Organisation and coordination of post discharge nursing care

Abstract

This dissertation's literature researched reviews some of the studies concerning nurses' perceptions regarding discharge organisation and coordination. These studies explore factors within the multidisciplinary team that impede or promote decision making in the discharge planning process. The authors sought to focus on effectiveness and efficiency of the various systems and roles. The issues of maintaining continuation of care after discharge from hospital have also been identified and discussed. The researcher's aim in this dissertation's small scale study was to look into discharge procedures as currently viewed by nurses in the medical and surgical wards. Moreover, this study attempted to reveal solutions that can improve discharge organisation and coordination. The population upon which research was conducted consisted of 21 ward managers. A response rate of 86% was achieved and data was collected by means of a self administered questionnaire using a mixed method approach to obtain qualitative and quantitative data. From the findings of this study, it was revealed that consultants decide on the patient's discharge date and the patients care needs, whereas nursing officers in charge were the organisers, coordinators and information givers to both patients and relatives of these discharge procedures. However, participants admit that discharge decisions and plans should be considered amongst a multidisciplinary team and then coordinated by the nurses. Overall the participant nurses felt that by the relationship built between the patient and nurse makes nurses the ideal coordinators of care. Findings have shown that nurses were dissatisfied with the current practices and show that discharge procedures seem to be more efficient then effective. Participants identified the patients' discharge problems as being mainly physical, social and psychological in nature. On the other hand participants viewed patients as being less involved then their relatives during their discharge procedures. Ideas and systems that could improve the current discharge care procedures were suggested by the participant nurses with a degree of enthusiasm and these are discussed later on in this dissertation.