Frances Fengzhi Lin, Jacqueline Peet, Lauren Murray, Huahua Yin, Mahesh Ramanan, Kylie Jacobs, Jane Brailsford, Amelia Osmond, Moreblessing Kajevu, Roslyn Prichard, Peter Garrett, Alexis Tabah, Carol Mock, Ahmed Mehdi, Yingyan Chen
{"title":"Contextual Factors Influencing Intensive Care Patients' Discharge Processes: A Multicentre Prospective Observational Study.","authors":"Frances Fengzhi Lin, Jacqueline Peet, Lauren Murray, Huahua Yin, Mahesh Ramanan, Kylie Jacobs, Jane Brailsford, Amelia Osmond, Moreblessing Kajevu, Roslyn Prichard, Peter Garrett, Alexis Tabah, Carol Mock, Ahmed Mehdi, Yingyan Chen","doi":"10.1111/jocn.17515","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To compare contextual factors influencing discharge practices in three intensive care units (ICUs).</p><p><strong>Design: </strong>A prospective observational study.</p><p><strong>Methods: </strong>Data were collected using a discharge process report form (DPRF) between May and September 2023. Descriptive statistics were performed to analyse demographic and clinical data. One-way analysis of variance (ANOVA) was used to test the time interval differences among the three sites.</p><p><strong>Results: </strong>Overall, 69 patients' discharge processes were observed. Among them, 41 (59%) experienced discharge delay, and 1 in 5 patients experienced after-hours discharge. There were statistically significant differences in mean hours in various time intervals during the discharge processes among the three sites. Patients in Hospital C waited the longest time (mean = 31.9 h) for the ward bed to be ready after the bed was requested and for being eventually discharged after ICU nurses to get them ready for discharge (mean = 26.7 h) compared to Hospital A and Hospital B.</p><p><strong>Conclusions: </strong>We found that discharge delay and after-hours discharge were common and there were significant differences in mean hours of various time intervals during the discharge processes occurred among the three sites. The influence of contextual factors in different hospitals/ICU needs to be considered to improve the ICU discharge process.</p><p><strong>Implications for the profession and/or patient care: </strong>Researchers and clinicians should consider targeted context-specific interventions and strategies to optimise patient discharge process from ICUs.</p><p><strong>Impact: </strong>The study findings will inform the development of tailored interventions to reduce the discharge delay and after-hours discharge and, in turn, improve the quality and safety of patient care and health service efficiency.</p><p><strong>Reporting method: </strong>The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.</p><p><strong>Patient or public contribution: </strong>Patients' discharge processes were observed, and consumer representatives were involved in the study design.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jocn.17515","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: To compare contextual factors influencing discharge practices in three intensive care units (ICUs).
Design: A prospective observational study.
Methods: Data were collected using a discharge process report form (DPRF) between May and September 2023. Descriptive statistics were performed to analyse demographic and clinical data. One-way analysis of variance (ANOVA) was used to test the time interval differences among the three sites.
Results: Overall, 69 patients' discharge processes were observed. Among them, 41 (59%) experienced discharge delay, and 1 in 5 patients experienced after-hours discharge. There were statistically significant differences in mean hours in various time intervals during the discharge processes among the three sites. Patients in Hospital C waited the longest time (mean = 31.9 h) for the ward bed to be ready after the bed was requested and for being eventually discharged after ICU nurses to get them ready for discharge (mean = 26.7 h) compared to Hospital A and Hospital B.
Conclusions: We found that discharge delay and after-hours discharge were common and there were significant differences in mean hours of various time intervals during the discharge processes occurred among the three sites. The influence of contextual factors in different hospitals/ICU needs to be considered to improve the ICU discharge process.
Implications for the profession and/or patient care: Researchers and clinicians should consider targeted context-specific interventions and strategies to optimise patient discharge process from ICUs.
Impact: The study findings will inform the development of tailored interventions to reduce the discharge delay and after-hours discharge and, in turn, improve the quality and safety of patient care and health service efficiency.
Reporting method: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
Patient or public contribution: Patients' discharge processes were observed, and consumer representatives were involved in the study design.
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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