University of Wisconsin-Madison School of Nursing, Madison, WI, United States.
University of Wisconsin-Madison School of Nursing, Madison, WI, United States; University of Wisconsin-Madison School of Medicine & Public Health, Department of Medicine, Division of Geriatrics, Madison, WI, United States; William S. Middleton Memorial Veterans Hospital, Geriatric Research Education and Clinical Center, Madison, WI, United States.
Geriatr Nurs. 2022 May-Jun;45:215-222. doi: 10.1016/j.gerinurse.2022.04.010. Epub 2022 May 13.
Hospital-to-skilled nursing facility (SNF) transitions constitute a vulnerable point in care for people with dementia and often precede important care decisions. These decisions necessitate accurate diagnostic/decision-making information, including dementia diagnosis, power of attorney for health care (POAHC), and code status; however, inter-setting communication during hospital-to-SNF transitions is suboptimal. This retrospective cohort study examined omissions of diagnostic/decision-making information in written discharge communication during hospital-to-SNF transitions. Omission rates were 22% for dementia diagnosis, 82% and 88% for POAHC and POAHC activation respectively, and 70% for code status. Findings highlight the need to clarify and intervene upon causes of hospital-to-SNF communication gaps.
医院到养老院（SNF）的过渡是痴呆患者护理的一个脆弱环节，往往是做出重要护理决策的前置步骤。这些决策需要准确的诊断/决策信息，包括痴呆症诊断、医疗保健授权书（POAHC）和医嘱预嘱（COD），但医院到养老院的过渡期间的跨机构沟通并不理想。本回顾性队列研究检查了医院到养老院过渡期间书面出院沟通中诊断/决策信息的遗漏情况。痴呆症诊断的遗漏率为 22%，POAHC 和 POAHC 激活的遗漏率分别为 82%和 88%，COD 遗漏率为 70%。研究结果强调了需要明确和干预医院到养老院沟通差距的原因。
