Objective:With the continuous advancement of aging in China,the number of older inpatients has increased sharply.Older patients have a high demand for planning their discharge services.Nurses serve as the leader of di...Objective:With the continuous advancement of aging in China,the number of older inpatients has increased sharply.Older patients have a high demand for planning their discharge services.Nurses serve as the leader of discharge planning for patients;there is a lack of reliable evaluation tool to evaluate the core competitiveness of nurses who implement discharge planning for older patients in China.The purpose of this study was to validate the index for the core competence of nurses who lead discharge planning for older patients developed by a project team through the Delphi method in the early stage.Methods:A cross-sectional questionnaire survey with 3-stage stratified sampling was used to select 1075 nurses from 17 public general hospitals in Ningxia,China.Results:The index consists of 4 first-level indicators,13 second-level indicators,and 57 third-level indicators.The results show that 57 third-level indicators had good discrimination.With exploratory factor analysis(EFA),4 common factors that explained 72.79%of the total variance were extracted.The Cronbach's a was 0.98,and the retest reliability within a 14-d interval was 0.86.The confirmatory factor analysis(CFA)results show that the fit of the index structure was good.The criterion validity was 0.73.Conclusions:The index presented excellent psychometric proper ties and can be used to measure the core competence of nurses in implementing discharge planning for older patients in China.展开更多
Objective:To evaluate the effectiveness of discharge planning on maternal caring knowledge,maternal caring behavior,maternal discharge readiness and the rehospitalization of children with ventricular septal defect and...Objective:To evaluate the effectiveness of discharge planning on maternal caring knowledge,maternal caring behavior,maternal discharge readiness and the rehospitalization of children with ventricular septal defect and pulmonary arterial hypertension(VSD-PAH).Background:Children with congenital heart disease(CHD)with pulmonary arterial hypertension(PAH)have more complications after surgery than those without PAH.Discharge planning is an effective strategy to help children leave the hospital safely,and receive appropriate care after discharge.Methods:A quasi-experimental design was used.Sixty children and their mothers were recruited and divided into two groups:the control group received conventional care,the intervention group received both conventional care and additional discharge planning care.Results:(1)After admission,maternal caring knowledge between the two groups was similar.(2)At discharge,maternal discharge readiness,maternal caring knowledge and maternal caring behavior in the intervention group was significantly higher compared to the control group(t=3.35,p=0.001;F=84.74,p<0.001;F=23.82,p<0.001).This difference persisted after discharge,and was evident at one month and three months after discharge.(3)However,no significant difference in the readmission rate of children after discharge was evident between the two groups.Conclusions:Discharge planning improves the maternal discharge readiness,maternal caring knowledge and maternal caring behaviors.However,this planning did not reduce the readmission rate of children with CHD-PAH.展开更多
The UK National Health Service (NHS) is faced with problems of managing patient discharge and preventing the problems that result from it such as frequent readmissions, delayed discharge, long waiting lists, bed block...The UK National Health Service (NHS) is faced with problems of managing patient discharge and preventing the problems that result from it such as frequent readmissions, delayed discharge, long waiting lists, bed blocking and other such consequences. The problem is exacerbated by the growth in size, complexity and the number of chronic diseases in the NHS. In addition, there is an increase in demand for high quality care, processes and planning. Effective Discharge Planning (DP) requires practitioners to have appropriate, patient personalised and updated knowledge in order to be able to make informed and holistic decisions about a patients’ discharge. This paper examines the role of Knowledge Management (KM) in both sharing knowledge and using tacit knowledge to create appropriate patient discharge pathways. The paper details the factors resulting in inadequate DP, and demonstrates the use of Internet of Things (IoT) and Machine2Machine (M2M) as candidate technologies and possible solutions which can help reduce the problem. The use of devices that a patient can take home and devices which are perused in the hospital generate information, which can serve useful when presented to the right person at the right time, thus harvesting knowledge. The knowledge when fed back can support practitioners in making holistic decisions with regards to a patients’ discharge.展开更多
