scholarly journals The Role Of The Pediatric Nurse In Discharge Planning; Identifying Gaps In Sri Lanka

2021 ◽  
Vol 5 (1) ◽  
pp. 36-50
Author(s):  
Kalpana Jeewanthi Subasinghe ◽  
A.M. Shyama Deepanie Pathiranage
Keyword(s):  
Sri Lanka ◽  
Planning Process ◽  
Transitional Care ◽  
Discharge Planning ◽  
Pediatric Population ◽  
Discharge Process ◽  
Sri Lankan ◽  
Care Coordinator ◽  
Pediatric Nurse ◽  
Effective Discharge

Background: Pediatric discharge planning is a complex process, and that nurses need lengthy preparations. Role confusion among nurses will disrupt the smooth planning of the discharge. In Sri Lanka, although there is a possibility of reducing health costs through effective discharge planning led by pediatric nurses, it is questionable whether Sri Lankan nurses have clarified their role in this process.Method: This systematic review was conducted to map the different roles of nurses in the pediatric discharge planning process. Electronic databases of PubMed and CINAHL were searched for peer-reviewed journal articles among the pediatric population from 2005-2019, using the keywords such as discharge planning, pediatric nurse, care transitions, transitional care, and Sri Lankan nurse.Results: Articles that resulted in the word combination ‘Discharge planning and pediatric nursing (n=329) were used for screening. Two hundred and forty articles out of the nursing scope and sixty articles that do not describe an apparent nursing involvement in the discharge process were excluded, based on abstract review and full-text review, respectively. Sixteen studies were included in the final review. Few literature was found on the topic among Sri Lankan pediatric population. Four main categories of nurses’ roles were identified with the thematic analysis: discharge educator, discharge collaborator, post-discharge care coordinator, and family counselor. Conclusion: In Sri Lanka, no such defined roles of a nurse have been established yet in the discharge planning of pediatric patients. These roles may help nurses carry out discharge planning effectively, and future studies are needed on this topic in Sri Lanka.

scholarly journals Psychiatric Discharge Process

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Hamzah M. Alghzawi
Keyword(s):  
Planning Process ◽  
Discharge Planning ◽  
Evidence Based ◽  
Discharge Process ◽  
Community Studies ◽  
Inclusion Criteria ◽  
Levels Of Evidence ◽  
Effective Discharge ◽  
Consensus Statements ◽  
Acute Psychiatric Wards

Background. Integration of research evidence into clinical nursing practice is essential for the delivery of high-quality nursing care. Discharge planning is an essential process in psychiatric nursing field, in order to prevent recurrent readmission to psychiatric units. Objective. The purpose of this paper is to perform literature overview on psychiatric discharge planning, in order to develop evidence-based practice guideline of psychiatric discharge plan. Methods. A search of electronic databases was conducted. The search process aimed to locate different levels of evidence. Inclusion criteria were studies including outcomes related to prevention of readmission as stability in the community, studies investigating the discharge planning process in acute psychiatric wards, and studies that included factors that impede discharge planning and factors that aid timely discharge. On the other hand, exclusion criteria were studies in which discharge planning was discussed as part of a multi faceted intervention and was not the main focus of the review. Result. Studies met inclusion criteria were mainly literature reviews, consensus statements, and descriptive studies. All of these studies are considered at the lower levels of evidence. Conclusion. This review demonstrated that discharge planning based on general principles (evidence based principles) should be applied during psychiatric discharge planning to make this discharge more effective. Depending on this review, it could be concluded that effective discharge planning includes main three stages; initial discharge meeting, regular discharge meeting(s), and leaving from hospital and discharge day. Each stage of them has requirements should be accomplished be go to the next stage.

