Hospital discharge preparation for homeward bound elderly
View File(s)
- Author(s)
- Details
-
Dr. Diane Storer Brown, RN, PhD, FNAHQ, FAAN
- Sigma Affiliation
- Alpha Eta
Visitor Statistics
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Country | Visits |
---|
Top Visiting Cities
City | Visits |
---|
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Brown, Diane Storer by View
Title | Page Views |
---|
Popular Works for Brown, Diane Storer by Download
Title | Downloads |
---|
View Citations
Citations
Hospital discharge planning (DCP) for the elderly is a research priority. Within the cost conscious healthcare environment, there is concern about short hospitalizations and responsibility shifts to patients for continued health care. While Health Maintenance Organizations (HMO) provide care for many elderly, there is no research on DCP outcomes for elderly HMO patients. The purpose of this study was to explore outcomes of DCP for elderly medical patients, satisfaction, service utilization, and relationships among the hospital environment, patients, and discharge outcomes. This study utilized a descriptive correlational design within an HMO hospital. A convenience sample of 140 patients age 65 years or older, and returning home were enrolled over one year. Subjects stated satisfaction with instruction and preparation for discharge. Knowledge scores for new regimes ranged from 72% to 95% of the possible score for activities, medications, diet, and treatments. After discharge, 76% stated they were involved in DCP but 86% of their families were not. Subjects utilized 2121 services or supplies. Prior to hospitalization, 33% used 93 services; 53% required 127 at discharge; and within 30-days of discharge, all subjects used 1901 services. Additional needs were identified by 21%. Within 30 days, 13% were readmitted to the hospital; all had stated they were prepared for discharge. Patient characteristics significantly explained variance in three outcomes. After multiple regression analyses, the percent of explained variance ranged from 11 to 17 for medication knowledge, arrangements, and services $(p<.01).$ Hospital variables were related to individual outcomes but were not significant in multiple regression analyses. Continuity of care was related to satisfaction $(r=.21,$ $p<.01)$ and the number of advice telephone calls $(r=.17,$ $p<.05).$ RN Workload was related to the number of emergency room visits (r = $-$.23, $p<.01),$ diagnostic tests (r = $-$.17, $p<.05),$ and additional referrals (r =.24, $p<.01).$ This study reinforced the importance of DCP for elderly patients--the majority were discharged with a regime change and service needs. Medication knowledge scores were low and patient ability to learn instruction was unclear. Patients may have been too ill to learn, their stay too short, or they may not have had the need to learn what health care providers considered essential.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9303539; ProQuest document ID: 304015225. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Observational |
Research Approach | Quantitative Research |
Keywords | Discharge Planning for the Elderly; Elderly Patient Outcomes; Self Care |
CINAHL Subject(s) | Discharge Planning; Aged, Hospitalized; Health Maintenance Organizations; Patient Satisfaction; Patient Education |
Grantor | University of California, San Francisco |
Advisor | Holzemer, William L. |
Level | PhD |
Year | 1992 |
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Related items
Showing items related by title, author, creator and subjects.
-
Outcome of discharge planning linked to Long-Term Care Plan 2.0 for elderly orthopedic surgery patient
Cheng, Pi-Fen; Chen, Hui-Zhu; Pan, Hui-ChuanIn January 2017, the "10-Year Long-Term Care plan 2.0" policy (Long-Term Care 2.0) promoted by the Government in Taiwan. Intervention improvement strategy, it showed that the effect of discharge planning linked to Long-Term ... -
Hospital nursing organization and outcomes for surgical oncology patients
Friese, Christopher R.As interest in the relationship between the organization of nursing care and patient outcomes grows, concerns exist that the quality of care for cancer patients is unequal. This study examined the association between the ... -
Antepartum, intrapartum, postpartum predictors and outcomes of readiness for hospital discharge
Malagon-Maldonado, Gabriella (2016-03-17)Session presented on Friday, July 24, 2015: Purpose: The antepartum, intrapartum, and postpartum periods are considered to be a time of critical adjustment in physical, psychological, and social well-being with considerable ... -
Effect of change in nursing skill mix on patient and organizational outcomes in one teaching hospital
Birmingham, Sharon A. EckThis study examined the effect of a change in nursing skill mix, RN hours, and total caregiver hours on patient satisfaction, adverse occurrences, mortality, length of stay, and cost on 19 nursing units (N = 46, 664 patients) ... -
Standardized multidisciplinary discharge planning rounds: Improving patient perception of care transitions
Bumpas, Jerilyn White; Copeland, Donna J.Multidisciplinary Discharge Planning Rounds can improve patient satisfaction with care by improving communication among the healthcare team. This original work provides a real-world, practical framework for nursing leaders ...