Introduction: The in-hospital rehabilitation of patients who have undergone surgery for hip fracture requires a team-based effort, in which nurses play an all-embracing role throughout the patients’ hospital stays. A...Introduction: The in-hospital rehabilitation of patients who have undergone surgery for hip fracture requires a team-based effort, in which nurses play an all-embracing role throughout the patients’ hospital stays. Although discharge planning has been widely studied, little is known about discharge planning from hospitals to homes in rural settings. Aim: To describe nurses’ views on discharge planning for older patients after hip fracture surgery who live in their own homes in rural areas. Methods: A qualitative method was used. Four focus group interviews were conducted with 18 nurses who work at an orthopaedic clinic. The interview texts were analysed with qualitative content analysis. Findings: Nurses expressed that patients needed support from healthcare personnel as well as relatives in order to prepare for life at home. They also expressed that patients were not supported in all aspects of discharge planning because they faced difficulties in having their voices heard. Nurses described that many of those aspects were beyond their own control, which had left them with little to non-ability to influence discharge planning. Findings additionally indicate that discharge planning seems not affected by occurring in rural settings. Conclusions: Although discharge planning is intended to meet the unique wishes and needs of each patient given the realities of existing resources, nurses’ responsibilities in discharge planning are unclear. This study shows an organisation in which healthcare personnel continue to make decisions for patients. Significance for nurses to perform a discharge planning that support patients’ participation seems to be a communication based on shared understanding.展开更多
Objective:To investigate the application effect of the discharge preparation plan based on the ADOPT nursing model in patients with first-visit ischemic stroke.Methods:Eighty patients with first-visit ischemic stroke ...Objective:To investigate the application effect of the discharge preparation plan based on the ADOPT nursing model in patients with first-visit ischemic stroke.Methods:Eighty patients with first-visit ischemic stroke admitted to our hospital from June 1,2024 to November 31,2024 were selected and divided into a control group(June 1,2024 to August 30,2024)and an intervention group(September 1,2024 to November 31,2024)according to different admission times,with 40 cases in each group.The control group received routine care and discharge guidance,while the intervention group received a discharge preparation plan based on the ADOPT model on the basis of routine care.The discharge readiness[Discharge Readiness Scale(RHDS)]of patients on the day of discharge was compared.Self-efficacy at 3 months after discharge[evaluated using the Chronic Disease Self-Efficacy Scale(SECD6)],activities of daily living[evaluated using the Barthel index(BI)],blood glucose and blood pressure indicators(diastolic blood pressure,systolic blood pressure,FPG,2 h PG),and readmission rate within 3 months after discharge were also compared between the two groups.Results:On the day of discharge,the RHDS-related dimension scores of the intervention group were higher than those of the control group(t=17.993,8.560,10.243,p<0.05);Three months after discharge,the SECD6 score and BI score of the intervention group were higher than those of the control group(t=8.910,10.899,both p<0.05);Systolic blood pressure,diastolic blood pressure,FPG and 2h PG in the intervention group were lower than those in the control group(t=8.868,4.794,3.829,7.121,all p<0.05);Within 3 months after discharge,the readmission rate of the intervention group was lower than that of the control group(χ^(2)=5.165,2 p<0.05).Conclusion:The discharge preparation plan based on the ADOPT nursing model,when applied to patients with first-visit ischemic stroke,can not only enhance self-efficacy and discharge preparation,improve activities of daily living,but also optimize blood glucose and blood pressure indicators and reduce the readmission rate,which is worthy of reference.展开更多
To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of ment...To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of mental health systems internationally.展开更多
