Wen Yuehui, Xu Li, Lee Geraldine, Liu Mengyun, Wang Xiyi
School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Adv Nurs. 2025 Jul 25. doi: 10.1111/jan.70100.
To evaluate the effects of the organisational environment on hospital discharge readiness during public health emergencies.
An observational study.
A regression-discontinuity design approach was employed to assess the impact of the organisational environment on hospital discharge readiness. Adult patients diagnosed with acute myocardial infarction and discharged from the Cardiac Critical Care Unit of a tertiary hospital in Shanghai, China, were recruited. Spearman correlation analysis was conducted to examine the associations between multiple factors at individual and organisational levels and hospital discharge readiness across three stages of pandemic policy changes.
A total of 411 patients were included in the analysis. The regression-discontinuity analysis revealed a significant discontinuity at the cut-off, indicating that policy-driven changes in the organisational environment during public health emergencies were associated with a 21.61% reduction in hospital discharge readiness. Additionally, family functioning and the quality of nursing discharge education were significantly associated with discharge readiness across all three pandemic stages.
These findings demonstrate that patient-perceived hospital discharge readiness is significantly influenced by changes in the organisational environment during public health emergencies. Future research should focus on developing targeted discharge preparation programmes that allow for organisational adaptation in response to emergencies, such as pandemics or natural disasters.
Organisational responses to public health emergencies need to prioritise enhancing discharge preparedness. This includes bolstering family involvement and ensuring that nurses are adequately trained to provide effective discharge education, especially when healthcare resources are strained.
The findings underscore the importance of adaptable and resilient discharge planning and transitional care, particularly in public health emergencies. Fostering an organisational environment that supports seamless discharge processes can significantly improve patient readiness for post-hospital care.
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.
No patient or Public Contributions.
评估公共卫生紧急事件期间组织环境对医院出院准备情况的影响。
一项观察性研究。
采用回归间断设计方法评估组织环境对医院出院准备情况的影响。招募了在中国上海一家三级医院心脏重症监护病房诊断为急性心肌梗死并出院的成年患者。进行Spearman相关性分析，以检验在大流行政策变化的三个阶段中，个人和组织层面的多个因素与医院出院准备情况之间的关联。
共有411名患者纳入分析。回归间断分析显示在临界点处存在显著间断，表明公共卫生紧急事件期间政策驱动的组织环境变化与医院出院准备情况降低21.61%相关。此外，在所有三个大流行阶段，家庭功能和护理出院教育质量与出院准备情况显著相关。
这些发现表明，公共卫生紧急事件期间患者感知的医院出院准备情况受到组织环境变化的显著影响。未来研究应侧重于制定有针对性的出院准备计划，以允许组织适应紧急情况，如大流行或自然灾害。
组织对公共卫生紧急事件的应对需要优先加强出院准备。这包括加强家庭参与，并确保护士接受充分培训以提供有效的出院教育，尤其是在医疗资源紧张时。
研究结果强调了适应性和弹性出院计划及过渡护理的重要性，特别是在公共卫生紧急事件中。营造支持无缝出院流程的组织环境可显著提高患者对院后护理的准备程度。
采用加强流行病学观察性研究报告（STROBE）声明。
无患者或公众贡献。
