Nursing’s Role in Successful Transitions Across Settings

Camicia, Michelle; Lutz, Barbara

doi:10.1161/strokeaha.116.012095

Cited by 22 publications

(31 citation statements)

References 22 publications

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“…problems in the hospital and poor discharge planning (Camicia & Lutz, 2016;Lichtman et al, 2013). In a recent report, the Centers for Disease Control called for further evaluation of system-level factors that may result in variation in stroke outcomes (Adeoye et al, 2019; Centers for Disease Control and Prevention, 2018).…”

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confidence: 99%

Better nurse work environments associated with fewer readmissions and shorter length of stay among adults with ischemic stroke: A cross‐sectional analysis of United States hospitals

Brom

Carthon

Sloane

et al. 2021

Research in Nursing & Health

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Stroke is among the most common reasons for disability and death. Avoiding readmissions and long lengths of stay among ischemic stroke patients has benefits for patients and health care systems alike. Although reduced readmission rates among a variety of medical patients have been associated with better nurse work environments, it is unknown how the work environment might influence readmissions and length of stay for ischemic stroke patients. Using linked data sources, we conducted a cross-sectional analysis of 543 hospitals to evaluate the association between the nurse work environment and readmissions and length of stay for 175,467 hospitalized adult ischemic stroke patients. We utilized logistic regression models for readmission to estimate odds ratios (OR) and zero-truncated negative binomial models for length of stay to estimate the incident-rate ratio (IRR). Final models accounted for hospital and patient characteristics. Seven and 30-day readmission rates were 3.9% and 10.1% respectively and the average length of stay was 4.9 days. In hospitals with better nurse work environments ischemic stroke patients experienced lower odds of 7-and 30-day readmission (7-day OR, 0.96; 95% confidence interval [CI]: 0.93-0.99 and 30-day OR, 0.97; 95% CI: 0.94-0.99) and lower length of stay (IRR, 0.97; 95% CI: 0.95-0.99). The work environment is a modifiable feature of hospitals that should be considered when providing comprehensive stroke care and improving post-stroke outcomes.ischemic stroke, length of stay, nurse work environment, readmissionGlobally, stroke is the second highest cause of death and third highest reason for disability (Benjamin et al., 2017;Gorelick, 2019). Despite acute stroke management being highly protocolized, variation still exists with regard to patient outcomes (Kaufman et al., 2019;Messé et al., 2016). For example, readmission rates among stroke patients are as high as 13% with most readmissions being unplanned and many avoidable (Bambhroliya et al., 2018;Vahidy et al., 2017).Variations in outcomes, including readmissions and length of stay, have been attributed to patient factors, including age and underlying general health (

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confidence: 99%

Better nurse work environments associated with fewer readmissions and shorter length of stay among adults with ischemic stroke: A cross‐sectional analysis of United States hospitals

Brom

Carthon

Sloane

et al. 2021

Research in Nursing & Health

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“…To prevent of aspiration pneumonia, the liaison nurse with practical education on how to feed the patient with a gastric tube, usually on the last day of hospitalization and during discharge, sought to increase the awareness of the family care givers. Care givers must be assessed for their capacity to provide the needed care and their readiness to assume the care giving role at home (2). We found that Involving the caregiver from the rst day of admission prevent confusion and can provide better living conditions for the patient and his/her family.…”

Section: Discussionmentioning

confidence: 98%

“…Despite the efforts of the liaison nurse for preventing our patients from having a permanent urinary catheter with a low level of consciousness, obtaining the consent of the physician for inserting a temporary catheter, and teaching how to insert it to the patient's family, a limited number of family caregivers were willing to do the procedure. Although programs are designed to train family members in caring skills, they often lack the preparation and support to take on a caring role (2).…”

Section: Discussionmentioning

confidence: 99%

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Effects of the Liaison Nurse Management on the Infectious Stroke Complications: A Randomized Controlled Trial

