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
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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":"{\"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. 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引用次数: 0
摘要
目的：比较影响三个重症监护病房（ICU）出院措施的环境因素：前瞻性观察研究：在2023年5月至9月期间，使用出院流程报告表（DPRF）收集数据。对人口统计学和临床数据进行描述性统计分析。采用单因素方差分析（ANOVA）检验三个地点的时间间隔差异：共观察了 69 名患者的出院过程。结果：共观察到 69 名患者的出院过程，其中 41 人（59%）出院延迟，1/5 的患者在下班后出院。三家医院在出院过程中不同时间段的平均时长差异有统计学意义。与医院 A 和医院 B 相比，医院 C 的患者在申请病床后等待病床准备就绪的时间（平均 = 31.9 小时）和在重症监护室护士做好出院准备后等待最终出院的时间（平均 = 26.7 小时）最长：我们发现，出院延迟和下班后出院是常见现象，而且三个医院在出院过程中不同时间间隔的平均时长存在显著差异。需要考虑不同医院/重症监护室环境因素的影响，以改善重症监护室的出院流程：研究人员和临床医生应考虑针对具体情况的干预措施和策略，以优化重症监护室患者的出院流程：研究结果将为制定有针对性的干预措施提供信息，以减少出院延迟和下班后出院，进而提高患者护理的质量和安全以及医疗服务的效率：报告方法：《加强流行病学观察性研究报告》（STROBE）指南：患者或公众的贡献：观察了患者的出院过程，消费者代表参与了研究设计。
Contextual Factors Influencing Intensive Care Patients' Discharge Processes: A Multicentre Prospective Observational Study.
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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