Adult Discharge Instructions - Ambulatory Surgery Center of 2026

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  1. Click ‘Get Form’ to open the Adult Discharge Instructions in the editor.
  2. Begin by placing the patient label at the designated area at the top of the form. This helps personalize the instructions for easy reference.
  3. Fill in your doctor’s name and telephone number, along with details about the operative procedure performed. This information is crucial for follow-up communication.
  4. Review the wound care section carefully. Indicate when you may remove your bandage and ensure you understand how to keep it dry.
  5. In the activity section, note any restrictions on driving or operating machinery post-surgery. Fill in when you can resume normal activities.
  6. Complete the diet section by specifying when you can start eating normally and any restrictions on alcohol consumption.
  7. Document any special instructions, medications, and prescriptions given. Ensure all fields are filled accurately for clarity.
  8. Finally, sign and date where indicated to confirm that you have received and understood these instructions.

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This assessment should include the intraoperative history and post-operative instructions, circulatory volume status, respiratory status and cognitive state. Common causes of confusion in the postoperative period include infection, hypoxia, sedatives and other medications such as anticholinergics [22].
Post Operative Instructions You MUST HAVE AN ADULT DRIVE YOU home from the facility. After surgery you MUST HAVE A RESPONSIBLE ADULT STAY WITH YOU a minimum of 24 hours. The effects of anesthesia can persist for 24 hours. DRINK fluids to help rid the body of the drugs used in surgery. Diet may be as tolerated.
Your discharge plan should include instructions on how to take care of your wound and dressings. It may also include information about medicines. For example, what medicines you should take for pain and when to resume your other medicines.

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Discharge Planning After Surgery Your discharge plan may include instructions on how to take care of the wound dressings, what medications to take, what exercises to do, and other home care instructions.
A written transition plan or discharge summary is completed and includes diagnosis, active issues, medications, services needed, warning signs, and emergency contact information. The plan is written in the patients language.
Switch to non-prescription pain medications like Tylenol as soon as tolerated. Stay active and avoid prolonged periods of rest during the day. This decreases your risk of blood clots. Avoid strenuous exercise or lifting weight heavier than 20 lbs.
Use the Admission/Discharge/Transfer (ADT) Navigator for discharging patients. Next click on the Discharge tab: Start with the Problem List subtab. Review the problems pertinent to and added on this hospitalizations.
Preparing for Discharge Make sure that family members or anyone assisting you understands the type of care you will need, what to look for if your condition changes, when to call for help and whom to contact. Make sure you know how to operate any equipment or devices that are going home with you.

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