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.

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 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.

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 Prioritising CAP Intervention Needs: An Improved Cumulative Voting Approach

2021 ◽  
Vol 13 (7) ◽  
pp. 3997
Author(s):  
Roberto Cagliero ◽  
Francesco Bellini ◽  
Francesco Marcatto ◽  
Silvia Novelli ◽  
Alessandro Monteleone ◽  
...  
Keyword(s):  
Decision Making ◽  
Planning Process ◽  
Strategic Plan ◽  
Evidence Based ◽  
Agricultural Activities ◽  
Agriculture Policy ◽  
Implementation Model ◽  
National Strategic Plan ◽  
Cumulative Voting ◽  
Regional Authorities

The process to define the 2023–2027 Common Agriculture Policy (CAP) is underway. The implementation model governing the process requires each EU Member State to design a National Strategic Plan to deliver operational actions exploiting the synergies under the two pillars of the policy. Each Plan must be built from an evidence-based needs assessment that undergoes rigorous prioritisation and planning to create comprehensive, integrated, and achievable interventions. In Italy, the success of this planning process requires all interested stakeholders to generate options for the regional authorities who plan, manage, and legislate agricultural activities. This research proposes a decision-making technique, based on the cumulative voting approach, that can be used effectively when multiple persons from different backgrounds and perspectives are engaged in problem-solving and needs prioritisation. The results indicate that the model can be applied both theoretically and practically to prioritise Strategic Plan needs that involve national and regional authorities. Validation of the model allows it to be used in the next consultative processes and for expansion to socioeconomic stakeholders.

Step 3: Critically Appraising Evidence

2021 ◽  
Vol 40 (6) ◽  
pp. 402-405
Author(s):  
Susan Givens Bell
Keyword(s):  
Critical Appraisal ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Appraisal Process ◽  
Levels Of Evidence ◽  
The Third

Critical appraisal of the evidence is the third step in the evidence-based practice process. This column, the first in a multipart series to describe the critical appraisal process, defines and provides examples of the levels of evidence and tools to begin the appraisal process using a rapid critical appraisal technique.

Efficacy, effectiveness, and quality of resilience-building mobile health apps for military, veteran and public safety personnel populations: a scoping literature review and app evaluation (Preprint)

2021 ◽  
Author(s):  
Melissa Voth ◽  
Shannon Chisholm ◽  
Hannah Sollid ◽  
Chelsea Jones ◽  
Lorraine Smith-MacDonald ◽  
...  
Keyword(s):  
Mental Health ◽  
Literature Review ◽  
Mobile Health ◽  
Public Safety ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Public Safety Personnel ◽  
Scoping Literature Review ◽  
Mhealth Apps ◽  
Safety Personnel

BACKGROUND Globally, military members (MM) and public safety personnel (PSP) are vulnerable to occupational stress injuries (OSIs) due to their job demands. Consequently, when MM and PSP transition out of these professions, they may continue to experience mental health challenges. In response to this, resilience building programs are being developed and implemented with the goal of promoting empowerment and primary stress regulation. The development of mobile health (mHealth) applications (apps) as an emergent mental health intervention platform has allowed for targeted, cost effective, and easily accessible treatment when in-person therapy may be limited or unavailable. However, current mHealth app development is not regulated, and often lacks both clear evidence-based research and the input of healthcare professionals. OBJECTIVE The purpose of this manuscript is to evaluate the evidence-based quality, efficacy, and effectiveness of resilience building mobile apps targeted towards MM, PSP, and veteran populations via: (1) a scoping literature review of the current evidence-base regarding resilience apps for these populations, and; (2) evaluation of free resilience apps designed for use amongst these populations. METHODS Studies were selected using a comprehensive search of MEDLINE, CINAHL Plus, PsycINFO, SocINDEX, Academic Search Complete, Embase, and Google and was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping reviews (PRISMA-ScR). The Alberta Rating Index for Apps (ARIA) was utilized to conduct a review of each of the identified apps. Inclusion criteria consisted of apps: 1) free to download in either Google Play or the App Store; 2) updated within the last 3 years; 3) available in English and in Canada; and 4) intended for use by MM and/or PSP. RESULTS Twenty-two apps met the inclusion criteria for evaluation. The resilience strategies offered by the majority of apps included psychoeducation, mindfulness, Cognitive Behavioural Therapy (CBT), and Acceptance and Commitment Therapy (ACT). Eleven apps (50%) had been tested with randomized controlled trials, seven (31.8%) were evaluated using other research methods, and five (22.7%) had not been researched. Using the ARIA, apps scores ranged from 37 to 56 out of 72 with higher rated apps demonstrating increased useability and security features. CONCLUSIONS The mHealth apps reviewed are well suited to providing resilience strategies for MMs, PSP and veterans. They offer easy accessibility to evidence-based tools while working to encourage the use of emotional and professional support with safety in mind. While not intended to function as a substitute for professional services, research has demonstrated that mHealth apps have the potential to foster a significant reduction in symptom severity for PTSD, depression, anxiety, and other stress-induced concerns. Within clinical practice, apps can be utilized to supplement treatment as well as provide clients with population-specific, confidential tools to increase engagement in the treatment process. CLINICALTRIAL N/A

scholarly journals An Evaluation of the Five Most Used Evidence Based Bedside Information Tools in Canadian Health Libraries

2008 ◽  
Vol 3 (2) ◽  
pp. 3 ◽  
Author(s):  
Alison Farrell
Keyword(s):  
Electronic Mail ◽  
Clinical Evidence ◽  
Resource Assessment ◽  
Ease Of Use ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Levels Of Evidence ◽  
Information Tools ◽  
Canadian Health ◽  
Clinical Questions

Objective – This project sought to identify the five most used evidence based bedside information tools used in Canadian health libraries, to examine librarians’ attitudes towards these tools, and to test the comprehensiveness of the tools. Methods – The author developed a definition of evidence based bedside information tools and a list of resources that fit this definition. Participants were respondents to a survey distributed via the CANMEDLIB electronic mail list. The survey sought to identify information from library staff regarding the most frequently used evidence based bedside information tools. Clinical questions were used to measure the comprehensiveness of each resource and the levels of evidence they provided to each question. Results – Survey respondents reported that the five most used evidence based bedside information tools in their libraries were UpToDate, BMJ Clinical Evidence, First Consult, Bandolier and ACP Pier. Librarians were generally satisfied with the ease of use, efficiency and informative nature of these resources. The resource assessment determined that not all of these tools are comprehensive in terms of their ability to answer clinical questions or with regard to the inclusion of levels of evidence. UpToDate was able to provide information for the greatest number of clinical questions, but it provided a level of evidence only seven percent of the time. ACP Pier was able to provide information on only 50% of the clinical questions, but it provided levels of evidence for all of these. Conclusion – UpToDate and BMJ Clinical Evidence were both rated as easy to use and informative. However, neither product generally includes levels of evidence, so it would be prudent for the practitioner to critically appraise information from these sources before using it in a patient care setting. ACP Pier eliminates the critical appraisal stage, thus reducing the time it takes to go from forming a clinical question to implementing the answer, but survey respondents did not rate it as high in terms of usability. There remains a need for user-friendly, comprehensive resources that provide evidence summaries relying on levels of evidence to support their conclusions.

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