Transição Do Cuidado Do Hospital Para O Domicílio: Revisão Integrativa

Weber, Luciana Andressa Feil; Lima, Maria Alice Dias da Silva; Acosta, Aline Marques; Marques, Gislaine Quintana

doi:10.5380/ce.v22i3.47615

Cited by 68 publications

(117 citation statements)

References 31 publications

(122 reference statements)

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“…Although not presented in the results of the present study, it is worth mentioning that indicators were defined for evaluation of the treatment plan. It is important to strengthen the idea that organizations, when evaluating the quality of care provided in healthcare services, must make use of indicators in the preparation of patients to return home, health education of these patients and families, support provided for continuity of care at home, and follow-up carried out after hospital discharge (12) .…”

Section: Discussionmentioning

confidence: 99%

“…Integrative reviews carried out regarding the transition from hospital to community showed that the instructions made available by nurses are essential so this transition is effective, as they promote adherence to medications, self-care management, increase adherence to treatments, and reduce rehospitalization, comorbidities, and mortality rates (12) .…”

Section: Discussionmentioning

confidence: 99%

“…It is nurses' responsibility to ensure that both patients and families, especially caregivers, leave the hospital properly prepared and supported, which is possible through a better interaction and communication among professionals, patients, caregivers, and healthcare services (12) .…”

Section: Introductionmentioning

confidence: 99%

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Project K: Training for hospital-community safe transition

et al. 2018

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Objective: To define the safe transition process from hospital to community of patients with chronic mental disorders and their families. Method: This was an action research study included in the constructivist paradigm. The participants in the study were nurses from a psychiatry service and from primary healthcare services. Results: After the identification of causes of continuity fragmentation, the following items emerged from the participants’ speeches: a) two criteria categories for safe transition (those associated with health status, dependence level, and self-care capacity of patients, and those associated with knowledge and competence level of informal caregivers); b) the design of an algorithm to facilitate clinical decision-making. Final considerations: In order to promote adherence to therapeutic treatment in the hospital-community transition, treatment plans must include patients and their families, and improve communication networks and support among care levels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Project K: Training for hospital-community safe transition

et al. 2018

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“…[3][4][5][6] The literature shows that the nurse has been one of the professionals most involved in care transition from the hospital to the domicile, developing activities in the care planning for discharge, aid for social rehabilitation, health education, articulation with other health services and post-discharge follow-up. [7][8][9] The nurse allows hospitalization to become a moment of learning, with an exchange of knowledge among patient, family and healthcare professional. Thus, in preparation for the discharge, actions focused on beyond the more acute health problems can be developed, providing meaningful and accurate information for the health self-care and selfmanagement, favoring the return to the domicile and to family and social life.…”

mentioning

confidence: 99%

“…In Brazil, however, little progress has been made in relation to investigations on the topic. 7,13 There is a lack of studies that identify the activities performed by nurses at discharge from the hospital to the domicile in the country, 7,11 which justifies the realization of this research.…”

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confidence: 99%

Atividades do enfermeiro na transição do cuidado: realidades e desafios

Acosta¹,

Câmara²,

Weber

et al. 2018

Rev enferm UFPE on line.

