Discharge summary

  • Compulsory
  • Even for left at own risk patients

Certificates

Worker’s compensation certificate

Medical Certificate

Return to RACF form

Patient information

  • Ensure patient has understood verbal instructions
  • Ask them to repeat back to you
  • Patient information leaflets:
    • Provision of written information is always preferred to verbal information alone
    • Write out medication regimes in plain language
    • Give patient handout leaflets
    • Printed common presentations on the wall in the Fast Track corridor
  • Use reputable websites, e.g.:
      • Emergency Care Institute of NSW (ECI) www.ecinsw.com.au
        • (the 20 most common ED discharge diagnoses plus much more! )
      • RCH for paediatrics
      • UpToDate and eTG for less common conditions

Prescriptions

  • with a valid prescriber number for medications on the PBS (particularly for patients who are pensioners or on other benefits)

Discharge scripts

If you are not familiar with writing scripts, check in with a senior doctor the first few times.

  • For dosage information
    • Use Therapeutic Guidelines (eTG), Australian Medicines Handbook (AMH) or AMH paediatric dosing companion
  • Use MIMS for pack sizes, PBS indications, authority.
    • Avoid relying on MIMS for dosage information, particularly for antibiotics.
  • Be especially careful with narcotic scripts
    • Always document that you have issued a script for e.g. oxycodone in the medical record, in case the pharmacy rings up later to check it’s a valid script. Include dosage and quantity in your notes.
  • Poorly written scripts:
    • The pharmacy may refuse to dispense the script, and your patient might miss out
    • Non-PBS compliant scripts can mean the patient pays full-price, which can be very expensive.
  • Both copies for the patient
  • Put the script pad away in its slot when you have finished

S8 scripts

  • Handwritten by the prescriber
  • Patient’s full name and address
  • Only one medication per script;
  • Medication quantity must be in both words and numbers.
    • E.g. 20 (twenty) tablets
    • In other Australian  states may also be required to write the strength in words and numbers
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