Transitional Care of Older Adults

2002 ◽  
Vol 20 (1) ◽  
pp. 127-147 ◽  
Author(s):  
MARY D. NAYLOR
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Health Care Providers ◽  
Planning Process ◽  
Transitional Care ◽  
Discharge Planning ◽  
Statistical Significance ◽  
Future Research ◽  
Care Providers ◽  
Care Needs

This chapter reviews 94 published research reports on transitional care of older adults by nurse researchers and researchers from other disciplines. Reports were identified through searches of MEDLINE, CINAHL, HealthSTAR, Sociological Abstracts and PsycINFO using combinations of the following search terms: transitional care, discharge planning, care coordination, case management, continuity of care, referrals, postdischarge follow-up, patient assessment, patient needs, interventions, and evaluation. Reports were included if published between 1985 and 2001, if conducted on samples age 55 and older, if relevant to nursing research, and if published in English. Intervention studies had to have a control or comparison group and a test for statistical significance. Four key findings from this review were identified. A high proportion of elders and their caregivers report substantial unmet transitional care needs, with the need for information and increased access to services consistently among the top priorities. Differences in expectations between and among patients, families, and health care providers, and the need for increased patient and family involvement in decision making, are common themes in discharge planning studies. Gaps in communication have been identified through the discharge planning process. Evidence about the effects of innovations in transitional care on quality and cost outcomes is sparse. Four main recommendations are made. Differences in older adults’ transitional care needs based on race, ethnicity, and educational level, with attention to potential disparities, require further study. Studies of strategies to promote effective involvement of patients and families in decision making throughout discharge planning are needed. The development and testing of referral and other information systems designed to promote the transfer of accurate and complete information across sites of care should be a research focus. A priority for future research should be continued study of strategies to improve transitional care outcomes of older adults and their caregivers.

scholarly journals Facilitators and barriers of heart surgery discharge: patients’ and nurses’ narrative accounts

2021 ◽  
Author(s):  
Jennifer L. Lapum ◽  
Suzanne Fredericks ◽  
Linda Liu ◽  
Terrence M. Yau ◽  
Bruktawit Retta ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Discharge Planning ◽  
Open Heart Surgery ◽  
Cognitive Capacity ◽  
Postoperative Phase ◽  
Discharge Process ◽  
Urban Hospital ◽  
Nursing Experience ◽  
Effective Discharge ◽  
Facilitators And Barriers

Background: Optimal patient recovery from open-heart surgery relies on effective discharge planning and education. However, the nature of the discharge experience has not been clearly described. Objective: The study purpose is to explore patients’ and nurses’ narrative accounts of the facilitators and barriers of heart surgery discharge. Methods: A qualitative study was employed using a narrative methodology that elicited and analyzed stories. This research was conducted in a large, urban hospital in Ontario, Canada. A total of 17 patients and nurses were recruited. Five female and 5 male patients were recruited from a preoperative clinic. Ages ranged from 37 to 80 years. Seven nurses were recruited from inpatient cardiovascular units. They had 2 to 19 years of cardiovascular nursing experience. Semistructured, narrative-based interviews were conducted. Two interviews were conducted with each patient at 1 week after discharge and at 4 to 6 weeks. One interview was conducted with each nurse. Results: Findings indicate that although the preoperative period was identified as an effective time for discharge preparation, the patient’s cognitive capacity was limited during the postoperative phase of surgery. Both nurses and patients also found that insufficient time impeded the discharge process and limited individualized discussions. The structured and standardized delivery of discharge information affected patients’ capacity to apply it to the particularities in their own lives and homes. The fostering of therapeutic relationships created a space where patients felt comfortable sharing their concerns and nurses learned more about patients and thus could better tailor the discharge approach. Conclusions: Study recommendations include group and scenario-based education in which patients and nurses brainstorm about how to apply the discharge information to the particularities of patients’ lives and homes. Provision of support needs to be bolstered during the home period, where patients have timely opportunities to discuss their concerns and questions with practitioners or possibly peers.

