Clinical nurses' perspectives on discharge practice changes from participating in a translational research study

Bobay, Kathleen L.; Conway–Phillips, Regina; Hughes, Ronda G.; Costa, Linda L.; Bahr, Sarah J.; Siclovan, Danielle M.; Nuccio, Susan; Weiss, Marianne

doi:10.1111/jonm.13171

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…The alert cards were paper‐based, and in one study some patients took a photo of the paper‐based card on their phones (Kapil et al, 2016; Keng et al, 2015). The final type 1 intervention was READI, where patients used a paper‐based assessment to report their discharge readiness 4 h prior to discharge; and nurses were provided with instructions on how to respond to patient scores (Bobay et al, 2021; Weiss et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

Patient‐mediated interventions in hospital: A systematic review

Tobiano

Roberts

Muir

et al. 2022

Journal of Advanced Nursing

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Aims To describe the characteristics of hospital‐based, patient‐mediated interventions and their impact on patient, clinician and organization outcomes. Design Systematic review. Data Sources Health literature databases (MEDLINE, CINAHL and EMBASE) were searched in August 2021. Backward and forward citation searching was conducted. Review Methods Studies investigating patient‐mediated interventions, targeted at adult hospitalized patients were eligible. Data were extracted related to study and intervention characteristics. Narrative synthesis was used to understand intervention impact on patient, clinician and organization outcomes (as per a framework). Methodological quality was assessed using the Mixed Methods Assessment Tool. Results Thirty‐three studies, reporting 18 interventions, were included. Twelve interventions prompted patients to report health information about their own health/needs/concerns and six interventions encouraged patients to provide feedback about clinical practice. Across all interventions, there was evidence that patients used patient‐mediated interventions and that they may improve patient communication. Healthcare professional outcomes were mixed for actual/intended use, acceptability and usefulness of interventions; yet there was some evidence of healthcare professional behaviour change. Interventions that encouraged patients to report health information about their own health/needs/concerns appeared more successful than other types of interventions. Conclusions There is some evidence that hospital‐based patient‐mediated interventions may influence patient communication and healthcare professional behaviour. Patient‐mediated interventions that encourage patients to report patient data before a clinical encounter may be more impactful than interventions that encourage patient feedback during or post‐encounter. Impact To date, most patient‐mediated intervention research has been conducted in primary care settings; we uncovered the types of patient‐mediated interventions that have been trialled in hospitals. We found that patient communication and healthcare professional behaviour may be influenced by these patient‐mediated interventions. Future researchers could explore the suitability and effectiveness of a wider range of hospital‐based patient‐mediated interventions. No patient or public contribution There was no funding to remunerate a patient/member of the public for this review.

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Section: Resultsmentioning

confidence: 99%

Patient‐mediated interventions in hospital: A systematic review

Tobiano

Roberts

Muir

et al. 2022

Journal of Advanced Nursing

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“…The implementation process was evaluated by Costa et al [ 106 ]. As part of the implementation study, nurses were interviewed in focus groups and their involvement in the discharge readiness assessment resulted in improved and earlier awareness of patients' discharge needs and greater patient/family involvement [ 107 ]. This result indicates that discharge readiness assessed from patients and nurses' points of view can be useful in avoiding negative patient outcomes and reinforcing the RHDS as a useful instrument for this purpose.…”

Section: Discussionmentioning

confidence: 99%

Theoretical concepts and instruments for measuring hospital discharge readiness: A scoping review

Feldbusch,

Schmidt,

Steeb

et al. 2024

Heliyon

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“…However, the nurses reported that a benefit of implementing the structured discharge readiness assessment was improved contribution to and communication with the care team in discharge planning and decision-making. 43 Fourth, we may not have accounted adequately for factors that increase the likelihood of HHC referral; for example, we included an indicator for medical or surgical case type but did not have data on the need for wound care, a common reason for HHC referral. Lastly, our study sampled only patients with Medicare insurance receiving care in Magnet facilities, limiting generalizability.…”

Section: Discussionmentioning

confidence: 99%

“…Third, while the READI study protocol included instructions to the discharging nurse to use the assessment in planning discharge care, no information was collected on communication and use within the multidisciplinary team process. However, the nurses reported that a benefit of implementing the structured discharge readiness assessment was improved contribution to and communication with the care team in discharge planning and decision-making 43 . Fourth, we may not have accounted adequately for factors that increase the likelihood of HHC referral; for example, we included an indicator for medical or surgical case type but did not have data on the need for wound care, a common reason for HHC referral.…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in Home Health Referral Among Adult Medicare Patients

Yakusheva,

Lee,

Keller

et al. 2023

Medical Care

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Background: Home health care (HHC) services following hospital discharge provide essential continuity of care to mitigate risks of posthospitalization adverse outcomes and readmissions, yet patients from racial and ethnic minority groups are less likely to receive HHC visits. Objective: To examine how the association of nurse assessments of patients’ readiness for discharge with referral to HHC services at the time of hospital discharge differs by race and ethnic minority group. Research Design: Secondary data analysis from a multisite study of the implementation of discharge readiness assessments in 31 US hospitals (READI Randomized Clinical Trial: 09/15/2014–03/31/2017), using linear and logistic models adjusted for patient demographic/clinical characteristics and hospital fixed effects. Subjects: All Medicare patients in the study’s intervention arm (n=14,684). Measures: Patient’s race/ethnicity and discharge disposition code for referral to HHC (vs. home) from electronic health records. Patient’s Readiness for Hospital Discharge Scale (RHDS) score (0–10 scale) assessed by the discharging nurse on the day of discharge. Results: Adjusted RHDS scores were similar for non-Hispanic White (8.21; 95% CI: 8.18–8.24), non-Hispanic Black (8.20; 95% CI: 8.12–8.28), Hispanic (7.92; 95% CI: 7.81–8.02), and other race/ethnicity patients (8.09; 95% CI: 8.01–8.17). Non-Hispanic Black patients with low RHDS scores (6 or less) were less likely than non-Hispanic White patients to be discharged with an HHC referral (Black: 26.8%, 95% CI: 23.3–30.3; White: 32.6%, 95% CI: 31.1–34.1). Conclusions: Despite similar RHDS scores, Black patients were less likely to be discharged with HHC. A better understanding of root causes is needed to address systemic structural injustice in health care settings.

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Clinical nurses' perspectives on discharge practice changes from participating in a translational research study

Cited by 5 publications

References 23 publications

Patient‐mediated interventions in hospital: A systematic review

Patient‐mediated interventions in hospital: A systematic review

Theoretical concepts and instruments for measuring hospital discharge readiness: A scoping review

Racial and Ethnic Disparities in Home Health Referral Among Adult Medicare Patients

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