Discharge planning and follow-up in the community.

Abstract

Discharge planning is the process which aims to facilitate transition of the patient from hospital to home. Literature shows that nurses play a key role in discharge planning which will involve assessment of the patient's needs, developing a discharge plan together with the patient and family, implementing the plan and then carry out an evaluation of the whole process. This research project aims to investigate the orthopaedic ward nurses' knowledge, awareness and perceptions in relation to discharge planning and follow-up in the community. This small-scale research project adapted a quantitative research method where data was collected by means of a questionnaire devised by the researcher using ideas from other existing questionnaires. Most of the questions were formulated on two main discharge planning protocols including 'Protocol on Patient discharge from hospital, NHS Shetland, (2003)' and 'Clinical Manual - Nursing Practice manual, John Dempsey Hospital, University of Connecticut Health Centre (2008)'. The sample consisted of the whole population of nurses working in all orthopaedic wards in the local state General Hospital. The response rate was that of65%. Data collected was analysed by means of descriptive analysis. Findings revealed that overall, the majority of the participants perceived themselves as being knowledgeable about discharge planning and showed overall good knowledge of discharge planning. However, only 23% of the participants knew the stages of discharge planning. As with regards to follow-up, participants provided relevant definitions, and also showed overall good knowledge of follow-up in the community. On the other hand, not all participants were accustomed with the community services available and with the support these services offer. Moreover, results revealed that the majority of the participants were able to perceive that the agency/unit that provide follow-up in the community should be involved in discharge planning. However, the majority of the participants were not able to recognise the only unit that provides follow-up in the community. Findings of this study suggests further research through an observational study that would be appropriate in order to investigate what is actually being practiced in the local situation. The introduction of structured guidelines will be a formal process that all the multidisciplinary team may follow in order to improve discharge planning. As with regards to recommendation for practice, liaison between hospital and the community could be enhanced by involving the Commcare team in case conference while the patient is still hospitalized to ensure seamless care. Through continues development courses, talks and seminars, the health care professionals should be constantly educated on the discharge process and should also be made aware of the present community care services available, while establishing and clarifying their role and the type of support these services offer.