Abstract 215: Leveraging Electronic Health Record Documentation for Failure Mode and Effects Analysis Team Identification on an Inpatient Cardiology Unit

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Gayle S Kricke ◽  
Matthew Carson ◽  
Young Ji Lee ◽  
Corrine Benacka ◽  
Faraz Ahmad ◽  
...  
Keyword(s):  
Quality Improvement ◽  
High Risk ◽  
Electronic Health Record ◽  
Failure Mode ◽  
Planning Process ◽  
Discharge Planning ◽  
Health Record ◽  
Discharge Process ◽  
Electronic Health ◽  
Risk Processes

Objectives: Failure Mode and Effects Analysis (FMEA) is a frequently-used approach for prospective risk assessment and quality improvement in healthcare, particularly for high-risk care processes such as hospital discharge planning. Our goal was to evaluate whether secondary use of metadata collected by the electronic health record (EHR) during daily practice can inform assembly of a comprehensive FMEA team by showing: 1) discrepancies between expected and observed process activities and individuals involved, and 2) the presence of individuals who may be appropriate to include in an FMEA based on their variable familiarity with a process. Methods: We extracted discharge planning data for an inpatient cardiology unit from the Enterprise Data Warehouse (EDW) and compared it to a hand-drawn map (HDM) indicating clinicians’ understanding of discharge activities and providers expected to complete each activity. We assessed the presence of providers highly experienced in the process, the diversity of involved disciplines, and the accuracy of the HDM compared to observation from EDW data. Findings: Over 500 providers completed nearly 35,000 discharge-related activities across 18 activity types over 2,000 encounters. Experience was skewed such that 90% (510 of 569) of providers completed between 0 and 99 activities while the remaining 10% (59 of 569) performed up to 1,200 activities. Frequent performers completed similar activities to their peers, but did so as many as 12 times more frequently than average for their discipline. Expectation of who performed an activity closely matched observation for 11 discipline-specific activities, such as case management assessment. However, providers from up to 10 different disciplines performed the remaining 7 activities, such as scheduling a follow-up visit or ordering a therapy consult. Overall, 35% (12,183 of 34,939) of activities were performed by an unexpected provider. Conclusions: Analyzing metadata from EHRs is a novel method to inform FMEA of high-risk processes. This study provides a framework for assessing process activities and the providers involved. In the discharge planning process, there appears to be significant discrepancy between clinicians’ understanding and the actual discharge process and team, which suggests the presence of providers who could be overlooked during typical FMEA team construction. This methodology can empirically enrich the FMEA team and highlight quality improvement target areas.

scholarly journals Facilitators and barriers of heart surgery discharge: patients’ and nurses’ narrative accounts

2021 ◽  
Author(s):  
Jennifer L. Lapum ◽  
Suzanne Fredericks ◽  
Linda Liu ◽  
Terrence M. Yau ◽  
Bruktawit Retta ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Discharge Planning ◽  
Open Heart Surgery ◽  
Cognitive Capacity ◽  
Postoperative Phase ◽  
Discharge Process ◽  
Urban Hospital ◽  
Nursing Experience ◽  
Effective Discharge ◽  
Facilitators And Barriers

