Article Text

other Versions

PDF
Home-care nurses’ perceptions of unmet information needs and communication difficulties of older patients in the immediate post-hospital discharge period
  1. Katrina M Romagnoli1,
  2. Steven M Handler1,2,3,4,5,
  3. Frank M Ligons1,
  4. Harry Hochheiser1,5,6
  1. 1Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  2. 2Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  3. 3Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Pittsburgh Healthcare System (VAPHS), Pittsburgh, Pennsylvania, USA
  4. 4Center for Health Equity Research and Promotion (CHERP), VAPHS, Pittsburgh, Pennsylvania, USA
  5. 5Geriatric Pharmaceutical Outcomes and Geroinformatics Research and Training Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  6. 6Intelligent Systems Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Katrina M Romagnoli, Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, 5607 Baum Boulevard, BAUM 417D, Pittsburgh, PA 15206-3701, USA; kak59{at}pitt.edu

Abstract

Objective To understand home-care nurses’ perceptions of the post-hospitalisation information needs and communication problems of older patients, and how these factors might contribute to undesirable outcomes including poor patient reintegration into prior living environments and unplanned hospital readmissions.

Design A ranked list of information needs experienced by patients was developed by two Nominal Group Technique (NGT) sessions from the perspective of home-care nurses. The list was combined with results from previously published work to develop a web-based survey administered to home-care nurses to elicit perceptions of patients’ post-hospitalisation information needs.

Results Seventeen nurses participated in the NGT sessions, producing a list of 28 challenges grouped into five themes: medications, disease/condition, non-medication care/treatment/safety, functional limitations and communication problems. The survey was sent to 220 home-care nurses, with a 54.1% (119/220) response rate. Respondents identified several frequent, high-impact information and communication needs that have received little attention in readmission literature, including information about medication regimens; the severity of their condition; the hospital discharge management process; non-medication care regimens such as wound care, use of durable medical equipment and home safety; the extent of care needed; and which providers are best suited to provide that care. Responses also identified several communication difficulties that may play a role in readmissions.

Conclusions Information needs and communication problems identified by home-care nurses expanded upon and reinforced results from prior studies. These results might be used to develop interventions that may improve information sharing among clinicians, patients and caregivers during care transitions to ensure patient reintegration into prior living environments, potentially preventing unplanned hospital readmissions.

  • Nurses
  • Patient safety
  • Qualitative research
  • Transitions in care
  • Medication reconciliation

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.