including primary care physicians, specialists, and other healthcare providers.

What is Discharge, Transfer, Home. Version: 3 Adopted by: Patient ... Form?

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The discharge transfer home version is a form used to document the transfer of a patient from a healthcare facility to their home, detailing the patient's health status and any ongoing care requirements.
Healthcare providers, including hospitals and nursing facilities, are required to file the discharge transfer home version for patients being discharged to ensure proper continuation of care.
To fill out the discharge transfer home version, providers must enter patient identification information, details of the discharge diagnosis, instructions for at-home care, and any follow-up appointments needed.
The purpose of the discharge transfer home version is to provide a comprehensive summary of the patient's care and needs, ensuring a smooth transition from a healthcare facility to home.
Required information includes the patient's personal details, medical history, the reason for discharge, medications, follow-up care instructions, and emergency contact information.
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