Date
of Last Review 5/19/08
SME: Associate Director of Nursing
Date of Last Review: October 10,2011
SME: Chief Nursing Officer
SME: changed to: Medical Director-October 10,2011
The
Statement
of Patient Leaving Against Medical Advice
form is used for patients who want to be discharged even though they have been
told they are in danger of adverse medical effects (mental or physical) by being
discharged.
This table describes what staff does when the patient is discharged against medical advice:
Stage |
Person Responsible |
Description | ||||||||
1 |
Staff |
Obtains a completed, signed Request for Release letter from the patient/parent/guardian, or documents the refusal to sign with two witnesses | ||||||||
2 |
The attending physician |
No longer than 4 hours after completion of the Request for Release does the following:
| ||||||||
3 |
Staff |
Performs the following:
| ||||||||
4 |
Discharge staff |
Discharges the patient | ||||||||
5 |
Head nurse or designee |
Completes and processes a Patient Care Variance report |
The physician provides the patient with appropriate prescriptions for the interim between discharge and the first aftercare appointment or two weeks.
A patient is discharged against medical advice if s/he does not return from an authorized release within 48 hours of the time limit on the release unless the physician extends that time. If the patient does not return, the attending physician notes in the medical record that the patient was discharged against medical advice.
Statement of Patient Leaving Against Medical Advice
Patient Care Variance Report form
Joint Commission: Provision of Care, Treatment, and Services
Center of Medicare/Medicaid Conditions of Participation for Psychiatric Hospitals
If you have questions regarding the content of this site please contact the Policy and Procedure Committee. If you experience any technical problems please contact the MIS Department.
