8.5 Discharge Teaching and Home Adherence

Discharge Teaching That Supports Reevaluation

Discharge is a high-risk moment for wound-care errors. The patient leaves a setting with staff, supplies, equipment, and routine monitoring and moves to a home, facility, or community setting with different support. WCC education questions often ask what must be taught before discharge or what to do when a home plan is not feasible.

The safest answer does not assume that a written order automatically becomes home care. It checks whether the patient or caregiver can perform the plan, obtain supplies, manage devices, recognize warning signs, and return for reevaluation. It also checks whether the receiving team has the same information.

Applied scenario: a patient is discharged with a pressure injury and a support surface recommendation, but the home bed will not arrive for several days. The exam answer should not ignore the gap. It should communicate the barrier, coordinate with case management or the receiving team, teach interim pressure-relief actions within the plan, and document the discharge risk.

Another scenario: a patient has a venous ulcer dressing plan and ordered compression but says supplies will be mailed next week. The WCC-style response checks what supplies are needed now, whether the patient has enough to bridge to the next visit, and who can help obtain them. A plan that cannot be performed is not complete education.

Discharge teaching should include escalation language. The patient should know what changes require calling the wound clinic, primary provider, home health nurse, or emergency service depending on severity and local instructions. Examples include fever, spreading redness, sudden pain, foul drainage, bleeding, rapidly increased swelling, dressing saturation, or device injury.

Home adherence also depends on routine. A patient may need to schedule dressing changes around dialysis, work, bathing, caregiver availability, transportation, or medication timing. The exam favors realistic planning. Saying do this twice daily is weak if the patient cannot identify when and how it will happen.

Exam trap: do not discharge education to a caregiver who has not demonstrated the skill when the caregiver is expected to perform it. Another trap is assuming home health will solve everything without confirming referral, orders, timing, and supply responsibility according to facility process.

Use this discharge sequence:

• Confirm the plan and who is responsible for each step.
• Teach and verify dressing, device, and prevention actions.
• Confirm supplies, equipment, and follow-up.
• Identify transportation, cost, language, or caregiver barriers.
• Give clear warning signs and contact instructions.
• Communicate with the receiving team and document.

WCC candidates should remember that Education and Re-Evaluation are connected. Discharge teaching is only successful if it sets up safe home performance and meaningful follow-up data.