Emily Wahlquist Topham, HBSN, RN, is an ICU registered nurse at (RN) the Huntsman Cancer Hospital in Salt Lake City, Utah. She received her Honors Bachelor of Science in Nursing (HBSN) from the College of Nursing, University of Utah, in May 2021. After working closely with patients and their family members for several years as a CNA, and during her training as an RN, Emily developed an interest in research and further exploring the role of family/informal caregivers during discharge processes, leading her to conduct these interviews and analyses.
Alycia Bristol, PhD, RN, AGCNS-BC, is an assistant professor at the College of Nursing, University of Utah. Dr. Bristol's research broadly seeks to address the care needs of hospitalized older adults and family caregivers, with a particular focus on patient safety and care quality. Dr. Bristol has conducted research in the areas of caregiving, palliative care, dementia symptom management, and care transitions. She is currently examining the influence of intrahospital transitions on discharge planning and caregivers' readiness for discharge.
Prof Case Manag. 2022;27(4):181-193. doi: 10.1097/NCM.0000000000000563.
Despite recognition that unpaid (e.g., family, friends) caregivers (caregivers) play an important role in successful transitions home after hospitalization, limited information is available about whether and how caregiver experiences of discharge align with current strategies for providing high-quality discharge processes, and how these experiences at discharge impact successful transitions home. The purpose of this study was to explore perceptions of caregivers regarding their discharge preparation, focusing particular attention on whether and how they believed discharge preparation impacted postdischarge patient outcomes.
We conducted in-depth, case interviews with four English-speaking caregivers (61-75 years of age). Content analysis was framed by the nature of caregiver involvement proposed by the Agency for Healthcare Research and Quality's (AHRQ's) IDEAL (Include, Discuss, Educate, Assess, Listen) discharge planning strategy.
Caregivers reported receiving clear discharge instructions, or basic education, and yet felt only passively included in discharge teaching. Once home, the caregivers reported gaps in their knowledge of how to care for the patient, suggesting key gaps related to knowledge of warning signs and problems. Two of the four caregiver participants attributed a hospital readmission to postdischarge knowledge gaps.
The experiences of these caregivers demonstrate how their limited, passive involvement in discharge education may result in suboptimal patient outcomes after hospitalization. Our findings suggest that structured programs aimed at increasing caregiver involvement in discharge, particularly related to assessment of caregiver problem solving, planning, and postdischarge support, are important in efforts seeking to improve care transitions and postdischarge outcomes.
This study assesses caregivers' experience with discharge planning and problems they encounter post-discharge, providing case managers with important information regarding the effectiveness of discharge processes. This study of caregiver experiences suggests that the IDEAL discharge planning strategy remains a useful and important framework for case managers to follow when providing discharge services.
尽管人们认识到无偿（例如，家人、朋友）照顾者（照顾者）在患者成功出院后过渡回家方面发挥着重要作用，但关于照顾者的出院体验是否以及如何与提供高质量出院流程的当前策略保持一致，以及这些出院体验如何影响患者成功出院回家，相关信息有限。本研究旨在探讨照顾者对其出院准备的看法，特别关注他们是否以及如何认为出院准备会影响出院后的患者结局。
我们对 4 名英语为母语的照顾者（61-75 岁）进行了深入的案例访谈。内容分析的框架是由医疗保健研究与质量局（AHRQ）的 IDEAL（包括、讨论、教育、评估、倾听）出院计划策略提出的照顾者参与性质。
照顾者报告说收到了明确的出院指示或基本教育，但他们只感到被动地参与了出院教学。一旦回家，照顾者报告说他们对如何照顾患者的知识存在差距，这表明与预警信号和问题相关的知识存在关键差距。这 4 名照顾者中有 2 名将患者的医院再入院归因于出院后知识差距。
这些照顾者的经历表明，他们在出院教育中的有限、被动参与可能导致患者出院后结局不佳。我们的研究结果表明，旨在增加照顾者在出院时的参与度的结构化计划，特别是与评估照顾者解决问题、计划和出院后支持相关的计划，对于寻求改善护理过渡和出院后结局的努力非常重要。
本研究评估了照顾者对出院计划的体验以及他们在出院后遇到的问题，为个案经理提供了有关出院流程效果的重要信息。这项对照顾者体验的研究表明，IDeal 出院计划策略仍然是个案经理在提供出院服务时遵循的有用且重要的框架。
