Communicating discharge instructions to patients: A survey of nurse, intern, and hospitalist practices

被引:23
作者
Ashbrook, Liza [1 ]
Mourad, Michelle [1 ]
Sehgal, Niraj [1 ]
机构
[1] Univ Calif San Francisco, Dept Med, Div Hosp Med, San Francisco, CA 94143 USA
关键词
PATIENTS AFTER-DISCHARGE; TEACHING HOSPITALS; HEALTH LITERACY; ADVERSE EVENTS; CARE; SAFETY; COLLABORATION; MORBIDITY; CHECKLIST; TEAMWORK;
D O I
10.1002/jhm.1986
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND: Comprehensive discharge education can improve patient understanding and may reduce unnecessary rehospitalization. OBJECTIVES: To understand nurse and physician communication practices around patient discharge education. SETTING: University of California, San Francisco Medical Center (UCSFMC). PARTICIPANTS: Nurses, interns, and hospitalists caring for hospitalized medicine patients. MEASUREMENTS: Participants were surveyed regarding discharge education practices. The survey asked respondents about 13 elements of discharge education found in the literature. For each element, participants were queried regarding: 1) the provider responsible for this element of patient education; 2) the frequency with which they communicate this teaching to patients; 3) how often they directly communicate with the nurse or physician caring for the patient about each element; and 4) tools to improve nursephysician communication. RESULTS: A total of 129/184 (70%) nurses, interns, and hospitalists responded to the survey. The majority of respondents in all 3 groups felt that 9 of 13 elements were a combined responsibility. Nurses reported educating patients on these 9 items significantly more often than physicians (P < 0.05). All groups also agreed that instruction on 2 of the elements, summary of hospital findings and pending results, should be primarily the physicians' responsibility; these were the elements least often discussed by any provider. Despite the majority of items being agreed upon as a shared responsibility, communication between nurses and physicians regarding discharge education was low. Standardized verbal communication on the day of discharge was supported most strongly by all providers. CONCLUSIONS: Ambiguous responsibility for providing discharge education and poor communication between nurses and physicians offers an opportunity for improvement. Journal of Hospital Medicine 2013. (c) 2012 Society of Hospital Medicine
引用
收藏
页码:36 / 41
页数:6
相关论文
共 20 条
[1]   Redefining Readmission Risk Factors for General Medicine Patients [J].
Allaudeen, Nazima ;
Vidyarthi, Arpana ;
Maselli, Judith ;
Auerbach, Andrew .
JOURNAL OF HOSPITAL MEDICINE, 2011, 6 (02) :54-60
[2]   Association between nurse-physician collaboration and patient outcomes in three intensive care units [J].
Baggs, JG ;
Schmitt, MH ;
Mushlin, AI ;
Mitchell, PH ;
Eldredge, DH ;
Oakes, D ;
Hutson, AD .
CRITICAL CARE MEDICINE, 1999, 27 (09) :1991-1998
[3]   Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions [J].
Davenport, Daniel L. ;
Henderson, William G. ;
Mosca, Cecilia L. ;
Khuri, Shukrl F. ;
Mentzer, Robert M., Jr. .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2007, 205 (06) :778-784
[4]   Improving the discharge process by embedding a discharge facilitator in a resident team [J].
Finn, Kathleen M. ;
Heffner, Rebecca ;
Chang, Yuchiao ;
Bazari, Hasan ;
Hunt, Daniel ;
Pickell, Karen ;
Berube, Rhodes ;
Raju, Shveta ;
Farrell, Elizabeth ;
Iyasere, Christiana ;
Thompson, Ryan ;
O'Malley, Terrence ;
O'Donnell, Walter ;
Karson, Andrew .
JOURNAL OF HOSPITAL MEDICINE, 2011, 6 (09) :494-500
[5]  
Forster AJ, 2004, CAN MED ASSOC J, V170, P345
[6]   The incidence and severity of adverse events affecting patients after discharge from the hospital [J].
Forster, AJ ;
Murff, HJ ;
Peterson, JF ;
Gandhi, TK ;
Bates, DW .
ANNALS OF INTERNAL MEDICINE, 2003, 138 (03) :161-167
[7]   "Out of sight, out of mind": Housestaff perceptions of quality-limiting factors in discharge care at teaching hospitals [J].
Greysen, S. Ryan ;
Schiliro, Danise ;
Horwitz, Leora I. ;
Curry, Leslie ;
Bradley, Elizabeth H. .
JOURNAL OF HOSPITAL MEDICINE, 2012, 7 (05) :376-381
[8]   Transition of care for hospitalized elderly patients - Development of a discharge checklist for hospitalists [J].
Halasyamani, L. ;
Kripalani, S. ;
Coleman, E. ;
Schnipper, J. ;
van Walraven, C. ;
Nagamine, J. ;
Toreson, P. ;
Bookwalter, T. ;
Budnitz, T. ;
Manning, D. .
JOURNAL OF HOSPITAL MEDICINE, 2006, 1 (06) :354-360
[9]   A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population. [J].
Haynes, Alex B. ;
Weiser, Thomas G. ;
Berry, William R. ;
Lipsitz, Stuart R. ;
Breizat, Abdel-Hadi S. ;
Dellinger, E. Patchen ;
Herbosa, Teodoro ;
Joseph, Sudhir ;
Kibatala, Pascience L. ;
Lapitan, Marie Carmela M. ;
Merry, Alan F. ;
Moorthy, Krishna ;
Reznick, Richard K. ;
Taylor, Bryce ;
Gawande, Atul A. .
NEW ENGLAND JOURNAL OF MEDICINE, 2009, 360 (05) :491-499
[10]   A Reengineered Hospital Discharge Program to Decrease Rehospitalization A Randomized Trial [J].
Jack, Brian W. ;
Chetty, Veerappa K. ;
Anthony, David ;
Greenwald, Jeffrey L. ;
Sanchez, Gail M. ;
Johnson, Anna E. ;
Forsythe, Shaula R. ;
O'Donnell, Julie K. ;
Paasche-Orlow, Michael K. ;
Manasseh, Christopher ;
Martin, Stephen ;
Culpepper, Larry .
ANNALS OF INTERNAL MEDICINE, 2009, 150 (03) :178-+