BACKGROUND Type 1 diabetes is one of the most common chronic diseases in childhood.The number of type 1 diabetes patients in China still ranks fourth in the world.Therefore,children with type 1 diabetes in China are a...BACKGROUND Type 1 diabetes is one of the most common chronic diseases in childhood.The number of type 1 diabetes patients in China still ranks fourth in the world.Therefore,children with type 1 diabetes in China are a group that needs attention.The management of type 1 diabetes mellitus(T1DM)involves many aspects of daily life.It is extremely challenging for children and their families.T1DM children have complex medical care needs.Despite the continuous development of therapeutic medicine and treatment technologies,blood glucose control in children with T1DM is still not ideal.They and their parents need to acquire more knowledge and skills before being discharged.AIM To explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness,quality of discharge education and blood glucose control level.METHODS In total,102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time.Fifty cases from February to June 2019 were selected as the control group,and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan.The Readiness for Hospital Discharge Scale,Hospital Discharged Education Quality Scale and children's blood glucose metabolism indicators were used to compare the differences in discharge preparation,discharge education quality and blood glucose control between the two groups of children and their parents.RESULTS On the day of discharge,the two groups of children had the following scores of readiness for discharge:The intervention group score was 225.34±32.47,and the control group score was 208.68±29.31.The P value was 0.007,and the difference was statistically significant.The discharge education quality scores were as follows:The intervention group score was 135.11±19.86,the control group score was 124.13±15.56,the P value was 0.002 and the difference was statistically significant.Three months after discharge,the blood glucose metabolism indicator showed that the glycosylated hemoglobin value of the two groups was(7.45%±1.04%),and that of the control group was(8.04%±1.27%),P=0.012.Therefore,the improvement of parents'readiness for discharge,quality of discharge education and blood glucose metabolism indicators(glycosylated hemoglobin,fasting blood glucose and postprandial blood glucose)in the intervention group were better than those in the control group(P<0.05),and the difference was statistically significant.CONCLUSION The discharge plan for children with T1DM can help the children and their families realize the transition from hospital care to home self-management and improve the parents'readiness for discharge,thereby improving children’s blood glucose control levels.展开更多
This study evaluated changes in inpatient adult medicine and adult surgery services in the metropolitan area of Syracuse New York. These are the two largest inpatient hospital services. The study involved the use of t...This study evaluated changes in inpatient adult medicine and adult surgery services in the metropolitan area of Syracuse New York. These are the two largest inpatient hospital services. The study involved the use of these services as a basis for health care planning over time. The first component of the study focused on changes in hospital discharges for adult medicine and adult surgery. It demonstrated that, between the first three quarters of 2019 and 2022, before and after the coronavirus epidemic, numbers of adult medicine and adult surgery discharges declined by 16 - 21 percent. The second component of the study focused on changes in hospital lengths of stay for adult medicine and adult surgery. It demonstrated that, between the first three quarters of 2019 and 2022, hospital inpatient lengths of stay increased by approximately 19 - 21 percent at the aggregate and hospital specific levels. Effective planning involving utilization indicators such as hospital discharges and efficiency will be necessary if the potential for effective management of this sector is to be preserved. This planning should involve comparisons of data such as hospital discharges and stays, and identification of the sources of these developments at the community level.展开更多
Background Severe cardiac surgery trauma can lead to cardiopulmonary function injury,resulting in prolonged postoperative bed occupancy and slowed recovery which in turn can cause a range of complications.Consequently...Background Severe cardiac surgery trauma can lead to cardiopulmonary function injury,resulting in prolonged postoperative bed occupancy and slowed recovery which in turn can cause a range of complications.Consequently,preparation for discharge is a critical aspect of patient recovery,thereby necessitating the utmost attention to discharge management.The objective of this paper was to review the concept of discharge readiness for patients after cardiac surgery,along with the current situation,evaluation tools,existing problems,and improvement strategies.The aim is to gain an understanding of the research progress made in this area and provide suggestions for enhancing the discharge readiness of patients.This study intended to offer theoretical guidance for further research on improving the discharge readiness of patients following cardiac surgery.展开更多
