Nurses’ perceptions of discharge planning

Abstract

The present paper investigates what the term discharge planning actually means to nurses working in the acute care environment. A qualitative approach was used for this study. Twelve volunteer registered nurses (RNs) working in a large metropolitan Victorian public hospital were interviewed. All participants stated emphatically that they were involved in the discharge planning process although differing levels of involvement existed. "Organizing" and "planning" were key words used by participants to define the term discharge planning. All but one participant considered the nurse to be the coordinator of the discharge planning process. How participants communicated with other nursing staff regarding the discharge planning needs of individual patients depended on the policy of each individual ward. Communication was perceived to be a major factor that either enhanced or impeded the discharge planning process.

Use of a patient classification instrument as a guide to plan nursing discharge

“…Several authors recognize that discharge planning still remains problematic and many questions have been raised about its effectiveness (2)(3)17) . The inappropriate preparation of patients and relatives and the consequent lack of knowledge and information concerning several aspects contribution the use of classification instruments represent when planning patients' care needs at home.…”

“…Table 2 -Distribution of care areas observed through the use of patient classification instrument and the content of nurses' discharge guidance (without instrument) of home care (6) contribute to the return of patients to the hospital with problems that could have been avoided, or even controlled (2) . Although the nurses acknowledge being responsible for the coordination of the discharge planning process and also that the identification of the care needs should be done during the hospitalization period (3) , in practice, the guidance provided to patients and relatives to guarantee care continuity is still reduced (18) . The findings in this study have evidenced an expressive increase of 71.3% in the identification of the care needs at the moment of hospital discharge by using the patient classification instrument.…”

“…Consequently, there was an increased readmission rate, with an care cost increase and effects on patients' health (2) . Since then, the contribution of effective hospitalhome transition planning to patients' health has been acknowledged, and discharge planning has become an integral part of health care (3) . Effective discharge planning can be defined as the construction and implementation of a planned program for care continuity, which satisfies the needs of the patient after hospital discharge (4) , equally incorporating psychological, economic and social aspects (3) .…”

“…Since then, the contribution of effective hospitalhome transition planning to patients' health has been acknowledged, and discharge planning has become an integral part of health care (3) . Effective discharge planning can be defined as the construction and implementation of a planned program for care continuity, which satisfies the needs of the patient after hospital discharge (4) , equally incorporating psychological, economic and social aspects (3) . The discharge planning is advised to start after admission to the hospital institution, and embodies four steps: evaluation of the patients' needs; development of discharge planning; patient/family education, mobilizing the necessary resources and services; and accompaniment and evaluation, usually the responsibility of community services (2) .…”

“…The discharge planning is advised to start after admission to the hospital institution, and embodies four steps: evaluation of the patients' needs; development of discharge planning; patient/family education, mobilizing the necessary resources and services; and accompaniment and evaluation, usually the responsibility of community services (2) . Even though the discharge process is considered to be multidisciplinary, the nurse plays a fundamental role, either acting to identify the patients' needs, patient and family education or coordinating the process (3,5) . Education is an essential component when it comes to care delivery and the nurses have more opportunities to educate the patients in comparison with other professionals.…”