Discharge

Quality statement 8

Following recovery and before discharge, the patient is advised verbally and in writing about the preliminary outcomes of the colonoscopy, the nature of any therapeutic interventions or adverse events, when to resume regular activities and medicines, and arrangements for medical follow-up. The patient is discharged into the care of a responsible adult when it is safe to do so.

Purpose

To ensure patients recover and are discharged safely with available information about the outcomes of the colonoscopy and arrangements for follow-up.

For consumers

  • After your colonoscopy, you will be cared for while you recover from the sedation. Before you go home, a doctor or nurse will tell you what happened during the colonoscopy, whether any polyps or other tissue was removed and whether there were any problems during the procedure. They will tell you about any arrangements or follow-up appointments you need to make. You may find it difficult to remember this information so it will be also be given to you in writing.

  • You will be able to go home once your doctor or nurse is satisfied that you have recovered from the sedation. You should not drive and will need an adult to accompany you home. It is also recommended that you have someone stay with you on the night after the colonoscopy. If this is not possible, discuss this with your doctor before you have the colonoscopy.

  • You will be given written instructions on how to care for yourself when you go home and when to start your regular medicines and diet again. You will be provided with information about what to do if you have any problems after going home including a phone number that you can call after hours.

For clinicians

Before discharge, the responsible clinician or their delegate should talk to the patient and briefly describe what happened during the colonoscopy, whether the colonoscopy was completed satisfactorily, initial observations, whether biopsies or polypectomies were performed, and if any adverse events occurred. Advise patients of any arrangements for follow-up medical consultation and when final results and recommendations will be provided to them and their referring clinician.

Ensure patients are discharged by authorised clinical personnel into the care of a responsible adult, once satisfactory discharge criteria are met. Provide instructions about early post-procedure care and resumption of normal activities, including making legally binding decisions, operating machinery and resuming regular medication. Advise patients of what to do if they experience symptoms suggesting a complication of the colonoscopy, and provide them with specific contact details for obtaining appropriate advice. Any information given verbally about the procedure or post-discharge should also be provided in written format. Consider admission for a patient at high risk of an adverse outcome if they are to be discharged without adequate adult support at home, or who is otherwise not suitable for discharge.

For health service organisations

Ensure that policies and procedures for monitoring, supervising and discharging patients align with current recommendations for post-operative care following anaesthesia (for example ANZCA guidelines for perioperative care [PS15]). Ensure that procedures are in place for discharging patients into the care of a responsible adult, and that written instructions are provided about early post-procedure care and resumption of normal activities including medicines. Ensure that there is a response plan for patients in the event of problems arising post-discharge, and that the discharge information includes specific health service contact details after hours. Policies should allow for overnight admission if needed for patients who have comorbidities and cannot be cared for adequately at home in the immediate period post-discharge or who do not meet discharge criteria (as appropriate to the type of facility).

For consumers

  • After your colonoscopy, you will be cared for while you recover from the sedation. Before you go home, a doctor or nurse will tell you what happened during the colonoscopy, whether any polyps or other tissue was removed and whether there were any problems during the procedure. They will tell you about any arrangements or follow-up appointments you need to make. You may find it difficult to remember this information so it will be also be given to you in writing.

  • You will be able to go home once your doctor or nurse is satisfied that you have recovered from the sedation. You should not drive and will need an adult to accompany you home. It is also recommended that you have someone stay with you on the night after the colonoscopy. If this is not possible, discuss this with your doctor before you have the colonoscopy.

  • You will be given written instructions on how to care for yourself when you go home and when to start your regular medicines and diet again. You will be provided with information about what to do if you have any problems after going home including a phone number that you can call after hours.

For clinicians

Before discharge, the responsible clinician or their delegate should talk to the patient and briefly describe what happened during the colonoscopy, whether the colonoscopy was completed satisfactorily, initial observations, whether biopsies or polypectomies were performed, and if any adverse events occurred. Advise patients of any arrangements for follow-up medical consultation and when final results and recommendations will be provided to them and their referring clinician.

Ensure patients are discharged by authorised clinical personnel into the care of a responsible adult, once satisfactory discharge criteria are met. Provide instructions about early post-procedure care and resumption of normal activities, including making legally binding decisions, operating machinery and resuming regular medication. Advise patients of what to do if they experience symptoms suggesting a complication of the colonoscopy, and provide them with specific contact details for obtaining appropriate advice. Any information given verbally about the procedure or post-discharge should also be provided in written format. Consider admission for a patient at high risk of an adverse outcome if they are to be discharged without adequate adult support at home, or who is otherwise not suitable for discharge.

For health service organisations

Ensure that policies and procedures for monitoring, supervising and discharging patients align with current recommendations for post-operative care following anaesthesia (for example ANZCA guidelines for perioperative care [PS15]). Ensure that procedures are in place for discharging patients into the care of a responsible adult, and that written instructions are provided about early post-procedure care and resumption of normal activities including medicines. Ensure that there is a response plan for patients in the event of problems arising post-discharge, and that the discharge information includes specific health service contact details after hours. Policies should allow for overnight admission if needed for patients who have comorbidities and cannot be cared for adequately at home in the immediate period post-discharge or who do not meet discharge criteria (as appropriate to the type of facility).

Read Quality Statement 9 - Reporting and follow-up