Objective:The study reviews status,main time nodes and hospital discharge services for family caregivers of children with Kawasaki disease complicated by coronary artery aneurysm to provide references for the developm...Objective:The study reviews status,main time nodes and hospital discharge services for family caregivers of children with Kawasaki disease complicated by coronary artery aneurysm to provide references for the development of hospital discharge preparation services for medical personnel and patients.Background:CAL of Kawasaki disease is the main cause of acquired heart disease in children,but there is not enough research on the readiness for hospital discharge.Design:Systematic review of observational and interventional studies.展开更多
基金supported by the Talent training project of General Hospital of Ningxia Medical University(No.XM2020163)the Nursing Young Talents Training Program of General Hospital of Ningxia Medical University(No.dangfa[2020]39)。
文摘Objective:With the continuous advancement of aging in China,the number of older inpatients has increased sharply.Older patients have a high demand for planning their discharge services.Nurses serve as the leader of discharge planning for patients;there is a lack of reliable evaluation tool to evaluate the core competitiveness of nurses who implement discharge planning for older patients in China.The purpose of this study was to validate the index for the core competence of nurses who lead discharge planning for older patients developed by a project team through the Delphi method in the early stage.Methods:A cross-sectional questionnaire survey with 3-stage stratified sampling was used to select 1075 nurses from 17 public general hospitals in Ningxia,China.Results:The index consists of 4 first-level indicators,13 second-level indicators,and 57 third-level indicators.The results show that 57 third-level indicators had good discrimination.With exploratory factor analysis(EFA),4 common factors that explained 72.79%of the total variance were extracted.The Cronbach's a was 0.98,and the retest reliability within a 14-d interval was 0.86.The confirmatory factor analysis(CFA)results show that the fit of the index structure was good.The criterion validity was 0.73.Conclusions:The index presented excellent psychometric proper ties and can be used to measure the core competence of nurses in implementing discharge planning for older patients in China.
文摘Objective:To evaluate the effectiveness of discharge planning on maternal caring knowledge,maternal caring behavior,maternal discharge readiness and the rehospitalization of children with ventricular septal defect and pulmonary arterial hypertension(VSD-PAH).Background:Children with congenital heart disease(CHD)with pulmonary arterial hypertension(PAH)have more complications after surgery than those without PAH.Discharge planning is an effective strategy to help children leave the hospital safely,and receive appropriate care after discharge.Methods:A quasi-experimental design was used.Sixty children and their mothers were recruited and divided into two groups:the control group received conventional care,the intervention group received both conventional care and additional discharge planning care.Results:(1)After admission,maternal caring knowledge between the two groups was similar.(2)At discharge,maternal discharge readiness,maternal caring knowledge and maternal caring behavior in the intervention group was significantly higher compared to the control group(t=3.35,p=0.001;F=84.74,p<0.001;F=23.82,p<0.001).This difference persisted after discharge,and was evident at one month and three months after discharge.(3)However,no significant difference in the readmission rate of children after discharge was evident between the two groups.Conclusions:Discharge planning improves the maternal discharge readiness,maternal caring knowledge and maternal caring behaviors.However,this planning did not reduce the readmission rate of children with CHD-PAH.
文摘The UK National Health Service (NHS) is faced with problems of managing patient discharge and preventing the problems that result from it such as frequent readmissions, delayed discharge, long waiting lists, bed blocking and other such consequences. The problem is exacerbated by the growth in size, complexity and the number of chronic diseases in the NHS. In addition, there is an increase in demand for high quality care, processes and planning. Effective Discharge Planning (DP) requires practitioners to have appropriate, patient personalised and updated knowledge in order to be able to make informed and holistic decisions about a patients’ discharge. This paper examines the role of Knowledge Management (KM) in both sharing knowledge and using tacit knowledge to create appropriate patient discharge pathways. The paper details the factors resulting in inadequate DP, and demonstrates the use of Internet of Things (IoT) and Machine2Machine (M2M) as candidate technologies and possible solutions which can help reduce the problem. The use of devices that a patient can take home and devices which are perused in the hospital generate information, which can serve useful when presented to the right person at the right time, thus harvesting knowledge. The knowledge when fed back can support practitioners in making holistic decisions with regards to a patients’ discharge.
