Ohuabunwa Ugochi, Shah Seema, Jordan Queenie, Johnson Kristen, Avent Elizabeth, Flacker Jonathan
Division of General Medicine and Geriatrics, Emory University School of Medicine, 49 Jesse Hill Jr Drive, Atlanta, GA 30303 USA.
Institute for Family Health, New York, NY USA.
Med Sci Educ. 2019 Sep 4;29(4):1017-1022. doi: 10.1007/s40670-019-00798-y. eCollection 2019 Dec.
Significant morbidity, mortality, and increased healthcare costs of up to 20.1 billion dollars annually occur as a result of poorly executed patient care transitions. The critical role of providers in ensuring patient safety at discharge requires provider knowledge of required care transitions processes to ensure optimal execution of transitions of care. The present study was designed to determine provider perception of their care transitions training, curriculum content, and self-identified care transitions knowledge gaps. A cross-sectional survey was conducted among key healthcare providers at the Grady Memorial Hospital, a 953 bed urban safety net hospital. Of these, 131 participants completed the surveys including 73 internal medicine residents, 51 nurses, and 7 social workers. Among participants, 13% reported that they had never had any formal training on care transitions. Of these, 88.2% were medical residents, while 11.8% were bedside nurses. Among participants who had received care transitions training, only 40% received their training prior to graduation. Healthcare providers across disciplines were least exposed to training on discharge settings of care, determining the most appropriate next level of care for patients at discharge, and communication and coordination with post-acute care facilities. Providers made recommendations regarding topics they considered important to be included in care transitions training. Defining the full discharge process and responsibilities of various healthcare providers were topics recommended by most providers as important to be included in care transitions training. This study has highlighted the extent of exposure to formal care transitions training among providers from multiple disciplines involved in various aspects of discharge care. It has demonstrated a paucity of formal care transitions training at the health professional school level. It has also highlighted self-identified care transitions training needs and will form a foundation for design of care transitions curricula for a broad range of healthcare professionals.
由于患者护理过渡执行不当,每年会出现严重的发病率、死亡率,并导致高达2010亿美元的医疗成本增加。提供者在确保患者出院时安全方面的关键作用要求其了解所需的护理过渡流程,以确保护理过渡的最佳执行。本研究旨在确定提供者对其护理过渡培训、课程内容以及自我认定的护理过渡知识差距的看法。在格雷迪纪念医院(一家拥有953张床位的城市安全网医院)的主要医疗保健提供者中进行了一项横断面调查。其中,131名参与者完成了调查,包括73名内科住院医师、51名护士和7名社会工作者。在参与者中,13%报告称他们从未接受过任何关于护理过渡的正式培训。其中,88.2%是住院医师,而11.8%是床边护士。在接受过护理过渡培训的参与者中,只有40%在毕业前接受了培训。跨学科的医疗保健提供者接受出院护理设置培训、确定患者出院时最合适的下一级护理以及与急性后护理机构沟通和协调的培训最少。提供者就他们认为对护理过渡培训重要的主题提出了建议。大多数提供者建议将定义完整的出院流程和各种医疗保健提供者的职责作为护理过渡培训中重要的主题纳入。本研究强调了参与出院护理各个方面的多学科提供者接受正式护理过渡培训的程度。它表明在卫生专业学校层面缺乏正式的护理过渡培训。它还突出了自我认定的护理过渡培训需求,并将为设计面向广泛医疗保健专业人员的护理过渡课程奠定基础。