RESUMO
AIM: This study sought to review documentation of client teaching and discharge planning performed on the medical wards of an urban Jamaican hospital. BACKGROUND: Amid a chronic disease epidemic in Jamaica, adequate discharge planning and client education among hospitalized clients are essential to ensure optimal health outcomes and reduced healthcare costs. METHOD: A total of 131 records from six medical wards were audited. The audit instrument was developed based on the Ministry of Health, Jamaica guidelines, and appraised the completeness of assessment, use of the nursing process, client teaching and discharge planning. Quota sampling facilitated the selection of medical records which met the inclusion criteria. The SPSS® version 22 for Windows® facilitated data analysis. RESULTS: Eighty-eight adult (67.2%) and 43 (32.8%) paediatric records were audited; 89.3% indicated the clients were diagnosed with at least one non-communicable disease. Fourteen percent of records reflected documented evidence of client teaching within the first 72 h of admission. On the day of discharge, only 18.3% reflected client teaching. Nurses seldom began discharge planning within the first 24 h of admission as only 6.9% records had documented evidence. These trends were common to adult and paediatric units. DISCUSSION AND CONCLUSION: The requisite client teaching and discharge planning appeared to be lacking in the records reviewed and may be contributory to deficiencies noted in self-care management. Research is needed to determine factors which could facilitate improved client teaching and discharge planning in the local context. Failure to address this gap in nursing care can significantly affect the country's ability to the reduce the economic burden associated with chronic diseases. IMPLICATIONS FOR NURSING AND HEALTH POLICY: This study highlighted an opportunity for advocacy among nurses and requires nursing leadership to collaboratively develop policies and guidelines to address discharge planning and client education among hospitalized clients. Given the significant health costs associated with non-communicable diseases this should be made a priority in the National Strategic and Action Plan for the Prevention and Control Non-communicable Diseases in Jamaica with clear articulations.
Assuntos
Registros de Enfermagem/estatística & dados numéricos , Recursos Humanos de Enfermagem Hospitalar/organização & administração , Alta do Paciente/estatística & dados numéricos , Educação de Pacientes como Assunto/estatística & dados numéricos , Padrões de Prática em Enfermagem/organização & administração , Adulto , Criança , Humanos , Jamaica , Auditoria de EnfermagemRESUMO
This is a study of nurses' perceptions of the Family Health Strategy seen as mediators of the workers actions towards achieving the aims and objectives of the job. This is a descriptive/qualitative survey carried out in Family Health Units in the city of Cuiabá, Mato Grosso, involving 11 nurses and using semi-structured interviews and thematic analysis of the data. Family Health is seen as a new model the main aim of which is the prevention of aggravation, by means of strategic action, working with families, territorialization and humanized relationships. Actions connected to central management and worker training are considered essential for its effectiveness. There is certain adhesion to the precepts of the Family Health program but there are also some important divergences and inconsistencies in its translation into the practical side, showing there is a need for permanent education of the workers.
O presente trabalho é um estudo das percepções de enfermeiros sobre a Estratégia Saúde da Família, compreendidas como mediadoras da ação direcionada a certos objetos e finalidades do trabalho local em saúde. A pesquisa é descritiva de abordagem qualitativa e foi realizada em 2008-2009, em unidades de Saúde da Família de uma regional administrativa de Cuiabá, Mato Grosso, com onze enfermeiros, mediante entrevista semiestruturada e análise temática do material empírico. A Estratégia Saúde da Família é vista como um modelo cuja finalidade principal é a prevenção de agravos à saúde, mediante trabalho direcionado a famílias, ações estratégicas definidas nacionalmente, territorialização e relações humanizadas e com vínculo. São consideradas essenciais à sua efetivação: ações conexas da gestão municipal do setor e de preparo dos trabalhadores da equipe. Identificou-se certa adesão aos preceitos da Estratégia Saúde da Família, mas também vazios importantes e algumas inconsistências em sua tradução prática, evidenciando a necessidade de educação permanente.