Due 12/2

Author/Date

Kate Gledhill, MPH, Tracey K. Bucknall, PhD, Natasha A. Lannin, PhD, Lisa Hanna, PhD

July 5th, 2023

Theoretical/Conceptual Framework

The theoretical framework behind this article seeks to develop a broad understanding of various stakeholder’s perspectives on decision-making involved with discharge planning.

Research Question/PICOT

What perspectives impact the level of decision-making upon discharge?

What type of individuals are routinely involved in this process?

Methodology

The authors illustrated a qualitative, descriptive study by initiating structured interviews or focus groups among diverse individuals involved in discharge planning. This included a semi-equal level of clients, families, clinicians, and unit managers (Gledhill et al., 2023).

Analysis & Results

A significant period of time was dedicated to comparing and contrasting the participants' input. The research team used systematic processes to find a common theme among the relayed input. The analysis was concluded as complete when no new themes arose after a three-year period. The results yielded collaborative communication as a key facilitator in effective discharge planning, with extraordinary education, perceptive goal setting, and intradisciplinary teamwork as crucial variables in this process (Gledhill et al., 2023).

Conclusions

In order for effective discharge planning to occur, preliminary expectations must be established, and concise dialogue must be shared among connected shareholders.

Implications for future research

Applying these conclusions to further research may demonstrate further implications for service design in the healthcare industry and will develop more remarkable demonstrations of professional education in this field.

Implication for practice

The principles obtained through this research will help foster more effective communication between various stakeholders in the discharge practice. Depending on the diagnostic conclusions, this process may also reduce readmission rates and length of stay.

Relevance to your PICOT/Capstone Project

This information will help to fortify the effectiveness of adequate communication in the discharge process. It also outlines the importance of goal-setting and the use of support systems, which may be effective in reducing readmission rates.

Author/Date

Yunmi Kim, Hyun-Young Kim & Eunyoung Cho

March 17th, 2020

Theoretical/Conceptual Framework

The conceptual framework designed by these authors was intended to establish specific results in discharge mortality based on exclusive criteria set within the parameters identified when this study was in development.

Research Question/PICOT

What factors affect post-discharge mortality after surgical intervention?

Does adequate staffing impact these factors?

Methodology

This study uses a cross-sectional analysis that surveys over 100,000 clients who underwent surgical interventions over a year. A chi-square test and logistic regression analyses were used to differentiate the impact of the nurse-to-client ratios association with post-discharge mortality (Kim et al., 2020)

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Analysis & Results

Using the cross-dimensional analysis, differences in specified variables impacting mortality were used to calculate adjusted ratios, separating controls that would not impact the study. Correlations in data between subjects were corrected for standard error when estimating comparable guidelines. The data collected demonstrated a reduction in mortality as the nurse-to-client ratio was reduced (Kim et al., 2020)

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Conclusions

The reduction in post-discharge mortality connected to the lower nurse-to-client ratio outlines the importance of a dedicated focus on discharge summaries. It also highlights the effectiveness of continued care beyond discharge and interprofessional communication.

Implications for future research

This study will help guide future clinical research on the impact of improving staffing ratios in healthcare. Further exploration of other factors that affect post-discharge complications will be compared.

Implication for practice

Hopefully, this analysis will help direct nursing leadership to ensure that hospital departments are adequately staffed and maintain a greater focus on the client's overall well-being. Further education should be dedicated to providing a more thorough discharge presentation.

Relevance to your PICOT/Capstone Project

The connection between the lower staff ratios and decreased mortality will further support the foundation of an adequate discharge. The more time there is to focus on the client's individualized needs, the better they will be equipped to care for themselves beyond the acute care period.

Author/Date

Brenda Luther, PhD, RN, Rebecca D. Wilson, PhD, RN, Clare Kranz, DNP, MSN, RN, CPNP-AC, Melody Krahulec, DNP, MS, RN

October, 2019

Theoretical/Conceptual Framework

This framework aims to review a structured discharge process that provides guidance in improving discharge education through a series of instructions. This particular instructional method is broken down into five steps and evaluated through its effectiveness in the field.

Research Question/PICOT

How do structured discharge methods translate to the workplace?

Do these methods allow an individuated approach to be used?

Methodology

This qualitative study helps determine the effectiveness of a specific discharge planning tool. The authors break down each section of the tool and analyze its characteristics for practical use.

Analysis & Results

After breaking down each section, the authors explain that the IDEAL (Include, Discuss, Educate, Assess, and Listen) model is a practical guide for planning future discharges. The planning steps provide the structure needed by new or inexperienced nurses in this subject (Luther et al., 2019).

