Home-care nurses’ perceptions of unmet information needs and communication difficulties of older patients in the immediate post-hospital discharge period

Abstract

Objective To understand home-care nurses‘ perceptions of the post-hospitalization information needs and communication problems of elderly patients, and how these factors might contribute to undesirable outcomes including poor patient reintegration into prior living environments and unplanned hospital readmissions. Design A ranked list of information needs experienced by patients was developed by two Nominal Group Technique (NGT) sessions from the perspective of home-care nurses. The list was combined with results from previously published work to develop a web-based survey administered to home care nurses‘ to elicit perceptions of patients‘ post-hospitalization information needs. Results Seventeen nurses participated in the NGT sessions, producing a list of 28 challenges grouped into five themes: medications, disease/condition, discharge, non-medication care, and functional limitations, and communication problems. The survey was sent to 220 home-care nurses, with a 54.1% (119/220) response rate. Respondents identified several frequent, high-impact information and communication needs that have received little attention in readmission literature, including information about medication regimens; the severity of their condition; hospital discharge management process; non-medication care regimens such as wound care, use of durable medical equipment and home safety; the extent of care needed, and which providers are best suited to provide that care. Responses also identified several communication difficulties that may play a role in readmissions. Conclusions Information needs and communication problems identified by home-care nurses expanded upon and reinforced results from prior studies. These results might be used to develop interventions that may improve information sharing among clinicians, patients, and caregivers during care transitions to ensure patient reintegration into prior living environments, potentially preventing unplanned hospital readmissions.

A Patient Safety Toolkit for Family Practices

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“…Os enfermeiros têm responsabilidade de assegurar que os pacientes voltem para casa adequadamente preparados e com apoio adequado, contribuindo para melhor articulação e comunicação entre profissionais, pacientes, cuidadores e serviços de saúde, visando proporcionar continuidade do cuidado para estratégias de transição bem sucedidas (11) . Muitas vezes, devido às inúmeras atividades, os enfermeiros fornecem informações apenas durante atividades rotineiras da sua prática assistencial (2) , por vezes de modo acelerado e com excesso de orientações em curto período de tempo (12) . Além disso, relatam a existência de intensa rotatividade dos leitos hospitalares, que prejudica a transmissão das informações sobre os cuidados domiciliares durante o processo de alta (2) .…”