Background: Optimal patient recovery from open-heart surgery relies on effective discharge planning and education. However, the nature of the discharge experience has not been clearly described. Objective: The study purpose is to explore patients’ and nurses’ narrative accounts of the facilitators and barriers of heart surgery discharge. Methods: A qualitative study was employed using a narrative methodology that elicited and analyzed stories. This research was conducted in a large, urban hospital in Ontario, Canada. A total of 17 patients and nurses were recruited. Five female and 5 male patients were recruited from a preoperative clinic. Ages ranged from 37 to 80 years. Seven nurses were recruited from inpatient cardiovascular units. They had 2 to 19 years of cardiovascular nursing experience. Semistructured, narrative-based interviews were conducted. Two interviews were conducted with each patient at 1 week after discharge and at 4 to 6 weeks. One interview was conducted with each nurse. Results: Findings indicate that although the preoperative period was identified as an effective time for discharge preparation, the patient’s cognitive capacity was limited during the postoperative phase of surgery. Both nurses and patients also found that insufficient time impeded the discharge process and limited individualized discussions. The structured and standardized delivery of discharge information affected patients’ capacity to apply it to the particularities in their own lives and homes. The fostering of therapeutic relationships created a space where patients felt comfortable sharing their concerns and nurses learned more about patients and thus could better tailor the discharge approach. Conclusions: Study recommendations include group and scenario-based education in which patients and nurses brainstorm about how to apply the discharge information to the particularities of patients’ lives and homes. Provision of support needs to be bolstered during the home period, where patients have timely opportunities to discuss their concerns and questions with practitioners or possibly peers.

The Role of Music and Allied Arts in Public Writings on Cultural Diversity: “People of Sri Lanka”

2020 ◽  
Vol 6 ◽  
pp. 93-100
Author(s):  
Gisa Jähnichen
Keyword(s):  
Sri Lanka ◽  
Cultural Diversity ◽  
South Asia ◽  
Case Studies ◽  
Sri Lankan ◽  
Culturally Different ◽  
The World ◽  
Official Languages ◽  
The Way

The Sri Lankan Ministry of National Coexistence, Dialogue, and Official Languages published the work “People of Sri Lanka” in 2017. In this comprehensive publication, 21 invited Sri Lankan scholars introduced 19 different people’s groups to public readers in English, mainly targeted at a growing number of foreign visitors in need of understanding the cultural diversity Sri Lanka has to offer. This paper will observe the presentation of these different groups of people, the role music and allied arts play in this context. Considering the non-scholarly design of the publication, a discussion of the role of music and allied arts has to be supplemented through additional analyses based on sources mentioned by the 21 participating scholars and their fragmented application of available knowledge. In result, this paper might help improve the way facts about groups of people, the way of grouping people, and the way of presenting these groupings are displayed to the world beyond South Asia. This fieldwork and literature guided investigation should also lead to suggestions for ethical principles in teaching and presenting of culturally different music practices within Sri Lanka, thus adding an example for other case studies.

Blood Pressure values of Sri Lankan Tamils in Jaffna District, Sri Lanka

2015 ◽  
Vol 2 (3) ◽  
pp. 66-71
Author(s):  
Balasubramaniam M ◽  
◽  
Sivapalan K ◽  
Tharsha J ◽  
Sivatharushan V ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sri Lanka ◽  
Sri Lankan ◽  
Sri Lankan Tamils

Diabetes Discharge Planning and Transitions of Care: A Focused Review

2019 ◽  
Vol 15 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Robin L. Black ◽  
Courtney Duval
Keyword(s):  
Patient Outcomes ◽  
Hospital Admissions ◽  
Discharge Planning ◽  
Medication Management ◽  
Hospital Readmissions ◽  
The United States ◽  
Transitions Of Care ◽  
Discharge Process ◽  
The Impact ◽  
Diabetes Patients

Background: Diabetes is a growing problem in the United States. Increasing hospital admissions for diabetes patients demonstrate the need for evidence-based care of diabetes patients by inpatient providers, as well as the importance of continuity of care when transitioning patients from inpatient to outpatient providers. Methods: A focused literature review of discharge planning and transitions of care in diabetes, conducted in PubMed is presented. Studies were selected for inclusion based on content focusing on transitions of care in diabetes, risk factors for readmission, the impact of inpatient diabetes education on patient outcomes, and optimal medication management of diabetes during care transitions. American Diabetes Association (ADA) guidelines for care of patients during the discharge process are presented, as well as considerations for designing treatment regimens for a hospitalized patient transitioning to various care settings. Results: Multiple factors may make transitions of care difficult, including poor communication, poor patient education, inappropriate follow-up, and clinically complex patients. ADA recommendations provide guidance, but an individualized approach for medication management is needed. Use of scoring systems may help identify patients at higher risk for readmission. Good communication with patients and outpatient providers is needed to prevent patient harm. A team-based approach is needed, utilizing the skills of inpatient and outpatient providers, diabetes educators, nurses, and pharmacists. Conclusion: Structured discharge planning per guideline recommendations can help improve transitions in care for patients with diabetes. A team based, patient-centered approach can help improve patient outcomes by reducing medication errors, delay of care, and hospital readmissions.

