Queensland Centre for Mothers and Babies, University of Queensland, Brisbane, Queensland, Australia.
Queensland Centre for Mothers and Babies, University of Queensland, Brisbane, Queensland, Australia.
Women Birth. 2014 Jun;27(2):114-20. doi: 10.1016/j.wombi.2013.12.001. Epub 2013 Dec 27.
Efforts to increase postnatal support available to women and families are hampered by inadequate referral mechanisms. However, the discharge process in maternity services has received little research attention.
To review current discharge practices in Queensland, in order to identify mechanisms to minimise fragmentation in the care of women and families as they transition from hospital-based postnatal care to community-based health and other services.
A survey of discharge practices in Queensland hospitals that offer birthing services (N=55) and content analysis of discharge summary forms used by those hospitals.
Fifty-two Queensland birthing hospitals participated in the study. Discharge summaries were most commonly sent to General Practitioners (83%), less commonly to Child and Family Health Nurses (CFHNs; 52%) and rarely to other care providers. Discharge summaries were usually disseminated within one week of discharge (87%), but did not capture any information about care provided by domiciliary services. Almost one-fifth (19%) of hospitals did not seek women's consent for the disclosure of their discharge summary and only 10% of hospitals had processes for women to check accuracy. Significant gaps in the content of discharge summaries were identified, particularly in psychosocial and cultural information, and post-discharge advice. The format of discharge summaries diminished their readability.
Discharge summaries (format and content) should be consistent, comprehensive and specific to maternity services. Discharge summaries should be generated and disseminated electronically at the time of discharge from the maternity service. Women should review their discharge summaries and direct and consent to its dissemination.
增加向妇女和家庭提供的产后支持的努力受到转诊机制不足的阻碍。然而，产妇服务中的出院流程很少受到研究关注。
审查昆士兰州目前的出院实践，以确定机制，尽量减少妇女和家庭在从医院产后护理过渡到社区健康和其他服务时护理的碎片化。
对昆士兰州提供分娩服务的医院的出院实践进行调查（N=55），并对这些医院使用的出院摘要表进行内容分析。
52 家昆士兰分娩医院参与了这项研究。出院摘要最常发送给全科医生（83%），其次是儿童和家庭健康护士（CFHNs；52%），很少发送给其他护理提供者。出院摘要通常在出院后一周内分发（87%），但没有记录任何关于家庭服务提供的护理信息。近五分之一（19%）的医院在披露出院摘要时没有征求妇女的同意，只有 10%的医院有妇女检查准确性的流程。出院摘要的内容存在明显差距，特别是在社会心理和文化信息以及出院后建议方面。出院摘要的格式降低了其可读性。
出院摘要（格式和内容）应一致、全面，并针对产妇服务具体制定。出院摘要应在产妇服务出院时以电子方式生成和分发。妇女应审查其出院摘要，并直接同意其传播。
