Assignment Phase 1

1 Running Head: Transitional Models for Recovering Patients during the Covid-19 Pandemic

Transitional Models for Recovering Patients during the Covid-19 Pandemic

Student’s Name: Mayra Oliva Rivero

Week 4, phase 1 of the final paper

Instructor: Dr. Nora Hernandez-Pupo

Nursing Research and Evidence Based Practice

Florida National University

September 25, 2021

2 Transitional Models for Recovering Patients during the Covid-19 Pandemic

Transitional Models for Recovering Patients during the Covid-19 Pandemic

Introduction

In any healthcare system, pandemics and outbreaks become an ultimate test of efficiency

and ability to provide quality care to the patient. Patients with critical conditions become a priority

for medical teams from the moment a hospital receives them to their healing. The hospital changes

from a normal working situation and swiftly responds to drastic changes in the most adaptive

manner. Throughout the process, healthcare providers transition patients based on the severity of

conditions and medical demand. Transitional care is an indispensable practice in moving patients

between settings (Sumikawa & Yamamoto-Mitani, 2021). If correctly observed, these methods

reduces post-treatment risks, enhances healthcare outcomes, and avoids potential reoccurrences of

patients' disease. Some of the transitions include the transition from the Intensive Care Unit (ICU)

to an inpatient ward, primary care to specialty care, and hospital care to home-based care with

assisted living. During the transformative period, the hospital considers the safety and progress of

the surviving patient and those who need urgent treatment. To effectively balance the two,

hospitals face challenges that may lead to poor healthcare outcomes.

When most healthcare facilities experienced a spike in Covid-19 patients, most essential

resources were inadequate. These essentials included personal protective equipment, ICU facilities

and equipment, wards bed capacity, information exposure, and the number of healthcare workers

(Schmidt et al., 2021). As a result, the transitioning required interdepartmental considerations to

give patients the best care. However, most patients and their caregivers faced challenges, especially

in ICU to ward or inpatient to home-based care transitioning. Some of these challenges are mixed

feelings, worry, and fear regarding the impacts of transitioning and inadequate information about

3 Transitional Models for Recovering Patients during the Covid-19 Pandemic

the type of care expected in the new setting. Therefore, facilities were under intense pressure to

manage the migratory process as they ensured the outcomes provided exceptional Covid-19

treatment outcomes. One of the significant challenges faced relates to the transition from inpatient

to home-based care. Patients need constant care in their new setting despite the inadequate number

of workers in facilities that render these services.

Statement of the problem

Transitioning from one management setting to another poses imminent challenges to the

healthcare system and practitioners. Research continuously identify and provide feasible solutions

to these challenges as they give relief to both patients and healthcare providers. However, most of

the identified problems and solutions concentrate on a hospital environment devoid of pandemic or

outbreak pressures. Most of these problems relate to the patients, roles played by each contributing

party, communication, behavior, and managing expected changes under normal circumstances.

Also, this research work has little consideration for the challenges of pandemics, such as Covid-19,

and how it hinders the swift transitional programs. Therefore, there is a limitation of research

regarding the solutions to challenges related to transitioning Covid-19 recovering patients back to

the community. These patients in the community and at home require a strict follow-up program

that follows a thorough assessment and rehabilitative protocol (Brown et al., 2020).

Some healthcare facilities launched rapid transition care models for surviving patients,

which faced challenges and could not sustain. In Japan, their previously-used transitional method

ensures the involvement of caregivers in the plan before discharging patients (Sumikawa &

Yamamoto-Mitani, 2021). However, during the Covid-19 pandemic, the system proved ineffective,

and the government had to change its transitional design. The new system intended to increase the

4 Transitional Models for Recovering Patients during the Covid-19 Pandemic

number of discharged patients, enhance their transition processes into their new environment, and

reduce possible hospital complications or readmission. Based on research, reducing the number of

patients in hospitals is essential for managing the disease. Arguably, hospitals experience a

shortage in protective equipment, nurses, and space which jeopardizes the effectiveness of

services. Therefore, these Covid-19 related challenges create a gap where there are no

comprehensive means of transitioning patients between settings. This gap provides avenues for

testing successful methods and incorporating them into the Covid-19 scenario to find the

applicable model for use by practitioners on patients who transition from hospitals to homes.