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RESUMOObjetivo: analisar as atividades realizadas pelo enfermeiro na transição do cuidado ao paciente com alta hospitalar. Método: trata-se de estudo quantitativo, transversal e descritivo com 72 enfermeiros de unidades de internação selecionados a partir da técnica de bola de neve. Realizou-se a coleta de dados por meio de questionário estruturado online, utilizando-se a ferramenta da plataforma Google DocsOffline. Analisaram-se os dados com estatística descritiva. Resultados: observou-se que a maioria das atividades foi quanto a esclarecimento de dúvidas durante as orientações de alta e orientações sobre continuidade dos cuidados com a equipe de saúde de referência. Viu-se que atividades menos realizadas foram: o acompanhamento do paciente após alta e a comunicação com equipe da unidade de saúde de referência. Viu-se que maiores dificuldades foram referentes: à realização de encaminhamentos ao hospital para a Atenção Primária à Saúde, comunicação entre os profissionais de saúde e pouca formação em serviço para qualificação dos profissionais. Conclusão: considera-se que o enfermeiro desempenha um papel fundamental na transição do cuidado, sendo as ações de educação em saúde realizadas com maior frequência. Devem-se ser feitos esforços para melhorar integração e articulação entre profissionais e serviços hospitalares e da Atenção Primária. Descritores: Alta do Paciente; Continuidade da Assistência ao Paciente; Cuidados de Enfermagem; Educação em Saúde; Integralidade em Saúde; Papel do Profissional de Enfermagem. ABSTRACT Objective: to analyze the activities performed by nurses in the transition of patient care with hospital discharge. Method: quantitative, cross-sectional and descriptive study, with 72 nurses from hospitalization units, selected from the snowball technique. Data collection occurred through an online structured questionnaire, using the tool of Google DocsOffline platform. The data were analyzed using descriptive statistics. Results: most activities regarded clarification of doubts during discharge guidance and guidelines on continuity of care with the healthcare team. Activities least performed were patient follow-up after discharge and communication with staff from the health unit of reference. The greatest difficulties related to the completion of referrals from hospital to Primary Health Care, communication between health professionals and little in-service training for qualification of professionals. Conclusion: the nurse plays a fundamental role in the care transition, with health education actions held with greater frequency. Efforts should be made to improve integration and articulation between professionals and hospital services and primary care. Descriptors: Patient Discharge; Continuity of Patient Care; Nursing Care, Health Education; Health Integrality; Nurse’s Role. RESUMEN Objetivo: analizar las actividades realizadas por los enfermeros en la transición del cuidado al paciente con el alta hospitalaria. Método: estudio cuantitativo, descriptivo y transversal, con 72 enfermeros de unidades de hospitalización, seleccionados a partir de la técnica de bola de nieve. La recolección de datos se realizó por medio de un cuestionario estructurado en línea, utilizando la herramienta de la plataforma Google DocsOffline. Los datos fueron analizados mediante estadística descriptiva. Resultados: la mayoría de las actividades era una aclaración de dudas durante las orientaciones de descarga y directrices sobre la continuidad de los cuidados con el equipo de salud. Actividades menos realizadas fueron el seguimiento de los pacientes tras el alta y la comunicación con el personal de la unidad de salud de referencia. Las mayores dificultades estaban relacionadas con la terminación de las remisiones del hospital a la atención primaria de la Salud, la comunicación entre los profesionales de la salud y la poca capacitación en servicio para la cualificación de los profesionales. Conclusión: el enfermero tiene un papel fundamental en la transición del cuidado, con acciones de educación para la salud con mayor frecuencia. Deben hacerse esfuerzos para mejorar la integración y articulación entre los profesionales y los servicios hospitalarios y de atención primaria. Descriptores: Alta del Paciente; Continuidad de la Atención al Paciente; Atención de Enfermería; Educación en Salud; Integralidad en Salud; Rol de la Enfermera.

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Self-Management Support (SMS) in Transition: The Case of Osteoporosis Management Support in a Chinese Hospital

Huang,

Ding

2024

Comput Supported Coop Work

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Self-management has become increasingly important with the growing population living with chronic conditions. Self-Management Support (SMS) provided in healthcare systems is essential for its success. While prior research mainly focuses on Western countries, this paper presents a study of SMS practices for osteoporosis management as part of a Whole Course Management (WCM) program recently implemented in the healthcare system in China, which features a new role called case manager in the hospital dedicated to SMS and related coordination. Based on interviews with 22 participants, including one case manager, two physicians, three nurses, seven patients, and nine caregivers, we highlight the importance of the role of case manager in promoting awareness of osteoporosis and self-management, integrated care coordination, and emotional support. At the same time, it also reveals challenges and promising directions to make SMS more effective, mainly in terms of self-management education, active patient involvement, and coordination among the care network. We ended by reflecting on our findings and discussing implications for SMS and the design of ICTs.

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Transição Do Cuidado Do Hospital Para O Domicílio: Revisão Integrativa

Cited by 68 publications

References 31 publications

Project K: Training for hospital-community safe transition

Project K: Training for hospital-community safe transition

Atividades do enfermeiro na transição do cuidado: realidades e desafios

Self-Management Support (SMS) in Transition: The Case of Osteoporosis Management Support in a Chinese Hospital

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