The consequences of poor communication during transitions from hospital to skilled nursing facility: a qualitative study.
The consequences of poor communication during transitions from hospital to skilled nursing facility: a qualitative study.
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DOI：
10.1111/jgs.12328
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发表时间：
2013-07
影响因子：
6.3
通讯作者：
Kind AJ
中科院分区：
文献类型：
--
作者：
King BJ;Gilmore-Bykovskyi AL;Roiland RA;Polnaszek BE;Bowers BJ;Kind AJ
熟练护理机构（SNF）的护士在每年从医院过渡到SNF的> 500万患者的初始/过渡护理中发挥着关键作用。虽然出院流程研究得很好，很少有人知道SNF护理过程或SNF为基础的过渡性护理质量的变化的后果。研究SNF护士如何转变从医院收治的患者的护理，他们所经历的障碍，以及与转变质量变化相关的结果。定性研究采用扎根维度分析、焦点小组和深度访谈。5个威斯康星州的SNF。27名注册护士SNF护士在很大程度上依赖于书面出院沟通，以有效地将患者转移到SNF。护士们列举了出院信息的多个不足之处，包括药物医嘱的常规问题（包括缺乏阿片类药物治疗疼痛的处方），很少有患者的心理社会/功能史，以及有关当前健康状况的不准确信息。这些沟通不足需要反复电话澄清，造成护理延迟（包括疼痛控制延迟），增加SNF工作人员的压力，使患者/家庭成员沮丧，直接导致SNF机构形象负面，并增加患者再次住院的风险。SNF护士确定了一个特定的信息/组件列表，他们需要促进安全，高质量的过渡。护士注意到在医院到SNF的过渡中存在多种缺陷，质量差的出院沟通被认为是安全有效过渡的主要障碍。这些信息应用于完善和支持传播支持护理过渡的循证干预措施，包括减少急性护理转移的干预措施II（INTERACT）计划。
Nurses in skilled nursing facilities (SNFs) play a key role in initiating/transitioning care for the >5 million patients who transition from hospitals-to-SNFs annually. Although hospital discharge processes are well studied, little is known about the SNF nursing processes or the SNF-based consequences of variation in transitional care quality. To examine how SNF nurses transition the care of patients admitted from hospitals, the barriers they experience, and the outcomes associated with variation in the quality of transitions. Qualitative study using grounded dimensional analysis, focus groups and in-depth interviews. 5 Wisconsin SNFs. 27 registered nurses. SNF nurses rely heavily on written hospital discharge communication to effectively transition patients into the SNF. Nurses cited multiple inadequacies of hospital discharge information, including regular problems with medication orders (including the lack of opioid prescriptions for pain), little patient psychosocial/functional history, and inaccurate information regarding current health status. These communication inadequacies necessitated repeated phone clarifications, created care delays (including delays in pain control), increased SNF staff stress, frustrated patients/family members, directly contributed to negative SNF facility image, and increased a patient's rehospitalization risk. SNF nurses identified a specific list of information/components that they need to facilitate a safe, high-quality transition. Nurses note multiple deficiencies in hospital-to-SNF transitions, with poor quality discharge communication being identified as the major barrier to safe and effective transitions. This information should be used to refine and support the dissemination of evidence-based interventions which support transitions of care, including the Interventions to Reduce Acute Care Transfers II (INTERACT) program.
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DOI：
10.1111/j.1532-5415.2008.01693.x
发表时间：
2008-06-01
影响因子：
6.3
作者：
Kind, Amy J. H.;Smith, Maureen A.;Finch, Michael D.
通讯作者：
Finch, Michael D.
影响因子：
5.7
作者：
Kind, Amy J. H.;Thorpe, Carolyn T.;Smith, Maureen A.
通讯作者：
Smith, Maureen A.
影响因子：
3.2
作者：
Kools, S;McCarthy, M;Robrecht, L
通讯作者：
Robrecht, L
DOI：
10.1377/hlthaff.2009.0629
发表时间：
2010-01
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Mor V;Intrator O;Feng Z;Grabowski DC
通讯作者：
Grabowski DC
DOI：
10.1016/s1525-8610(04)70355-2
发表时间：
2003-07-01
影响因子：
7.6
作者：
Dimant, Jacob
通讯作者：
Dimant, Jacob