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Discharge of older patients with chronic diseases: What nurses do and what they record. An observational study

Author

Listed:
  • Gabriella Facchinetti
  • Andrea Ianni
  • Michela Piredda
  • Anna Marchetti
  • Daniela D’Angelo
  • Ivziku Dhurata
  • Maria Matarese
  • Maria Grazia De Marinis

Abstract

Aims and objectives To describe which nursing activities are observed during the discharge of older patients with chronic diseases and to investigate the consistency between the nursing activities actually observed and those documented. Background The discharge from hospital of older patients with chronic diseases is a critical transition that can lead to dissatisfaction, delays in discharge, re‐admission, adverse events and increased mortality. Although nurses’ interventions during discharge are important for patient outcomes, little is known about the nursing activities actually performed as compared with those documented. Design An observational study of the nursing activities performed during patients’ discharge and a retrospective audit of the nursing records of the same patients and nurses. Methods Structured nonparticipant observations were conducted of the activities performed by nurses at discharge. A retrospective audit of the nursing records relating to patient discharge, including the nursing diary and the assessment of critical issues at hospital discharge, was also conducted. The STROBE guidelines were followed (See Supporting Information Appendix S2). Results During hospital discharge of 102 patients, 1,224 nursing activities were observed. The number of activities was not related to patients’ age, gender and educational level, nor to nurses’ postgraduate education. Statistically significant correlations emerged between the number of activities observed and the nurses’ work experience. Conclusions A predefined discharge plan guiding nurses’ activities during discharge would enable them to respond better to the care needs of elderly patients. Relevance to clinical practice Results from the study could help clinical nurses to address care priorities of patients at discharge, by using appropriate plans and checklists and improving recording rates. Novice nurses should be supported when caring for elderly patients with chronic disease at discharge.

Suggested Citation

  • Gabriella Facchinetti & Andrea Ianni & Michela Piredda & Anna Marchetti & Daniela D’Angelo & Ivziku Dhurata & Maria Matarese & Maria Grazia De Marinis, 2019. "Discharge of older patients with chronic diseases: What nurses do and what they record. An observational study," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(9-10), pages 1719-1727, May.
    • Handle: RePEc:wly:jocnur:v:28:y:2019:i:9-10:p:1719-1727
    DOI: 10.1111/jocn.14782
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    References listed on IDEAS

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    1. Maria Grazia De Marinis & Michela Piredda & Maria Chiara Pascarella & Bruno Vincenzi & Fiorenza Spiga & Daniela Tartaglini & Rosaria Alvaro & Maria Matarese, 2010. "‘If it is not recorded, it has not been done!’? consistency between nursing records and observed nursing care in an Italian hospital," Journal of Clinical Nursing, John Wiley & Sons, vol. 19(11‐12), pages 1544-1552, June.
    2. Louise Bélanger & Anne Bourbonnais & Roxanne Bernier & Monique Benoit, 2017. "Communication between nurses and family caregivers of hospitalised older persons: a literature review," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(5-6), pages 609-619, March.
    3. Fatima Yatim & Paula Cristofalo & Marie Ferrua & Anne Girault & Marilene Lacaze & Mario Di Palma & Etienne Minvielle, 2017. "Analysis of nurse navigators’ activities for hospital discharge coordination: a mixed method study for the case of cancer patients," Post-Print hal-01446306, HAL.
    4. Jane M Nosbusch & Marianne E Weiss & Kathleen L Bobay, 2011. "An integrated review of the literature on challenges confronting the acute care staff nurse in discharge planning," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(5‐6), pages 754-774, March.
    5. Lisbeth Fagerström & Paula Vainikainen, 2014. "Nurses’ Experiences of Nonpatient Factors That Affect Nursing Workload: A Study of the PAONCIL Instrument’s Nonpatient Factors," Nursing Research and Practice, Hindawi, vol. 2014, pages 1-9, June.
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