Compliance with emergency department discharge instructions

J Emerg Nurs. 2014 Jan;40(1):51-5. doi: 10.1016/j.jen.2012.10.004. Epub 2013 Jan 7.


Objective: The purpose of this study was to assess patient understanding of ED discharge instructions. It is essential for ED patients to understand their discharge instructions. ED staff face unique challenges when providing information in a distraction-filled, limited-time setting, often with no knowledge of the patient's medical history.

Methods: A qualitative study was conducted with a sample of patients discharged from our emergency department. Data were collected via a semi-structured interview.

Results: A total of 36 patients participated in the study; 29 patients were discharged with a drug prescription, and complementary investigations were scheduled for 3 patients. Most patients were satisfied with the time staff spent explaining the discharge instructions. However, some patients admitted that they did not intend to fully comply with the medical prescription. Nearly half of the patients reported difficulties understanding their drug prescription (the dose or purpose of the treatment). Most patients said that their poor understanding primarily was related to lack of clarity of the written prescription.

Discussion: Even the most comprehensive instructions may not be clearly understood. Despite the patients' high stated levels of satisfaction with communication in the emergency department, more than half of patients failed to comply with important discharge information. Health care staff must be aware of the importance of discharge information. Further research is needed to improve the patient discharge process.

Keywords: Emergency department; France; Health literacy; Patient compliance; Qualitative study.

MeSH terms

  • Adult
  • Communication
  • Drug Prescriptions / statistics & numerical data
  • Emergency Service, Hospital*
  • Female
  • France
  • Hospitals, Teaching
  • Humans
  • Interviews as Topic / methods
  • Male
  • Patient Compliance / statistics & numerical data*
  • Patient Discharge*
  • Patient Satisfaction / statistics & numerical data
  • Qualitative Research
  • Young Adult