Nurses' discharge planning and risk assessment: behaviours, understanding and barriers

Authors

  • Jane Graham MN, RN,

    Service Manager, Corresponding author
    • Rehabilitation and Aged Care, Calvary Health Care, Sydney, NSW, Australia
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  • Robyn Gallagher PHD, RN,

    Associate Professor of Chronic and Complex Care
    1. Faculty of Nursing, St George Hospital, Sydney, NSW, Australia
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  • Janine Bothe DN, RN

    Clinical Nurse Consultant-Surgery
    1. Faculty of Nursing, St George Hospital, Sydney, NSW, Australia
    2. Midwifery and Health, University of Technology, Sydney, NSW, Australia
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Correspondence: Jane Graham, Service Manager Rehabilitation and Aged Care, Calvary Health Care, 91-111 Rocky Point Road Beverley Park, Sydney, NSW 2217, Australia. Telephone: +61 02 95533039.

E-mail: jane.graham@sesiahs.health.nsw.gov.au

Abstract

Aims and objectives

To examine nurses' discharge planning understanding, adherence and barriers.

Background

Discharge planning commenced at admission by nurses plays a key role in improving patient outcomes,but policies in place to maintain effective discharge planning are often not followed by nurses.

Design

This is a descriptive study.

Methods

Nurses (n = 64) working in acute wards undertook a self-report survey of discharge planning understanding, adherence and barriers.

Results

Adherence to discharge planning policy is low (23%), despite a general awareness of the reduced quality of patient outcomes that may result. The most common barriers to discharge planning identified were lack of time and patient factors. Further contradictions occurred in that nurses understood the importance of discharge planning, yet did not comply with discharge planning policies.

Conclusions

Nurses require additional encouragement and support in complying with discharge planning policies, and discharge planning policies should be adapted to better handle unpredictable illness trajectories.

Relevance to clinical practice

Completion of discharge planning is important for the safe transition of patients from one care setting to the next. Before a systematic approach to discharge planning can be implemented, a greater understanding of nurses' discharge planning practice in acute care wards is required. Greater incorporation of discharge planning activities into nurses' daily practice may also occur if nurses are involved in the development and implementation of the discharge processes and then provided with education and regular feedback on monthly audit results.

Ancillary