From Clinic to Recovery · First Edition
Appendix A — Personal Discharge Instruction Card
Dr. Tamer Rushdy Elalfy · 1 min read
Appendices
To be completed by the surgical team, explained to the patient with teach-back, and given to the patient at discharge. The card records the individual plan where it differs from the general timelines in the patient guide. [Pilot template: the final version will match the layout of the patient guides.]
| About my operation | |
| My name | |
| Operation done | |
| Date of operation | |
| My surgeon | |
| Who to contact | |
| Clinic phone number and hours | |
| Out-of-hours number | |
| Wound, drains, and stitches | |
| Dressing: what to do | |
| I can shower from | |
| Stitches or clips removed on | |
| Drain care (if any) | |
| My medicines | |
| Pain medicines: what to take, and when to stop | |
| Medicines to stop | |
| Medicines to continue | |
| Medicines to restart, and when | |
| Blood-thinning injections until | |
| My activity | |
| Walking | |
| Driving from | |
| Lifting: no more than … until … | |
| Work or study from | |
| Prayer postures (standing, bowing, prostration) from | |
| Travel and flying from | |
| Follow-up | |
| Appointment: date and place | |
| Results: how and when I will get them | |
| My warning signs | |
| GREEN: expected. What helps: | |
| AMBER: call the clinic today if: | |
| RED: go to the emergency department now if: |
Completed by: ____________________ Role: ______________ Date: ____________