Conclusions

The analysis of this discharge planning tool infers that structured steps in guiding care can help eliminate the associated anxiety related to future arrangements. The IDEAL model encompasses multiple aspects of care; therefore, essential details are less likely to be missed.

Implications for future research

This review will help guide future researchers in developing new strategic guides for directing discharge processes. Further consideration will be given to improving the resources needed for the initiation of protocols in this area of healthcare.

Implication for practice

This guide will improve interprofessional skills in enhancing overall client care by including a comprehensive plan for their journey after hospitalization. By initiating a dedicated, personalized plan early, more attention can be focused on caring for the client in the present.

Relevance to your PICOT/Capstone Project

The IDEAL model is a step toward developing standardized protocols to address all aspects of care upon discharge. This way, the client is not left wondering what steps need to be taken to ensure no complications arise in the future.

Author/Date

Nurhayati Nurhayati, Praneed Songwathana, Ratjai Vachprasit

May, 2019

Theoretical/Conceptual Framework

In this theoretical framework, Meleis’ Middle-Range Theory was utilized to direct the concepts between the perspective of preparedness for discharge for the client and the quality of discharge instruction given. Four components related to the nature, conditions, therapies, and patterns of the setting were measured in this study (Nurhayati et al., 2019).

Research Question/PICOT

How do client perceptions of discharge readiness and quality of discharge teaching affect surgical outcomes?

Are these two variables associated in any way?

Methodology

This correlational descriptive study follows 96 post-surgical clients who share their discharge process during their hospital stay. Demographic scales were developed to properly distinguish the two variables assessed over the two-month trial (Nurhayati et al., 2019).

Analysis & Results

Of the participants that were involved, the majority expressed a low quality of discharge instruction. However, there was a positive correlation in client readiness related to the content received and delivery of instructional material. Also, client support and coping factors played a significant role in expressing confidence in self-efficacy (Nurhayati et al., 2019).

Conclusions

The low quality of discharge instruction may have a significant role in decreasing client readiness. This is indicated by the positive correlation between content comprehension and discharge readiness (Nurhayati et al., 2019). Support systems and preliminary instruction are vital for increasing client coping and adherence to prescribed therapies.

Implications for future research

Further investigation may be indicated for the correlation between client readiness and quality of discharge instruction, as the study yielded no direct connection between the two. However, content comprehension did impact client confidence, suggesting that correlational studies between discharge education and client confidence should be pursued.

Implication for practice

This study can imply the need for more comprehensive discharge education. As the majority of participants indicated a low level of discharge education, continued training for this purpose should be encouraged.

Relevance to your PICOT/Capstone Project

An adequate discharge encompasses all aspects of care that are individualized for each client. This study revealed the importance of support systems and content comprehension at discharge, two main elements of discharge completion. Without these, client self-efficacy can decrease, increasing the risk of complications that lead to readmission.

Author/Date

Emma Säfström, Kristofer Årestedt, Maria Liljeroos. Lena Nordgren,

Tiny Jaarsma, Anna Strömberg

January 20th, 2023

Theoretical/Conceptual Framework

This conceptual design links care associations to readmission rates and quality of life after discharge. Using various data sources, correlations are made to suggest interventions that aid in the prevention of complications in healthcare (Säfström et al., 2023).

Research Question/PICOT

What outlets of care are effective in reducing readmission rates?

How can healthcare workers improve care for clients at home?

What type of interventions improve self-efficacy for clients post-discharge?

Methodology

Clients hospitalized at four different hospitals for various cardiovascular issues were given questionnaires shortly after discharge. This cross-sectional data was analyzed to generate a correlational model that describes the relationship between continuality of care and readmission rates (Säfström et al., 2023).

Analysis & Results

Of the over 500 clients who participated in the survey, the majority indicated an improvement in self-care with the addition of continued care from support systems. In addition, as continuity of care increased, the client felt a greater sense of perspective control (Säfström et al., 2023).

Conclusions

The author concluded the article by emphasizing the importance of improving the quality of life for clients through the resurgence of continued care beyond discharge and the promotion of self-responsibility.

Implications for future research

This data may benefit future researchers in developing protocols to improve home health care. This correlative study may also result in new training courses for case managers and home health workers.

Implication for practice

This study can reduce the impact of readmission rates by encouraging the implementation of continued care practices and using tactics that promote self-efficacy in the hospital setting and in the home. This could also be beneficial in reducing caregiver burnout and increasing healthcare resources that can be allocated for other interventions.

Relevance to your PICOT/Capstone Project

The correlation between continued care beyond discharge and improving perspective control encompasses the purpose of an adequate discharge: preparing clients to take the next step in improving their lifestyle and gaining control of their health.