Institute of Higher Education and Research in Healthcare (IUFRS), Lausanne University and Lausanne University Hospital, Lausanne, Switzerland.
Bureau d'Echange des Savoirs pour des praTique exemplaires de soins: an Affiliate Center of the Joanna Briggs Institute, Lausanne, Switzerland.
J Adv Nurs. 2018 Apr;74(4):788-799. doi: 10.1111/jan.13475. Epub 2017 Nov 17.
To determine the effectiveness of nursing discharge planning interventions on health-related outcomes for older inpatients discharged home.
Inadequate discharge planning for the ageing population poses significant challenges for health services. Effective discharge planning interventions have been examined in several studies, but little information is available on nursing interventions for older people. Despite the research published on the importance of discharge planning, the impact on patient's health outcomes still needs to be evaluated in practice.
Systematic review and meta-analysis.
A systematic search was undertaken across 13 databases to retrieve published and unpublished studies in English between 2000-2015.
Critical appraisal, data extraction and meta-analysis followed the methodology of the Joanna Briggs Institute.
Thirteen studies were included in the review, 2 of 13 were pilot studies and one had a pre-post design. Included studies involved 3,964 participants with a median age of 77 years. Nurse discharge planning did not significantly reduce hospital readmission or quality of life, except readmission was lower across studies conducted in the USA. The overall effect score for nurse discharge planning on length of stay was statistically significant and positive.
Nursing discharge planning is a complex intervention and difficult to evaluate. Findings suggest that nursing discharge planning for older inpatients discharged home increases the length of stay yet neither reduces readmission rate nor improves quality of life.
确定护理出院计划干预对出院回家的老年住院患者健康相关结局的效果。
人口老龄化导致出院计划不足，给卫生服务带来重大挑战。已有多项研究对有效的出院计划干预措施进行了检验，但关于老年人护理干预的信息却很少。尽管已经发表了关于出院计划重要性的研究，但仍需要在实践中评估其对患者健康结果的影响。
系统评价和荟萃分析。
对 2000 年至 2015 年间以英文发表和未发表的研究进行了 13 个数据库的系统检索。
采用 Joanna Briggs 研究所的方法进行批判性评估、数据提取和荟萃分析。
13 项研究纳入综述，其中 2 项为试点研究，1 项具有前后设计。纳入的研究共涉及 3964 名参与者，中位年龄为 77 岁。护士出院计划并未显著降低医院再入院率或生活质量，除了在美国进行的研究中再入院率较低。护士出院计划对住院时间的总体效果评分具有统计学意义且为正。
护理出院计划是一项复杂的干预措施，难以评估。研究结果表明，对出院回家的老年住院患者进行护理出院计划会延长住院时间，但不会降低再入院率或提高生活质量。
