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      Nurses’ information exchange during older patient transfer: prevalence and associations with patient and transfer characteristics

      research-article
      , RN, MNSc, , RN, PhD, , RN, PhD
      International Journal of Integrated Care
      Igitur publishing
      older people, transfer, nursing documentation, hospitalization, home care

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          Abstract

          Introduction

          To ensure continuity of care, it is important to effectively communicate the health status of older patients who are transferred between health care organizations. The objectives of this study were to: (1) evaluate the prevalence of nursing transfer documents, and (2) identify patient and transfer characteristics associated with the presence of nursing transfer documents for older patients transferred from home care to hospital and back to home care again after hospitalization.

          Methods

          Nursing documents were reviewed from a total of 102 records of older inpatients admitted from home care to medical wards at a local hospital in central Norway and later discharged home. Frequencies were used to describe patient and transfer characteristics, and the prevalence of transfer documents. Pearson’s χ 2 test and logistic regression were used to identify possible associations between patient and transfer characteristics and the presence of nursing transfer documents.

          Results

          While nursing admission notes were present in 1% of the patient transfers from home care to the hospital, 69% of patient discharges from the hospital to home care were accompanied by nursing discharge notes. Patient and transfer characteristics associated with the presence of a nursing discharge note were age, gender, medical department facility, and length of hospital stay.

          Conclusions

          The low prevalence of nursing transfer documents constitutes a challenge to the continuity of care for hospitalized home care patients. Patient and transfer characteristics may impact the nurses’ propensity to exchange patient information. These findings emphasize the need for nurses and managers to improve the exchange of written information. While nurses must strive to transfer accurate patient information at the right place and at the right time, the managers must facilitate this by providing appropriate guidelines and standards, as well as adequate personnel and resources.

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          Most cited references64

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          Applied Logistic Regression

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            Falling through the cracks: challenges and opportunities for improving transitional care for persons with continuous complex care needs.

            Persons with continuous complex care needs frequently require care in multiple settings. During transitions between settings, this population is particularly vulnerable to experiencing poor care quality and problems of care fragmentation. Despite how common these transitions have become, the challenges of improving care transitions have received little attention from policy makers, clinicians, and quality improvement entities. This article begins with a definition of transitional care and then discusses the nature of the problem, its prevalence, manifestations of poorly executed transitions, and potentially remediable barriers. Necessary elements for effective transitions are then presented, followed by promising new directions for quality improvement at the level of the delivery system, information technology, and national health policy. The article concludes with a proposed research agenda designed to advance the science of high-quality transitional care.
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              The association between continuity of care and outcomes: a systematic and critical review.

              Numerous studies have tried to determine the association between continuity and outcomes. Studies doing so must actually measure continuity. If continuity and outcomes are measured concurrently, their association can only be determined with time-dependent methods. To identify and summarize all methodologically studies that measure the association between continuity of care and patient outcomes. We searched MEDLINE database (1950-2008) and hand-searched to identify studies that tried to associate continuity and outcomes. English studies were included if they: actually measured continuity; determined the association of continuity with patient outcomes; and properly accounted for the relative timing of continuity and outcome measures. A total of 139 English language studies tried to measure the association between continuity and outcomes but only 18 studies (12.9%) met methodological criteria. All but two studies measured provider continuity and used health utilization or patient satisfaction as the outcome. Eight of nine high-quality studies found a significant association between increased continuity and decreased health utilization including hospitalization and emergency visits. Five of seven studies found improved patient satisfaction with increased continuity. These studies validate the belief that increased provider continuity is associated with improved patient outcomes and satisfaction. Further research is required to determine whether information or management continuity improves outcomes. © 2010 Blackwell Publishing Ltd.
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                Author and article information

                Contributors
                Role: PhD-Student
                Role: Professor
                Role: Associated Professor
                Journal
                Int J Integr Care
                Int J Integr Care
                IJIC
                International Journal of Integrated Care
                Igitur publishing (Utrecht, The Netherlands )
                1568-4156
                Jan-Mar 2013
                1 March 2013
                : 13
                : e005
                Affiliations
                Faculty of Health and Science, Nord-Trøndelag University College, Finn Christiansens vei 1, No-7800 Namsos, Norway
                Department of Health Sciences, Mid-Sweden University, S-851 70 Sundsvall, Sweden
                Faculty of Health and Science, Nord-Trøndelag University College, Finn Christiansens vei 1, No-7800 Namsos, Norway; Centre for Care Research Mid-Norway, Servicebox 2501, NO-7729 Steinkjer, Norway
                Author notes
                Correspondence to: Rose Mari Olsen, Faculty of Health and Science, Nord-Trøndelag University College, Finn Christiansens vei 1, No-7800 Namsos, Norway, Phone: +47 74212339, Fax: +47 74212301, E-mail: rose.olsen@ 123456hint.no
                Article
                ijic2013005
                10.5334/ijic.879
                3653276
                23687477
                03a03c7e-7b89-4480-984c-d0cb59a15b36
                Copyright 2013, Authors retain the copyright of their article

                This work is licensed under a ( http://creativecommons.org/licenses/by/3.0) Creative Commons Attribution 3.0 Unported License

                History
                : 25 May 2012
                : 29 October 2012
                : 1 November 2012
                Categories
                Research and Theory
                Custom metadata
                Int J Integr Care 2013; Jan–Mar, URN:NBN:NL:UI:10-1-114282

                Health & Social care
                older people,transfer,nursing documentation,hospitalization,home care
                Health & Social care
                older people, transfer, nursing documentation, hospitalization, home care

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