Communication and coordination during transition of older persons between nursing homes and hospital still in need of improvement

Journal of Advanced Nursing

Volumn 69, Issue 4, 2013, Pages 886-895

  Kirsebom, Marie ^a   Wadensten, Barbro ^a   Hedström, Mariann ^a  

^a UPPSALA UNIVERSITY   (Sweden)

Author keywords

Admission to hospital; Communication; Coordination; Discharge from hospital; Focus groups; Nursing homes; Older person

Indexed keywords

ARTICLE; HOSPITAL MANAGEMENT; HUMAN; INFORMATION PROCESSING; INTERPERSONAL COMMUNICATION; NURSING HOME; ORGANIZATION AND MANAGEMENT; PATIENT CARE; SWEDEN;

COMMUNICATION; CONTINUITY OF PATIENT CARE; FOCUS GROUPS; HOSPITAL ADMINISTRATION; HUMANS; NURSING HOMES; SWEDEN;

EID: 84874981998     PISSN: 03092402     EISSN: 13652648     Source Type: Journal    
DOI: 10.1111/j.1365-2648.2012.06077.x     Document Type: Article

References (49)

1. Armitage S.K. & Kavanagh K.M. (1995) Continuity of care: discharge planning and community nurses. Contemporary Nurse 4(4), 148-155.
2. Armitage S.K. & Kavanagh K.M. (1998) Consumer-orientated outcomes in discharge planning: a pilot study. Journal of Clinical Nursing 7(1), 67-74.
3. Atwal A. (2002) Nurses' perceptions of discharge planning in acute health care: a case study in one British teaching hospital. Journal of Advanced Nursing 39(5), 450-458.
4. Barbour R. (2005) Making sense of focus groups. Medical Education 39, 742-750.
5. Bolch D., Johnston J.B., Giles L.C., Whitehead C., Phillips P. & Crotty M. (2005) Hospital to home: an integrated approach to discharge planning in a rural South Australian town. Australian Journal of Rural Health 13(2), 91-96.
6. Buchanan J.L., Murkofsky R.L., O'Malley A.J., Karon S.L., Zimmerman D., Caudry D.J. & Marcantonio E.R. (2006) Nursing home capabilities and decisions to hospitalize: a survey of medical directors and directors of nursing. Journal of the American Geriatric Society 54(3), 458-465.
7. Bull M.J.K. & Robert L. (1996) Gaps in discharge planning. The Journal of Applied Gerontology 15(4), 486-500.
8. Bull M.J. & Roberts J. (2001) Components of a proper hospital discharge for elders. Journal of Advanced Nursing 35(4), 571-581.
9. Carter M.W. & Porell F.W. (2005) Vulnerable populations at risk of potentially avoidable hospitalizations: the case of nursing home residents with Alzheimer's disease. American Journal of Alzheimers Disease Other Dementias 20(6), 349-358.
10. Codex (2011) Rules and Guidelines for Research. Retrieved from http://www.codex.uu.se/ on 13 May 2011.
11. Cortes T.A., Wexler S. & Fitzpatrick J.J. (2004) The transition of elderly patients between hospitals and nursing homes. Improving nurse-to-nurse communication. Journal of Gerontological Nursing 30(6), 10-15.
12. Dobalian A. (2004) Nursing facility compliance with do-not-hospitalize orders. Gerontologist 44(2), 159-165.
13. Ehnfors E.A. & Thorell-Ekstrand I. (ed.) (2000) VIPS-boken. Om en forskningsbaserad modell för dokumentation av omvårdnad i patientjournalen. Forskning & Utveckling, Vårdförbundet, FoU 48, Sweden.
14. Evans G. (2011) Factors influencing emergency hospital admissions from nursing and residential homes: positive results from a practice-based audit. Journal of Evaluation in Clinical Practice 17(6), 1045-1049.
15. Gillespie S.M., Gleason L.J., Karuza J. & Shah M.N. (2010) Health care providers' opinions on communication between nursing homes and emergency departments. Journal of American Medical Directors Association 11(3), 204-210.
16. Grönroos E. & Perälä M.-L. (2005) Home care personnel's perspectives on successful discharge of elderly clients from hospital to home setting. Scandinavian Journal of Caring Sciences 19(3), 288-295.
17. Gustafsson C., Asp M. & Fagerberg I. (2009) Municipal night nurses' experience of the meaning of caring. Nursing Ethics 16(5), 599-612.
18. Harrington C., Kovner C., Mezey M., Kayser-Jones J., Burger S., Mohler M., Burke R. & Zimmerman D. (2000) Experts recommend minimum nurse staffing standards for nursing facilities in the United States. Gerontologist 40(1), 5-16.
19. Kane R.L., Keckhafer G., Flood S., Bershadsky B. & Siadaty M.S. (2003) The effect of Evercare on hospital use. Journal of the American Geriatrics Society 51(10), 1427-1434.
20. Kripalani S., LeFevre F., Phillips C.O., Williams M.V., Basaviah P. & Baker D.W. (2007) Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. Journal of the American Medical Association 297(8), 831-841.
21. Krueger R.A. & Casey M.A. (ed.) (2000) Focus Groups: A Practical Guide for Applied Research. Sage Publications, London.
22. Lamb G., Tappen R., Diaz S., Herndon L. & Ouslander J.G. (2011) Avoidability of hospital transfers of nursing home residents: perspectives of frontline staff. Journal of American Geriatrics Society 59(9), 1665-1672.
