Caregiver Inclusion in IDEAL Discharge Teaching: Implications for Transitions From Hospital to Home.
Caregiver Inclusion in IDEAL Discharge Teaching: Implications for Transitions From Hospital to Home.
复制标题
将护理人员纳入 IDEAL 出院教学：对从医院到家庭过渡的影响。
DOI：
10.1097/ncm.0000000000000563
复制
发表时间：
2022
影响因子：
1.5
通讯作者：
Wallace,AndreaS
中科院分区：
文献类型：
--
作者：
Topham,EmilyWahlquist;Bristol,Alycia;Luther,Brenda;Elmore,CatherineE;Johnson,Erin;Wallace,AndreaS
目的：尽管认识到无偿(例如，家人、朋友)照料者(照顾者)在住院后成功过渡回家方面发挥了重要作用，但关于照顾者出院经历是否以及如何与提供高质量出院过程的当前战略相一致，以及这些出院经历如何影响成功过渡回家，可获得的信息有限。本研究旨在探讨照顾者对出院准备的看法，特别关注他们认为出院准备是否以及如何影响出院后患者的结果。方法：我们对四名讲英语的照顾者(61-75岁)进行了深入的个案访谈。内容分析以医疗研究机构提出的照顾者参与的性质和质量理想(包括讨论、教育、评估、倾听)出院计划策略为框架。结果：照顾者报告接受了明确的出院指示或基础教育，但感觉只是被动地被纳入出院教学。回到家后，照顾者报告说，他们在如何护理患者方面的知识存在差距，这表明与警告迹象和问题的知识相关的关键差距。四位护理者中的两位将再次入院归因于出院后的知识差距。结论：这些护理者的经历表明，他们有限的、被动的参与出院教育可能会导致住院后患者结局不佳。我们的发现表明，旨在增加照顾者在出院时的参与的结构化计划，特别是与评估照顾者问题解决、规划和出院后支持相关的计划，对于寻求改善护理过渡和出院后结果的努力是重要的。病例管理的意义：本研究评估照顾者在出院计划方面的经验和他们在出院后遇到的问题，为病例经理提供关于出院过程有效性的重要信息。这项对照顾者经验的研究表明，理想的出院计划策略仍然是病例经理在提供出院服务时遵循的有用和重要的框架。
Purpose:Despite recognition that unpaid (eg, family, friends) caregivers (caregivers) play an important role in successful transitions home after hospitalization, limited information is available about whether and how caregiver experiences of discharge align with current strategies for providing high-quality discharge processes, and how these experiences at discharge impact successful transitions home. The purpose of this study was to explore perceptions of caregivers regarding their discharge preparation, focusing particular attention on whether and how they believed discharge preparation impacted postdischarge patient outcomes.Methods:We conducted in-depth, case interviews with four English-speaking caregivers (61–75 years of age). Content analysis was framed by the nature of caregiver involvement proposed by the Agency for Healthcare Research and Quality's (AHRQ's) IDEAL (Include, Discuss, Educate, Assess, Listen) discharge planning strategy.Results:Caregivers reported receiving clear discharge instructions, or basic education, and yet felt only passively included in discharge teaching. Once home, the caregivers reported gaps in their knowledge of how to care for the patient, suggesting key gaps related to knowledge of warning signs and problems. Two of the four caregiver participants attributed a hospital readmission to postdischarge knowledge gaps.Conclusion:The experiences of these caregivers demonstrate how their limited, passive involvement in discharge education may result in suboptimal patient outcomes after hospitalization. Our findings suggest that structured programs aimed at increasing caregiver involvement in discharge, particularly related to assessment of caregiver problem solving, planning, and postdischarge support, are important in efforts seeking to improve care transitions and postdischarge outcomes.Implications for Case Management:This study assesses caregivers' experience with discharge planning and problems they encounter post-discharge, providing case managers with important information regarding the effectiveness of discharge processes. This study of caregiver experiences suggests that the IDEAL discharge planning strategy remains a useful and important framework for case managers to follow when providing discharge services.