Development, validation and testing of a nursing home to emergency room transfer checklist

Tsai, Hsiu‐Hsin; Tsai, Yun‐Fang

doi:10.1111/jocn.13853

Cited by 13 publications

(8 citation statements)

References 25 publications

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“…The delivery rate of 14 measures achieved a statistically signi cant improvement. These ndings are similar to those of other studies [25]. Previous prone position studies or training usually aim to prevent one particular complication or to introduce the prone positioning method [7,14,15], but not analyze the high-risk factors and measures during each stage of prone positioning.…”

Section: Discussionsupporting

confidence: 86%

An Evidence-based General Anesthesia and Prone Position Nursing Checklist: Development and Testing

Cai

Huang

2021

Preprint

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Background and Aim: Prone positioning during general anesthesia is one of the most difficult practices for the perioperative nurse. Patients in this position are vulnerable to many preventable complications. However, no studies have developed an evidenced-based tool to improve nursing practice during general anesthesia and prone positioning. This study aimed to develop and test a general anesthesia and prone position nursing checklist for use by the circulating nurse. Methods: The WHO checklist development model and evidence-based methods guided the checklist development process. A prospective pre-post study was performed between November 2020 and March 2021. We prospectively observed circulating nurses that attended to prone general anesthesia during posterior lumbar spine surgery for three months before and after the introduction of the general anesthesia and prone position nursing risk checklist. The main outcomes were successful delivery of essential prone positional nursing practices during each surgery and the nurse's opinion of the checklist’s efficacy and utility. Results: A general anesthesia and prone position nursing checklist comprised of 4 pause points and 22 necessary nursing practices was developed. Seventy-two nurses participated in this study. Use of the checklist significantly increased the average performance of essential practices during each surgery from 72.72% to 95.45%. Three measures had a compliance rate of 100%. The delivery rate of 14 measures was significantly improved, 91.7% of nurses considered the checklist easy to use, and 94.4% nurses would want the checklist to be used if they underwent a prone position and general anesthesia operation. Conclusions: A general anesthesia and prone position nursing checklist was developed. The instrument was found to be an effective and positively received tool for facilitating key measures of prone positioning during nursing care, translating evidence into practice, and standardizing the nursing process.

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Section: Discussionsupporting

confidence: 86%

An Evidence-based General Anesthesia and Prone Position Nursing Checklist: Development and Testing

Cai

Huang

2021

Preprint

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“…This idea was also discussed in other studies [33,64]. Standardized transfer forms-as one part of these standards-were already developed in some countries [65,66]; however, the use of them is just recommended and not obligatory. For a successful implementation of standards, qualified nursing staff is needed.…”

Section: Approaches To Reduce Hospital Transfersmentioning

confidence: 97%

Paramedics’ Perspectives on the Hospital Transfers of Nursing Home Residents—A Qualitative Focus Group Study

Pulst

Fassmer

Hoffmann

et al. 2020

IJERPH

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Emergency department (ED) visits and hospital admissions are common among nursing home residents (NHRs). Little is known about the perspectives of emergency medical services (EMS) which are responsible for hospital transports. The aim of this study was to explore paramedics’ experiences with transfers from nursing homes (NHs) and their ideas for possible interventions that can reduce transfers. We conducted three focus groups following a semi-structured question guide. The data were analyzed by content analysis using the software MAXQDA. In total, 18 paramedics (mean age: 33 years, male n = 14) participated in the study. Paramedics are faced with complex issues when transporting NHRs to hospital. They mainly reported on structural reasons (e.g., understaffing or lacking availability of physicians), which led to the initiation of an emergency call. Handovers were perceived as poorly organized because required transfer information (e.g., medication lists, advance directives (ADs)) were incomplete or nursing staff was insufficiently prepared. Hospital transfers were considered as (potentially) avoidable in case of urinary catheter complications, exsiccosis/infections and falls. Legal uncertainties among all involved professional groups (nurses, physicians, dispatchers, and paramedics) seemed to be a relevant trigger for hospital transfers. In paramedics’ point of view, emergency standards in NHs, trainings for nursing staff, the improvement of working conditions and legal conditions can reduce potentially avoidable hospital transfers from NHs.

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“…However, transfer document information is not always standardised across healthcare settings. International evidence highlights that standardised documentation improves communication between staff by recording important clinical and personal information (Morphet et al, 2014 ; Tsai & Tsai, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

“…International evidence highlights that standardised documentation improves communication between staff by recording important clinical and personal information (Morphet et al, 2014;Tsai & Tsai, 2018).…”

Section: Introductionmentioning

confidence: 99%

Towards the development of a national patient transfer document between residential and acute care—A pilot study

Tuohy

Fahy

O’Doherty

et al. 2021

Int J Older People Nursing

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Background A lack of standardisation of documentation accompanying older people when transferring from residential to acute care is common and this may result in gaps in information and in care for older people. In Ireland, this lack of standardisation prompted the development of an evidence based national transfer document. Objectives To pilot a new national transfer document for use when transferring older people from residential to acute care and obtain the perceptions of its use from staff in residential and acute care settings. Methods This was a pre‐ and post‐study design using purposive sampling following the STROBE guidelines. The pilot was conducted in 26 sites providing residential care and three university hospitals providing acute care. Pre‐pilot questionnaires focused on current documentation and were distributed to staff in residential care (n = 875). A pilot of the new paper‐based transfer document was then conducted over three months and post‐pilot questionnaires distributed to staff from both residential and acute care settings (n = 1085). The findings of the pilot study were discussed with multidisciplinary expert advisory and stakeholder groups who recommended some revisions. This consensus informed the development of the final design of the new revised transfer document. Results Pre‐pilot: 23% response rate; 83% (n = 168) participants agreed/strongly agreed that existing documentation was straightforward to complete but could be more person‐centred. Post‐pilot: 11% response rate; 75% (n = 93) of participants agreed/strongly agreed that the new transfer document promoted person‐centred care but recommended revisions to the new document regarding layout and time to complete. Conclusions This study highlighted some of the challenges of providing safe, effective and relevant transfer information that is feasible and usable in everyday practice. Implications for practice Standardisation and being person‐centred are important determining factors in the provision of relevant up to date information on the resident being transferred.

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Development, validation and testing of a nursing home to emergency room transfer checklist

Abstract: Use of the nursing home to emergency room transfer checklist for nursing home transfers could fill the information gap that exists when transferring older adults between facilities such as nursing homes and hospitals.

Cited by 13 publications

References 25 publications

An Evidence-based General Anesthesia and Prone Position Nursing Checklist: Development and Testing

An Evidence-based General Anesthesia and Prone Position Nursing Checklist: Development and Testing

Paramedics’ Perspectives on the Hospital Transfers of Nursing Home Residents—A Qualitative Focus Group Study

Towards the development of a national patient transfer document between residential and acute care—A pilot study

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