23. Littlejohn S.W. (ed.) (1992) Theories of Human Communication. Wadsworth Publishing Company, Belmont, CA.
24. Marcantonio E.R., McKean S., Goldfinger M., Kleefield S., Yurkofsky M. & Brennan T.A. (1999) Factors associated with unplanned hospital readmission among patients 65 years of age and older in a Medicare managed care plan. The American Journal of Medicine 107(1), 13-17.
25. Marengoni A., Angleman S., Melis R., Mangialasche F., Karp A., Garmen A., Meinow B. & Fratiglioni L. (2011) Aging with multimorbidity: a systematic review of the literature. Ageing Research Review 10(4), 430-439.
26. Morgan D. (ed.) (1998) The Focus Group Kit, The Focus Group Guidebook. Sage Publications, London.
27. Morgan D., Reed J. & Palmer A. (1997) Moving from hospital into a care home - the nurse's role in supporting older people. Journal of Clinical Nursing 6(6), 463-471.
28. Murray L.M. & Laditka S.B. (2010) Care transitions by older adults from nursing homes to hospitals: implications for long-term care practice, geriatrics education and research. Journal of American Medical Directors Association 11(4), 231-238.
29. Nyamathi A. & Shuler P. (1990) Focus group interview: a research technique for informed nursing practice. Journal of Advanced Nursing 15, 1281-1288.
30. Ouslander J.G., Lamb G., Perloe M., Givens J.H., Kluge L., Rutland T., Atherly A. & Saliba D. (2010) Potentially avoidable hospitalizations of nursing home residents: frequency, causes and costs. Journal of American Geriatrics Society 58(4), 627-635.
31. Payne S., Hardey M. & Coleman P. (2000) Interactions between nurses during handovers in elderly care. Journal of Advanced Nursing 32(2), 277-285.
32. Payne S., Kerr C., Hawker S., Hardey M. & Powell J. (2002) The communication of information about older people between health and social care practitioners. Age and Ageing 31(2), 107-117.
33. Polit D.F. & Beck C.T. (ed.) (2008) Nursing Research: Generating and Assessing Evidence for Nursing Practice. Wolters Kluwer Health/Lippincott Williams &Wilkins, cop., Philadelphia.
34. Rydeman I. & Tornkvist L. (2006) The patient's vulnerability, dependence and exposed situation in the discharge process: experiences of district nurses, geriatric nurses and social workers. Journal of Clinical Nursing 15(10), 1299-1307.
35. SALAR (2008) Open Comparison, Swedish Association of Local Authorities and Regions (SALAR). Swedish Board of Health and Welfare, Stockholm, Sweden.
36. SALAR (2010) Care and Services to Elderly Persons, Open Comparison. Swedish Board of Health and Welfare, Stockholm, Sweden.
37. Sandelowski M. (1995) Qualitative analysis: what it is and how to begin. Research in Nursing & Health 18, 371-375.
38. Swedish Code of Statutes, SFS (2003):460. Act Concerning the Ethical Review of Research Involving Humans. Retrieved from http://www.regeringen.se/ on 13 May 2011.
39. Shanley C., Sutherland S., Stott K., Tumeth R. & Whitmore E. (2008) Increasing the profile of the care of the older person in the ED: a contemporary nursing challenge. International Emergency Nursing 16(3), 152-158.
40. Smith K., Smith V., Krugman M. & Oman K. (2005) Evaluating the impact of computerized clinical documentation. Computers, Informatics, Nursing 23(3), 132-138.
41. Schleyer R.H., Burch C.K. & Schoessler M.T. (2011) Defining and integrating informatics competencies into a hospital nursing department. Computers, Informatics, Nursing 29(3), 167-173.
42. Tierney A.J. (1993) Challenges for nursing research in an era dominated by health service reform and cost containment. Clinical Nursing Research 2(4), 382-395.
43. Waters K.R. (1987) Discharge planning: an exploratory study of the process of discharge planning on geriatric wards. Journal of Advanced Nursing 12(1), 71-83.
44. Watts R., Gardner H. & Pierson J. (2005) Factors that enhance or impede critical care nurses' discharge planning practices. Intensive and Critical Care Nursing 21(5), 302-313.
45. Weber R. (ed.) (1990) Basic Content Analysis. Sage Publications Inc, Newbury Park.
46. WHO (2012) World Health Organization Vol. 2012, pp. Retrieved from http://www.who.int/ageing/age_friendly_cities/en/index.html on 31 January 2012.
47. Wicke D., Coppin R. & Payne S. (2004) Teamworking in nursing homes. Journal of Advanced Nursing 45(2), 197-204.
48. Williams V., Smith A., Chapman L. & Oliver D. (2011) Community matrons-an exploratory study of patients' views and experiences. Journal of Advanced Nursing 67(1), 86-93.
49. Young Y., Barhydt N.R., Broderick S., Colello A.D. & Hannan E.L. (2010) Factors associated with potentially preventable hospitalization in nursing home residents in New York State: a survey of directors of nursing. Journal of American Geriatrics Society 58(5), 901-907.