Significance of the problem

The unavailability of a feasible transitioning model for Covid-19 patients is significant to

many health stakeholders. First, the problem causes challenges to healthcare facilities, which risk

discharging patients without the proper means of follow-up. This medical inconvenience threatens

the efficiency and effectiveness of services and medical outcomes. Second, covid-19 treatments

impact healthcare facilities financially. Institutions lost most of their projected revenues after some

income-generating services ceased to function (Kaye et al., 2021). Therefore, hospitals would

benefit from an effective transitional model since it would increase survivorship and outcomes,

thus instilling trust to present and future patients. Second, the healthcare workers face a significant

impact from the problem. After the surge in Covid-19 patients, most nursing and care service

providers could not meet the patient's demand. Additionally, nurses were learning how to handle

different Covid-19 scenarios. After discharging patients, healthcare providers switch to critical

patients. Lack of a model reduces the effectiveness of nurses and healthcare workers, and

therefore, this research would help change the phenomenon. Lastly, the community shares the

5 Transitional Models for Recovering Patients during the Covid-19 Pandemic

plight with patients who transit to home. The community may stigmatize Covid-19 patients as they

lack adequate knowledge on how to welcome them back.

Purpose of the research

The purpose of this study is to assess and identify the appropriate model that would suit the

transition of Covid-19 recovery patients from the inpatient hospital setting to home-based and

community settings. By placing the transitional model, health practitioners can amply dispense

medical resources and employ appropriate mechanisms of approach that ensure patients' transition

provides the best outcomes, minimal risks, and effectiveness. Furthermore, the study intends to

provide healthcare facilities with the best model to use when facing transitional challenges during

outbreaks or pandemics. Additionally, the research aims at providing a conducive forum where all

stakeholders in the transition process feel comfortable and adapt quickly. Finally, since recovering

Covid-19 patients continue their treatment a home, this study aims at providing good practices for

healthcare practitioners to achieve desired healthcare outcomes.

Research Questions

Research questions relate to the purpose of research, and they provide answers to the

suggested problems. Therefore, these are the research questions that relate to the aim of the study.

1. Which is the most appropriate transitional model for Covid-19 survivors as they transit

from hospital to home-based settings?

2. Which transitional model would yield quality healthcare output when used during a health

pandemic?

6 Transitional Models for Recovering Patients during the Covid-19 Pandemic

3. Which transitional practice do healthcare practitioners use on discharged Covid-19 patients

who require home-based care?

Masters Essentials Aligned to the Topic

There are two Master’s Essentials that align with the research topic of transitional nursing

during the Covid-19 pandemic. One is the Master’s Essential III which concerns quality

improvement and safety. Quality healthcare and safety of programs and measures are paramount in

managing Covid-19 in healthcare facilities. For example, an increase in patients in hospitals could

affect healthcare outcomes. Therefore, safe transitioning Covid-19 patients from hospitals to the

community requires a model that assures safety and prevents reoccurrence of Covid-19

complications, which employs this Master's Essential. The other Master's Essential IV on

translating and integrating scholarship into practice. Through research on nursing-related topics,

researchers can provide solutions to practical problems and disseminate results and solutions to

problems the healthcare system faces.

References

7 Transitional Models for Recovering Patients during the Covid-19 Pandemic

Brown, Z., Messaoudi, C., Flynn, A., Bleau, H., Leska, E., Khalilullah, M., & Ball, T. (2020).

Prompt Launch of a Rapid Transitions Care Model Prevents Re-hospitalizations of Covid-

19 Patients. NEJM Catalyst Innovations in Care Delivery, 1(6).

Kaye, A. D., Okeagu, C. N., Pham, A. D., Silva, R. A., Hurley, J. J., Arron, B. L., Sarfraz, N., Lee,

H. N., Ghali, G., Gamble, J. W., Liu, H., Urman, R. D., & Cornett, E. M. (2021). Economic

impact of COVID-19 pandemic on healthcare facilities and systems: International

perspectives. Best Practice & Research Clinical Anaesthesiology, 35(3), 293–306.

https://doi.org/10.1016/j.bpa.2020.11.009

Schmidt, K., Gensichen, J., Gehrke-Beck, S., Kosilek, R. P., Kühne, F., Heintze, C., Baldwin, L.

M., & Needham, D. M. (2021). Management of COVID-19 ICU-survivors in primary care:

- a narrative review. BMC Family Practice, 22(1), 1–8. https://doi.org/10.1186/s12875-

021-01464-2

Sumikawa, Y., & Yamamoto-Mitani, N. (2021). Transitional care during COVID-19 pandemic in

Japan: Calls for new strategies to integrate traditional approaches with information and

communication technologies. BioScience Trends, 15(1), 55–57.

https://doi.org/10.5582/bst.2021.01056