Nurses' assessments of staffing adequacy in care services for older patients following hospital discharge

Veenstra, Marijke; Gautun, Heidi

doi:10.1111/jan.14636

Cited by 14 publications

(8 citation statements)

References 33 publications

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“…Yet, there are further notable effects on a macro level. Home care facilities encounter di culties with staff shortages (19,20), which increases the workload for nurses. Not only could this lead to an enhanced risk of unintended errors (21)(22)(23) but it could also contribute to nurses' motivation to leave the eld (24).…”

Section: Discussionmentioning

confidence: 99%

The effect of family centered care on unplanned emergency room visit, hospital readmissions and intensive care admissions after abdominal surgery: a root cause analysis

Kreca,

Albers,

Musters

et al. 2024

Preprint

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Background Optimising transitional care by practicing family-centred care might reduce unplanned events for patients who undergo major abdominal cancer surgery. However, it remains unknown whether involving family caregivers in patients’ healthcare also has negative consequences for patient safety. This study assesses the safety of family involvement in patients’ healthcare by examining the cause of unplanned events in patients who participated in a family involvement programme (FIP) after major abdominal cancer surgery. Unplanned events per patient were compared between patients who received care from their family caregiver and patients who received professional at-home care after discharge. Methods This is a secondary analysis of the intervention group of a prospective cohort study. Participants in the intervention group were patients who engaged in a FIP. Unplanned events were analysed, and root causes were identified using the medical version of a prevention- and recovery-information system that analyses unintended events in healthcare. Statistical differences in the number of unplanned events were compared between patients who participated in the FIP and were cared for by their family caregiver after discharge and patients who participated in the FIP but received professional at-home care after discharge. A Mann-Whitney U test was used to analyse data. Results Of the 152 FIP participants, 68 experienced an unplanned event and were included. In total, 112 unplanned events occurred with 145 root causes since some unplanned events had several root causes. Most root causes of unplanned events were patient-related factors (n = 109, 75%), such as patient characteristics, patient conditions and disease-related factors. No root causes due to inadequate healthcare from the family caregiver were identified. Unplanned events did not differ statistically (interquartile range 1-2) (p = 0.35) between patients who received care from trained family caregivers and those who received professional at-home care after discharge. Conclusion Active family engagement in healthcare after major abdominal cancer surgery does not lead to unexpected events such as unplanned ER visits or unplanned hospital readmissions and ICU admissions. Additionally, the risk of experiencing an unplanned event does not increase when the family caregiver provides care after hospital discharge.

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Section: Discussionmentioning

confidence: 99%

The effect of family centered care on unplanned emergency room visit, hospital readmissions and intensive care admissions after abdominal surgery: a root cause analysis

Kreca,

Albers,

Musters

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Yet, there are further notable effects on a macro level. Home care facilities encounter difficulties with staff shortages [ 40 , 41 ], which increases the workload for nurses. Not only could this lead to an enhanced risk of unintended errors [ 42 – 44 ] but it could also contribute to nurses’ motivation to leave the field [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of family-centered care on unplanned emergency room visits, hospital readmissions and intensive care admissions after surgery: a root cause analysis from a prospective multicenter study in the Netherlands

Kreca,

Albers,

Musters

et al. 2024

Patient Saf Surg

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Background Optimizing transitional care by practicing family-centered care might reduce unplanned events for patients who undergo major abdominal cancer surgery. However, it remains unknown whether involving family caregivers in patients’ healthcare also has negative consequences for patient safety. This study assessed the safety of family involvement in patients’ healthcare by examining the cause of unplanned events in patients who participated in a family involvement program (FIP) after major abdominal cancer surgery. Methods This is a secondary analysis focusing on the intervention group of a prospective cohort study conducted in the Netherlands. Data were collected from April 2019 to May 2022. Participants in the intervention group were patients who engaged in a FIP. Unplanned events were analyzed, and root causes were identified using the medical version of a prevention- and recovery-information system for monitoring and analysis (PRISMA) that analyses unintended events in healthcare. Unplanned events were compared between patients who received care from family caregivers and patients who received professional at-home care after discharge. A Mann-Whitney U test was used to analyze data. Results Of the 152 FIP participants, 68 experienced an unplanned event and were included. 112 unplanned events occurred with 145 root causes since some unplanned events had several root causes. Most root causes of unplanned events were patient-related factors (n = 109, 75%), such as patient characteristics and disease-related factors. No root causes due to inadequate healthcare from the family caregiver were identified. Unplanned events did not differ statistically (interquartile range 1–2) (p = 0.35) between patients who received care from trained family caregivers and those who received professional at-home care after discharge. Conclusion Based on the insights from the root-cause analysis in this prospective multicenter study, it appears that unplanned emergency room visits and hospital readmissions are not related to the active involvement of family caregivers in surgical follow-up care. Moreover, surgical follow-up care by trained family caregivers during hospitalization was not associated with increased rates of unplanned adverse events. Hence, the concept of active family involvement by proficiently trained family caregivers in postoperative care appears safe and feasible for patients undergoing major abdominal surgery.

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“…Laugaland et al 13 point out that it is advantageous to have personnel with proper education and skills in a support function to ensure safe patient pathways. However, Veenstra and Gautun's 35 survey of Norwegian municipalities shows that there is too little staff with education related to patient transfers. In addition, Røsstad et al's 8 study suggests that the focus of home services is often on support functions and the patient's ability to function in daily life.…”

Section: Discussionmentioning

confidence: 99%

A qualitative study of purchaser unit employees’ experiences of patient pathways from specialist healthcare to primary healthcare in Norway

Killie

Jakobsen

Sørensen

2022

International Journal of Care Coordination

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Introduction Understanding the purchaser–provider split model in the patient pathway is important. The purchaser is a key player in managing the flow between specialist and municipal healthcare services. A smoother patient transfer has been a priority in Norway, but also challenging. Accordingly, this study aims to describe and explain how the purchasers operate as liaisons during patient transfers from specialist to primary healthcare services. Methods Eleven interviews were conducted with employees at purchaser units in primary healthcare in Norway. The interviewees’ professional backgrounds were in nursing and physiotherapy, as well as casework, and management. The interviews took place in 2018–2019 and analyzed with Graneheim and Lundman's content analysis strategy. Results The interviewees’ views reflected the changes they experienced in the wake of healthcare reforms in specialist healthcare services and municipal healthcare institutions. Three themes emerged from the analyses: (1) increased efficiency requirements after the Coordination Reform, (2) better reporting systems and the need for role clarifications in contact with hospitals, and (3) the need for good assessments for safe transfer to the municipality. Discussion Purchaser unit employees’ experiences with patient pathways point towards a need for certain changes. There is a need for increased efficiency requirements for purchasing units, even with new electronic tools, as well as a growing need for better reporting systems and a common understanding between the service levels about what patients can expect in the municipalities.

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Nurses' assessments of staffing adequacy in care services for older patients following hospital discharge

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 14 publications

References 33 publications

The effect of family centered care on unplanned emergency room visit, hospital readmissions and intensive care admissions after abdominal surgery: a root cause analysis

The effect of family centered care on unplanned emergency room visit, hospital readmissions and intensive care admissions after abdominal surgery: a root cause analysis

The effect of family-centered care on unplanned emergency room visits, hospital readmissions and intensive care admissions after surgery: a root cause analysis from a prospective multicenter study in the Netherlands

A qualitative study of purchaser unit employees’ experiences of patient pathways from specialist healthcare to primary healthcare in Norway

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