scholarly journals Enhancing Our Understanding of Transitional Care Programs

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 136-137
Author(s):  
Katherine McGilton ◽  
Shirin Vellani ◽  
Alexandra Krassikova ◽  
Alexia Cumal ◽  
Sheryl Robertson ◽  
...  
Keyword(s):  
Older Adults ◽  
Transitional Care ◽  
Discharge Planning ◽  
Grey Literature ◽  
Occupational Therapists ◽  
Community Dwelling ◽  
Bibliographic Databases ◽  
Multidisciplinary Teams ◽  
Term Care ◽  
Hospitalized Older Adults

Abstract Many hospitalized older adults experience delayed discharge. Transitional care programs (TCPs) provide short-term care to these patients to prepare them for transfer to nursing homes or back to the community. There are knowledge gaps related to the processes and outcomes of TCPs. We conducted a scoping review following Arksey & O’Malley’s framework to identify the: 1) characteristics of older patients served by TCPs, 2) services provided within TCPs, and 3) outcomes used to evaluate TCPs. We searched bibliographic databases and grey literature. We included papers and reports involving community-dwelling older adults aged ≥ 65 years and examined the processes and/or outcomes of TCPs. The search retrieved 4828 references; 38 studies and 2 reports met the inclusion criteria. Most studies were conducted in Europe (n=19) and America (n=13). Patients admitted to TCPs were 59-86 years old, had 2-10 chronic conditions, 26-74% lived alone, the majority were functionally dependent and had mild cognitive impairment. Most TCPs were staffed by nurses, physiotherapists, occupational therapists, social workers and physicians, and support staff. The TCPs provided 5 major types of services: assessment, care planning, treatment, evaluation/care monitoring and discharge planning. The outcomes most frequently assessed were discharge destination, mortality, hospital readmission, length of stay, cost and functional status. TCPs that reported significant improvement in older adults’ functions (which was the main goal of the TCPs) included multiple services delivered by multidisciplinary teams. There is a wide variation in the operationalization of TCPs within and between countries.

scholarly journals Sri Lanka: Physical Reconstruction and Economic Development as Conflict Prevention Factors

2013 ◽  
Vol 19 (69) ◽  
pp. 55-76
Author(s):  
Boženko Đevoić
Keyword(s):  
Economic Development ◽  
Sri Lanka ◽  
External Pressure ◽  
Power Sharing ◽  
Sri Lankan ◽  
Conflict Prevention ◽  
Prevention Measures ◽  
Postconflict Reconstruction ◽  
Post Conflict ◽  
The Government

ABSTRACT This article gives an overview of the 26 year long ethnic conflict in Sri Lanka and examines physical reconstruction and economic development as measures of conflict prevention and postconflict reconstruction. During the years of conflict, the Sri Lankan government performed some conflict prevention measures, but most of them caused counter effects, such as the attempt to provide “demilitarization”, which actually increased militarization on both sides, and “political power sharing” that was never honestly executed. Efforts in post-conflict physical reconstruction and economic development, especially after 2009, demonstrate their positive capacity as well as their conflict sensitivity. Although the Sri Lankan government initially had to be forced by international donors to include conflict sensitivity in its projects, more recently this has changed. The government now practices more conflict sensitivity in its planning and execution of physical reconstruction and economic development projects without external pressure.

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