Vat Molywan, Common Carol, Laizner Andrea Maria, Borduas Coralie, Maheu Christine
Ingram School of Nursing, McGill University, Montreal, QC, Canada.
MUHC - adult sites, McGill University Health Centre, Montreal, QC, Canada.
J Clin Nurs. 2015 Dec;24(23-24):3605-14. doi: 10.1111/jocn.13011. Epub 2015 Oct 14.
To understand the patients' reasons for returning to the emergency department soon after their discharge from an internal medicine unit and to compare these reasons with the liaison nurse clinician's risk assessment tools used for discharge planning.
Returns to the emergency departments soon after discharge from the hospital are a recurrent problem. Factors precipitating readmission to hospital have been analysed through the lens of health care providers, but few studies have explored the patients' perspectives on their reasons for returning to the emergency departments.
A qualitative, descriptive study.
Semi-structured interviews were conducted with a convenience sample of eight patients recruited from a major teaching hospital in Montreal, Canada. Three different data sources were triangulated: patients' perspectives obtained through interviews and data from the tools used by the liaison nurse clinician, the Bounceback Probability Legend and the LACE Index Scoring Tool.
Most patients attributed their return to the emergency department on being discharged too soon, feeling weak at discharge, having limited help at home with managing chronic illnesses and insufficient discharge instructions. participants' reasons for returning differed from those predicted by the liaison nurse clinician's evaluation using the risk assessment tools of each participant's risk of return.
This study highlights patients' frailty upon discharge from the hospital and their informational need on their health condition and their support need to rely on during convalescence at home. Patient's readiness and concerns were not integrated as part of the liaison nurse clinician's evaluation tools for discharge planning. This led to discrepancies between the perspectives of the patients and the liaison nurse clinician about discharge planning.
Health care professionals should evaluate patients' understanding of their illness, their readiness for self-management and work collaboratively with patients to assess concerns before discharge, so that appropriate support can be mobilised to prevent readmission.
了解患者在内科病房出院后不久返回急诊科的原因，并将这些原因与联络护士临床医生用于出院计划的风险评估工具进行比较。
出院后不久返回急诊科是一个反复出现的问题。已从医疗保健提供者的角度分析了促使再次入院的因素，但很少有研究探讨患者对返回急诊科原因的看法。
一项定性描述性研究。
对从加拿大蒙特利尔一家大型教学医院招募的8名患者进行便利抽样的半结构式访谈。对三个不同的数据来源进行了三角测量：通过访谈获得的患者观点以及联络护士临床医生使用的工具、反弹概率图例和LACE指数评分工具的数据。
大多数患者将返回急诊科归因于出院太早、出院时感觉虚弱、在家中管理慢性病的帮助有限以及出院指导不足。参与者返回的原因与联络护士临床医生使用风险评估工具预测的每个参与者返回风险不同。
本研究强调了患者出院时的虚弱状况以及他们对健康状况的信息需求，以及在家康复期间需要依赖的支持。患者的准备情况和担忧未被纳入联络护士临床医生出院计划评估工具的一部分。这导致了患者和联络护士临床医生在出院计划方面的观点存在差异。
医疗保健专业人员应评估患者对自身疾病的理解、自我管理的准备情况，并在出院前与患者合作评估担忧，以便能够调动适当的支持措施来预防再次入院。