文摘Introduction: The in-hospital rehabilitation of patients who have undergone surgery for hip fracture requires a team-based effort, in which nurses play an all-embracing role throughout the patients’ hospital stays. Although discharge planning has been widely studied, little is known about discharge planning from hospitals to homes in rural settings. Aim: To describe nurses’ views on discharge planning for older patients after hip fracture surgery who live in their own homes in rural areas. Methods: A qualitative method was used. Four focus group interviews were conducted with 18 nurses who work at an orthopaedic clinic. The interview texts were analysed with qualitative content analysis. Findings: Nurses expressed that patients needed support from healthcare personnel as well as relatives in order to prepare for life at home. They also expressed that patients were not supported in all aspects of discharge planning because they faced difficulties in having their voices heard. Nurses described that many of those aspects were beyond their own control, which had left them with little to non-ability to influence discharge planning. Findings additionally indicate that discharge planning seems not affected by occurring in rural settings. Conclusions: Although discharge planning is intended to meet the unique wishes and needs of each patient given the realities of existing resources, nurses’ responsibilities in discharge planning are unclear. This study shows an organisation in which healthcare personnel continue to make decisions for patients. Significance for nurses to perform a discharge planning that support patients’ participation seems to be a communication based on shared understanding.
基金Construction and Practice of a discharge Preparation Plan for First-visit Ischemic stroke patients Based on the ADOPT model(Project No.:XJ2023005101)。
文摘Objective:To investigate the application effect of the discharge preparation plan based on the ADOPT nursing model in patients with first-visit ischemic stroke.Methods:Eighty patients with first-visit ischemic stroke admitted to our hospital from June 1,2024 to November 31,2024 were selected and divided into a control group(June 1,2024 to August 30,2024)and an intervention group(September 1,2024 to November 31,2024)according to different admission times,with 40 cases in each group.The control group received routine care and discharge guidance,while the intervention group received a discharge preparation plan based on the ADOPT model on the basis of routine care.The discharge readiness[Discharge Readiness Scale(RHDS)]of patients on the day of discharge was compared.Self-efficacy at 3 months after discharge[evaluated using the Chronic Disease Self-Efficacy Scale(SECD6)],activities of daily living[evaluated using the Barthel index(BI)],blood glucose and blood pressure indicators(diastolic blood pressure,systolic blood pressure,FPG,2 h PG),and readmission rate within 3 months after discharge were also compared between the two groups.Results:On the day of discharge,the RHDS-related dimension scores of the intervention group were higher than those of the control group(t=17.993,8.560,10.243,p<0.05);Three months after discharge,the SECD6 score and BI score of the intervention group were higher than those of the control group(t=8.910,10.899,both p<0.05);Systolic blood pressure,diastolic blood pressure,FPG and 2h PG in the intervention group were lower than those in the control group(t=8.868,4.794,3.829,7.121,all p<0.05);Within 3 months after discharge,the readmission rate of the intervention group was lower than that of the control group(χ^(2)=5.165,2 p<0.05).Conclusion:The discharge preparation plan based on the ADOPT nursing model,when applied to patients with first-visit ischemic stroke,can not only enhance self-efficacy and discharge preparation,improve activities of daily living,but also optimize blood glucose and blood pressure indicators and reduce the readmission rate,which is worthy of reference.
基金funded by National Institute for Health Research(NIHR)(RP-PG-1212-20019)。
文摘To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of mental health systems internationally.
