RESUMEN
BACKGROUND: Emergency Department (ED) discharge involves the communication of healthcare information to optimise patient safety, selfmanagement, and understanding and compliance with ongoing treatment. However, little is known about the discharge practices or processesn undertaken by emergency clinicians. Therefore, the aim of this study was to explore the experience and perceptions of managing ED patient discharge by clinicians. METHODS: A qualitative descriptive study was conducted in one district Tasmanian hospital. Data collection involved face to face interviews with emergency clinicians. RESULTS: Twenty-one (36%) (12 medical officers, 6 registered nurses and 3 nurse practitioners) emergency clinicians agreed to participate in the study. From the data, five key themes emerged; (1) managing emergency department discharge; (2) Managing the workload of discharge; (3) Working as a team to support discharge; and (4) Building a safety net for the transition of care and (5) Improving emergency discharge. CONCLUSIONS: Emergency discharge can be improved with the availability of a broader range of written patient discharge flyers, family and carer involvement, greater discharge role clarification, integration of electronic medical record and investigation ordering systems, defined nurse led discharge roles particularly after hours (after 4pm) to improve the safety of patient discharged.
Asunto(s)
Enfermeras y Enfermeros/psicología , Alta del Paciente/normas , Percepción , Médicos/psicología , Servicio de Urgencia en Hospital/organización & administración , Servicio de Urgencia en Hospital/normas , Servicio de Urgencia en Hospital/estadística & datos numéricos , Humanos , Entrevistas como Asunto/métodos , Enfermeras y Enfermeros/estadística & datos numéricos , Alta del Paciente/estadística & datos numéricos , Médicos/estadística & datos numéricos , Investigación Cualitativa , Estadísticas no Paramétricas , TasmaniaRESUMEN
BACKGROUND: Across Australia over one million patients are discharged from the emergency department. Discharge planning involves the communication of healthcare information to optimise patient safety, self-management and compliance with ongoing treatment. Little is known about the adequacy of discharge planning, therefore, the aim of this study was to explore the experience, confidence, satisfaction and perceptions of patients recently discharged from ED.. METHODS: The descriptive exploratory study was conducted in one district Tasmanian hospital. Data collection involved patient telephone interviews and a retrospective medical record audit. RESULTS: A convenience sample of 100 patients was used for the study. Overall, the majority (93%) of patients understood their treatment, were confident to be discharged home (88%), and satisfied (90%) with emergency care. The majority of patients' understood their discharge diagnosis (86%) and were provided with verbal (84%) discharge information. Discharge referral instructions were followed up by 60% of patients with 26% of patients re-presenting to emergency. CONCLUSIONS: The study highlighted that the majority of patients were satisfied with care, complied with discharge healthcare information and confident to be discharged. However, a number of patients failed to adhere to discharge follow up advice and re-presented to the emergency.