The nurses' role in the hospital discharge planning of older patients

Abstract

Available literature shows that nurses are involved in the discharge planning process albeit at differing levels. The literature also states that the coordinating fonction of the nurse in discharge planning is vital but whilst some authors indicate cautiously that additional role clarity is still required, others disagree and declare that nurses should take a proactive lead in discharge planning. Moreover a number of studies suggest that nurses experienced in managing the process of discharge planning, can reduce inpatient costs, improve patient outcomes and satisfaction, decrease readmission rates, and facilitate continuity of care. It has also been claimed that discharge planning is a daily but inadequately defined or unseen component of the staff nurse role and that nurses are exclusively positioned to recognize barriers and opportunities in the processes of discharge planning. This study examined the role nurses play locally as regards to the hospital discharge planning of older patients. Data was collected by means of a qualitative approach through a descriptive design method consisting of semi-structured interviews and direct non participant observation. 32 qualified nurses working within four different hospital settings, consisting of medical, surgical, orthopaedic and rehabilitation wards, were interviewed by means of semi structured one to one interviews whilst direct non participative observation sessions were also conducted to observe and record the role nurses play during multidisciplinary ward rounds and case conferences in particular to hospital discharge planning of older patients. In total, 6 ward rounds, 5 case conference meetings and 1 pre admission clinic were attended. The interviews were transcribed using the verbatim method and thematic analysis was used to analyse the data from the semi structured one to one interviews. Transcribed notes from the observations visits were also analysed and particular attention was given to those interactions involving nurses which were related to the hospital discharge planning of older patients.