Nursing home hospital transfers in the terminally ill: night shift nurses matter!

被引:4
作者
Economos, Guillaume [1 ]
Tholly, Francoise [2 ]
Rhondali, Wadih [1 ]
Ruer, Murielle [1 ]
Tricou, Colombe [1 ]
Fawoubo, Audrey [1 ]
Perceau-Chambard, Elise [1 ]
Filbet, Marilene [1 ]
机构
[1] Hosp Civils Lyon, Palliat Care, F-69495 Lyon, France
[2] Agence Reg Sante Auvergne Rhone Alpes, Lyon, France
关键词
Hospice care; Nursing Home care; End of life care; OF-LIFE CARE; RESIDENTS; PLACE; DEATH; CANCER; END; VIEWS; QUALITY; PEOPLE; STAFF;
D O I
10.1136/bmjspcare-2019-001832
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background French demographic projection expects an increasing number of older, dependent patients in the next few years. A large proportion of this population lives in nursing homes and their transfer to hospitals at the end of life is an ongoing issue. Objective This study explored the factors influencing the transfer of patients living in nursing homes to hospital at the end of life. Design We used a mixed-methods questionnaire developed by an expert group and assessing different characteristics of the nursing homes. Participants All the nursing homes in the Rhone-Alpes area (n=680) were surveyed. Results We obtained 466 (68%) answers. We found that a palliative care programme was present in 336 (72%) nursing homes. The majority had a coordinating physician 428 (82%) and a mean number of 6 nurses for 83 beds, with 83 (18%) having a night shift nurse. There was a mean number of 19 deaths per nursing home during the recorded year. The main cause of death was dementia (41%), cancer-related death (13%). Death occurred mostly in the nursing home (14 74%). Night shift nurse attendance was significantly associated with the place of death: 27 deaths occurred in nursing homes with a night shift nurse versus 12 in those without one (p<0001). Conclusions The location of the death of frail elderly patients is a major health issue that needs to be addressed. Our results suggests that the presence of a night shift nurse decreases the number of emergency transfers and deaths in the hospital.
引用
收藏
页码:228 / 233
页数:6
相关论文
共 28 条
[21]   The changing prevalence of comorbidity across the age spectrum [J].
Piccirillo, Jay F. ;
Vlahiotis, Anna ;
Barrett, Laurel B. ;
Flood, Kellie L. ;
Spitmagel, Edward L. ;
Steyerberg, Ewout W. .
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2008, 67 (02) :124-132
[22]   Use of hospital palliative care according to the place of death and disease one year before death in 2013: a French national observational study [J].
Poulalhon, Claire ;
Rotelli-Bihet, Laureen ;
Moine, Sebastien ;
Fagot-Campagna, Anne ;
Aubry, Regis ;
Tuppin, Philippe .
BMC PALLIATIVE CARE, 2018, 17
[23]   Palliative care in advanced dementia; A mixed methods approach for the development of a complex intervention [J].
Sampson E.L. ;
Thuné-Boyle I. ;
Kukkastenvehmas R. ;
Jones L. ;
Tookman A. ;
King M. ;
Blanchard M.R. .
BMC Palliative Care, 7 (1)
[24]  
SEAMARK DA, 1995, BRIT J GEN PRACT, V45, P359
[25]   When death is imminent - Where terminally ill patients with cancer prefer to die and why [J].
Tang, ST .
CANCER NURSING, 2003, 26 (03) :245-251
[26]   Family perspectives on end-of-life care at the last place of care [J].
Teno, JM ;
Clarridge, BR ;
Casey, V ;
Welch, LC ;
Wetle, T ;
Shield, R ;
Mor, V .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (01) :88-93
[27]   Decisions to Transfer Nursing Home Residents to Emergency Departments: A Scoping Review of Contributing Factors and Staff Perspectives [J].
Trahan, Lisa M. ;
Spiers, Jude A. ;
Cummings, Greta G. .
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 2016, 17 (11) :994-1005
[28]   Place of Death: Correlations With Quality of Life of Patients With Cancer and Predictors of Bereaved Caregivers' Mental Health [J].
Wright, Alexi A. ;
Keating, Nancy L. ;
Balboni, Tracy A. ;
Matulonis, Ursula A. ;
Block, Susan D. ;
Prigerson, Holly G. .
JOURNAL OF CLINICAL ONCOLOGY, 2010, 28 (29) :4457-4464