Kalani¹,

Ebrahimi²,

Fallahzadeh³

2021

Preprint

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Background Two of the most serious complications after stroke are pneumonia, and urinary tract infection. Liaison nurse, from hospital admission to discharge and then at home helps patients with complicated caring issues stroke. This study investigates the effect of liaison nurse management on the incidence of pneumonia and urinary tract infection in patients with stroke after discharge from the hospital. Methods This randomized controlled trial was conducted on 80 patients in a hospital in Iran. The intervention group was assessed and developed a caring program by the liaison nurse and the control group received routine care. Two weeks and two months after discharge, the patients were evaluated for the incidence of pneumonia and urinary tract infection. Collected data were analyzed using the Chi-square test. P < 0.05 was considered statistically significant. Results The two groups were homogenous in terms of mean age; gender frequently distribution, and having urinary catheter. The incidence of pneumonia in intervention and control groups (11.6% vs. 19.2%, P = 0.35) had no statistically significant differences, but there was a significant difference in the incidence of urinary tract infection (0% vs. 24.6%, P < 0.001). Conclusions With liaison nurse performance, there was a significant difference in the incidence of urinary tract infection, in two months after discharge from hospital, but the incidence of pneumonia had no statistically significant differences in two groups. Nurse's evaluation each patient individually according to needs, developing and monitoring the home-based care program, beyond overall education to these patients, could reduce some of complications of a stroke. Trial registration: This study is retrospectively registered by Iranian Registry of Clinical Trials with decree code: IRCT20170605034330N3 on April 4, 2018.

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“… 27 , 28 Nurses are considered to be key members of the transitional care team. 29 , 30 Their crucial role encompasses evaluating the transitional care plan, recognizing potential problems and then resolving them in order to improve patient safety. 31 Involvement of nurses in medicines management of transitional care helps with the provision of access to care for patients with fragmented care or those at high risk of readmission.…”

Section: Introductionmentioning

confidence: 99%

<p>The Role of the Nurse in the Management of Medicines During Transitional Care: A Systematic Review</p>

Mardani¹,

Griffiths²,

Vaismoradi³

2020

JMDH

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Purpose To synthesise knowledge and to explore the role of the nurse in medicines management during transitional care. Methods An integrative systematic review was conducted. Electronic databases such as PubMed [including Medline], Web of Knowledge, Scopus, and Cinahl from January 2010 to April 2020 were searched. Original qualitative and quantitative studies written in English that focused on the role of the nurse in medicines management during transitional care, which included movement between short-term, long-term, and community healthcare settings were included. Results The search process led to the retrieval of 10 studies, which were published in English from 2014 to 2020. They focused on the role of the nurse in patients' medicines management during transitional care in various healthcare settings. Given variations in the aims and methods of selected studies, the review findings were presented narratively utilizing three categories developed by the authors. In the first category as ‘medication reconciliation process’ the nurse participated in obtaining medication history, performing medication review, identifying medication discrepancies, joint medication reconciliation and adjustment. The second category as ‘collaboration with other healthcare providers’ highlighted the nurses' role in clarifying medicines' concerns, interdisciplinary communication and consultation, discharge planning and monitoring. In the third category as ‘provision of support to healthcare recipients’, the nurse was responsible for interpersonal communication with patients, education about medicines, and simplification of medication regimens, and symptoms management during transitional care. Conclusion Nurses play a crucial role in the safety of medicines management during transitional care. Therefore, they should be empowered and more involved in medicines management initiatives in the healthcare system. Patient safety and avoidance of medication errors during transitional care require that medicines management becomes a multidisciplinary collaboration with effective communication between healthcare providers.

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Nursing’s Role in Successful Transitions Across Settings

Cited by 22 publications

References 22 publications

Better nurse work environments associated with fewer readmissions and shorter length of stay among adults with ischemic stroke: A cross‐sectional analysis of United States hospitals

Better nurse work environments associated with fewer readmissions and shorter length of stay among adults with ischemic stroke: A cross‐sectional analysis of United States hospitals

Effects of the Liaison Nurse Management on the Infectious Stroke Complications: A Randomized Controlled Trial

<p>The Role of the Nurse in the Management of Medicines During Transitional Care: A Systematic Review</p>

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