文摘BACKGROUND Type 1 diabetes is one of the most common chronic diseases in childhood.The number of type 1 diabetes patients in China still ranks fourth in the world.Therefore,children with type 1 diabetes in China are a group that needs attention.The management of type 1 diabetes mellitus(T1DM)involves many aspects of daily life.It is extremely challenging for children and their families.T1DM children have complex medical care needs.Despite the continuous development of therapeutic medicine and treatment technologies,blood glucose control in children with T1DM is still not ideal.They and their parents need to acquire more knowledge and skills before being discharged.AIM To explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness,quality of discharge education and blood glucose control level.METHODS In total,102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time.Fifty cases from February to June 2019 were selected as the control group,and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan.The Readiness for Hospital Discharge Scale,Hospital Discharged Education Quality Scale and children's blood glucose metabolism indicators were used to compare the differences in discharge preparation,discharge education quality and blood glucose control between the two groups of children and their parents.RESULTS On the day of discharge,the two groups of children had the following scores of readiness for discharge:The intervention group score was 225.34±32.47,and the control group score was 208.68±29.31.The P value was 0.007,and the difference was statistically significant.The discharge education quality scores were as follows:The intervention group score was 135.11±19.86,the control group score was 124.13±15.56,the P value was 0.002 and the difference was statistically significant.Three months after discharge,the blood glucose metabolism indicator showed that the glycosylated hemoglobin value of the two groups was(7.45%±1.04%),and that of the control group was(8.04%±1.27%),P=0.012.Therefore,the improvement of parents'readiness for discharge,quality of discharge education and blood glucose metabolism indicators(glycosylated hemoglobin,fasting blood glucose and postprandial blood glucose)in the intervention group were better than those in the control group(P<0.05),and the difference was statistically significant.CONCLUSION The discharge plan for children with T1DM can help the children and their families realize the transition from hospital care to home self-management and improve the parents'readiness for discharge,thereby improving children’s blood glucose control levels.
文摘This study evaluated changes in inpatient adult medicine and adult surgery services in the metropolitan area of Syracuse New York. These are the two largest inpatient hospital services. The study involved the use of these services as a basis for health care planning over time. The first component of the study focused on changes in hospital discharges for adult medicine and adult surgery. It demonstrated that, between the first three quarters of 2019 and 2022, before and after the coronavirus epidemic, numbers of adult medicine and adult surgery discharges declined by 16 - 21 percent. The second component of the study focused on changes in hospital lengths of stay for adult medicine and adult surgery. It demonstrated that, between the first three quarters of 2019 and 2022, hospital inpatient lengths of stay increased by approximately 19 - 21 percent at the aggregate and hospital specific levels. Effective planning involving utilization indicators such as hospital discharges and efficiency will be necessary if the potential for effective management of this sector is to be preserved. This planning should involve comparisons of data such as hospital discharges and stays, and identification of the sources of these developments at the community level.
基金supported by Guangdong Provincial People's Hospital-Peak Climbing Program (Nursing Research Project) (No.DFJH2021004)。
文摘Background Severe cardiac surgery trauma can lead to cardiopulmonary function injury,resulting in prolonged postoperative bed occupancy and slowed recovery which in turn can cause a range of complications.Consequently,preparation for discharge is a critical aspect of patient recovery,thereby necessitating the utmost attention to discharge management.The objective of this paper was to review the concept of discharge readiness for patients after cardiac surgery,along with the current situation,evaluation tools,existing problems,and improvement strategies.The aim is to gain an understanding of the research progress made in this area and provide suggestions for enhancing the discharge readiness of patients.This study intended to offer theoretical guidance for further research on improving the discharge readiness of patients following cardiac surgery.
文摘Objective:The study reviews status,main time nodes and hospital discharge services for family caregivers of children with Kawasaki disease complicated by coronary artery aneurysm to provide references for the development of hospital discharge preparation services for medical personnel and patients.Background:CAL of Kawasaki disease is the main cause of acquired heart disease in children,but there is not enough research on the readiness for hospital discharge.Design:Systematic review of observational and interventional studies.
