Patients’ and nurses’ perceptions of nursing problems in an acute care setting

Florin, Jan; Ehrenberg, Anna; Ehnfors, Margareta

doi:10.1111/j.1365-2648.2005.03477.x

Cited by 68 publications

(88 citation statements)

References 38 publications

(73 reference statements)

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“…Current studies in the literature related to decision making in discharge planning focus on the decision to refer a patient to post-hospital services (Bowles, Foust, & Naylor, 2003; Jette, Grover, & Keck, 2003) and perceptions and knowledge about the discharge planning process in general (Florin, Ehrenberg, & Ehnfors, 2005; Tilus, 2002). Recent systematic reviews of discharge planning activities and interventions concluded that insufficient evidence (beyond expert opinion-based standards of practice) currently exists to guide practice changes (Maramba, Richards, Myers, & Larrabee, 2004; Mistiaen, Francke, & Poot, 2007; Shepperd, Parkes, McClaran, & Phillips, 2004).…”

Section: Background and Conceptual Frameworkmentioning

confidence: 99%

Illuminating hospital discharge planning: staff nurse decision making

Rhudy

Holland

Bowles

2010

Applied Nursing Research

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This qualitative study proposed to examine staff RN's decision making related to discharge planning and perceptions of their role. Themes resulting from interviews were following the script, and RN as coordinator. The decision to consult a Discharge Planner occurred when the patient's situation did not follow the RN's expectations. Discharge planning for non-routine situations was considered disruptive to the RN's workflow. The RN's role was limited to oversight when a Discharge Planner was involved. Understanding RNs' decision-making in this key process provides valuable insights into differentiating routine from non-routine patient situations and deploying appropriate resources in a timely fashion.Nurses' decision making in complex patient situations and the resulting influences on patient outcomes are important aspects of nurses' work. The recent Institute of Medicine report (Committee on the Work Environment for Nurses and Patient Safety Board on Health Care Services, 2004) describes this 'invisible work' of nursing as the cognitive work that incorporates knowledge gained through both formal education programs and experience. This cognitive work includes activities related to assessing a patient's health, monitoring for changes that require nursing intervention(s), interdisciplinary care planning, and provision of care.The responsibility for each patient's discharge planning involves a series of complex decision-making activities performed by Registered Nurses (RNs). The first and very important step in the discharge planning process is to screen the patient to determine the need to involve hospital discharge planning resources (e.g., Discharge Planner nurse [DPN] or social worker [SW]) for further assessment, design or implementation of the discharge Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. plan. When the need for further evaluation of the patient's discharge planning situation is not identified and acted on, the potential for the patient to experience adverse post-hospital outcomes increases (Code of Federal Regulations, 2004). Adverse outcomes associated with poor discharge planning include unaddressed continuing care needs, unexpected deterioration or medical complications, psychological distress, hospital readmissions, and death (Bowles, Foust, & Naylor, 2003; Coleman & Berenson, 2004;Mistiaen, 2007). Furthermore, eliminating just 5.2% of preventable Medicare rehospitalizations is estimated to save 5 billion annually (Lubell, 2007). NIH Public AccessEarly recognition of these types of patient DP situations is important in order to meet patient sa...

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Section: Background and Conceptual Frameworkmentioning

confidence: 99%

Illuminating hospital discharge planning: staff nurse decision making

Rhudy

Holland

Bowles

2010

Applied Nursing Research

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“…According to the code of ethics for nurses (2005), adopted by the International Council of Nurses, respect for the individuality and uniqueness of all persons receiving nursing care is a nursing obligation. Although being cared for as an individual is important for patients (Radwin, 2000;Suhonen et al, 2002), the provision of nursing care is not always so (Attree, 2001;Florin et al, 2005;Muntlin et al, 2006). At times, when practice is governed by clinical guidelines and standardized protocols (Jones and Kamath, 1998;Woolf et al, 1999), especially in surgical care (Sade et al, 2000), questions related to individuality in care are of particular importance.…”

Section: Introductionmentioning

confidence: 99%

A survey of orthopaedic patients’ assessment of care using the Individualised Care Scale

Berg

Suhonen

Idvall

2007

Journal of Orthopaedic Nursing

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“…The lack of emphasis on the relational aspect in the nursing process may have contributed to the limited focus on the patient's perspective in documented nursing care. Research reports a lack of attention to patients' individual perspectives, preferences, and/or experiences in the documentation of their care (Adamsen & Tewes, 2000;Florin, Ehrenberg, & Ehnfors, 2005). It is acknowledged that personal experiences, preferences, and values need to be integrated and supported to optimize health decisions in the clinical encounter .…”

Section: Clinical Support Systems For the Positive Aspects Of Healthmentioning

confidence: 99%

“…Research reports a lack of attention to patients' individual perspectives, preferences, and/or experiences in the documentation of their care 5,6 . It is acknowledged that personal experiences, preferences, and values need to be integrated and supported to optimize health decisions in the clinical encounter 7 .…”

Section: Introductionmentioning

confidence: 99%