Active Life: a project for a safe hospital-community transition after arthroplasty

Abstract

Objective: To define the criteria for the continuity of care to elderly people submitted to arthroplasty. Method: This is a qualitative study, inserted in the constructivist paradigm, whose methodological option fell on research-action. The participants were the health professionals of an orthopedic service and of the community care teams in the area of the hospital. Results: The different techniques allowed us to identify the difficulties in the safe transition from the hospital to the community. At this level, two categories of criteria for continuity of care emerged: criteria associated with the risk of ineffective management of the therapeutic regimen, and criteria associated with the knowledge and level of competence of the informal caregiver. Final Considerations: An elderly person undergoing arthroplasty (hip or knee) has functional alterations that affect their capacity for self-care and may lead to dependence, our findings allowed the design of an algorithm to facilitate clinical decision making and promote a safe hospital-community transition.

Transitional care to caregivers of dependent older people: an integrative literature review

“…The situation is even more difficult because organizations remain centered at sick people's needs rather than caregivers' (12) , and the clinical approach of professionals during the planning process is oriented to the former and the changes that dependence brings to their self-care. In this scenario, caregivers are seen as a resource to solve the problem (12,15) instead of care receivers. A ILR that was excluded from the sample for not meeting one of the predefined eligibility criteria (it examined caregivers of people 18 years old or older) identified a set of needs of caregivers of dependent people that included: need for knowledge and learning; need for time to carry out varied activities; emotional and interpersonal needs; social needs, support network for caregivers, financial and structural support; information and communication (1) .…”

“…Even studies on care continuity lack information about what the needs related to transitional care to caregivers are, which allows to corroborate the statement that the focus of interventions remains on older people, although it is known that caregivers are crucial in the process of transition to the home environment (12) . To change this situation, it is necessary that the focus of the planning of hospital discharge and return to home includes caregivers and the evaluation of their needs, to guarantee a safe transition from hospital to community for both dependent older people and caregivers (15)(16) .…”

“…People admitted to hospitals are vulnerable to experiencing care continuity loss when there are alterations in their health condition or when they are transferred between care institutions (16) . This poses a remarkable challenge for health systems to guarantee the execution of a set of actions whose objective is ensuring care continuity between different care levels (17) , which helps in the process of adapting to the new care reality (15)(16)(17) . Additionally, care continuity contributes to decreasing costs and is an adequate strategy and a policy to be replicated by health services (16) .…”

Autopercepção Dos Estudantes Sobre a Participação Em Atividades Extracurriculares De Transferência De Conhecimento: O Exemplo Da Transição Segura

“…Os achados apontam para ganhos no envolvimento no projeto TS, com uma adequada integração teórico-prática potenciada por novas aprendizagens, em contexto, sobre intervenções que solucionam problemas, melhoram cuidados e reduzem o tempo de internamento, promovendo a articulação entre níveis de cuidados (Ferreira et al, 2019). O facto de se criar uma experiência eficaz de aprendizagem ajuda na construção do conhecimento de enfermagem e potencialmente contribui para a saúde da comunidade (Jansen et al, 2015;Jong, Meijer, Schout , & Abma, 2018;Long, Bischoff, & Aduddell, 2018) e pode potenciar os resultados de aprendizagem do próprio EC.…”

“…Conhecimento para a resolução de problemas dos diferentes serviços de internamento hospitalar para aumentarem o conhecimento e capacitarem os doentes e as suas famílias no processo de transição do hospital para a comunidade, favorecendo circuitos de comunicação que promovam a continuidade de cuidados, diminuindo os reinternamentos após a alta hospitalar, e promovendo a reabilitação e a inserção na comunidade (Paniagua et al, 2018;Ferreira et al, 2019).…”