Medicine and Health Sciences Commons^™

Examining The Course Of Transitions From Hospital To Home-Based Palliative Care: A Mixed Methods Study, Stephanie Saunders, Marianne Weiss, Chris Meaney, Tieghan Killackey, Jaymie Varenbut, Emily Lovrics, Natalie Ernecoff, Amy T. Hsu, Maya Stern, Ramona Mahtani, Kirsten Wentlandt, Sarina R. Isenberg

College of Nursing Faculty Research and Publications

Background:

Hospital-to-home transitions in palliative care are fraught with challenges. To assess transitions researchers have used patient reported outcome measures and qualitative data to give unique insights into a phenomenon. Few measures examine care setting transitions in palliative care, yet domains identified in other populations are likely relevant for patients receiving palliative care.

Aim:

Gain insight into how patients experience three domains, discharge readiness, transition quality, and discharge-coping, during hospital-to-home transitions.

Design:

Longitudinal, convergent parallel mixed methods study design with two data collection visits: in-hospital before and 3–4 weeks after discharge. Participants completed scales assessing discharge readiness, transition quality, and …

Parent Readiness For Hospital Discharge Scale: Psychometrics And Association With Postdischarge Outcomes, Marianne Weiss, Stacee M. Lerret, Rachel Schiffman

College of Nursing Faculty Research and Publications

Introduction The purpose of this study is to validate the Readiness for Hospital Discharge Scale (RHDS) for use with parents of hospitalized children. PedRHDS is a structured tool for a discharge readiness assessment before pediatric discharge. Methods Using combined data from four studies with 417 parents, psychometric testing and item reduction proceeded with principal component analysis for factor structure delineation, Cronbach's alpha for reliability estimation, and regression analysis for predictive validity. Results A 23-item PedRHDS retained the a priori factor structure. Reliability ranged from 0.73 to 0.85 for the 23-item and 10- and 8-item short scales. PedRHDS (all forms) was …

Discharge Teaching, Readiness For Discharge, And Post-Discharge Outcomes In Parents Of Hospitalized Children, Marianne E. Weiss, Kathleen Sawin, Karen Gralton, Norah L. Johnson, Carol Klingbeil, Stacee M. Lerret, Shelly Malin, Olga Yakusheva, Rachel Schiffman

College of Nursing Faculty Research and Publications

Purpose

This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits).

Design/methods

In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3 weeks post-discharge …

Bridges And Barriers: Patients' Perceptions Of The Discharge Process Including Multidisciplinary Rounds On A Trauma Unit, Dawn Zakzesky, Katie Klink, Natalie S. Mcandrew, Kathryn Schroeter, Grace Johnson

College of Nursing Faculty Research and Publications

Discharge planning is a complex process and ideally begins early in the patient stay. Despite evidence about the importance of discharge readiness, there is limited literature about the patient's view during this transition. The goal of this study was to explore patient perspectives about the discharge process, including multidisciplinary rounds. Multidisciplinary rounding is a process where care providers from various specialties meet to communicate, coordinate patient care, make decisions, and manage responsibilities. The theme found was “bridges and barriers to discharge.” Participants identified timelines and tasks, communication, social support, and motivation as helpful and medical setbacks, insurance limitations, and infrequent …

Validation Of Patient And Nurse Short Forms Of The Readiness For Hospital Discharge Scale And Their Relationship To Return To The Hospital, Marianne E. Weiss, Linda L. Costa, Kathleen Bobay, Olga Yakusheva

College of Nursing Faculty Research and Publications

Objective: To validate patient and nurse short forms for discharge readiness assessment and their associations with 30-day readmissions and emergency department (ED) visits.

Data Sources/Study Setting: A total of 254 adult medical-surgical patients and their discharging nurses from an Eastern US tertiary hospital between May and November, 2011. Study Design Prospective longitudinal design, multinomial logistic regression analysis.

Data Collection/Extraction Methods: Nurses and patients independently completed an eight-item Readiness for Hospital Discharge Scale on the day of discharge. Patient characteristics, readmissions, and ED visits were electronically abstracted.

Principal Findings: Nurse assessment of low discharge readiness was associated with a six- to …

Quality And Cost Analysis Of Nurse Staffing, Discharge Preparation, And Postdischarge Utilization, Marianne E. Weiss, Olga Yakusheva, Kathleen Bobay

College of Nursing Faculty Research and Publications

Objectives. To determine the impact of unit-level nurse staffing on quality of discharge teaching, patient perception of discharge readiness, and postdischarge readmission and emergency department (ED) visits, and cost-benefit of adjustments to unit nurse staffing.

Data Sources. Patient questionnaires, electronic medical records, and administrative data for 1,892 medical–surgical patients from 16 nursing units within four acute care hospitals between January and July 2008.

Design. Nested panel data with hospital and unit-level fixed effects and patient and unit-level control variables.

Data Collection/Extraction. Registered nurse (RN) staffing was recorded monthly in hours-per-patient-day. Patient questionnaires were completed before discharge. Thirty-day readmission and ED …

Predictors And Outcomes Of Postpartum Mothers' Perceptions Of Readiness For Discharge After Birth, Marianne E. Weiss, Lisa Lokken

College of Nursing Faculty Research and Publications

Objective: To identify predictors and outcomes of postpartum mothers' perceptions of their readiness for hospital discharge. Design: A correlational design with path analyses was used to explore predictive relationships among transition theory-related variables. Setting: Midwestern tertiary perinatal center. Participants: One hundred and forty-one mixed-parity postpartum mothers who had experienced vaginal birth or Cesarean delivery of normal healthy infants. Methods: Before hospital discharge, patients completed questionnaires about sociodemographic characteristics, hospitalization factors, quality of discharge teaching, and readiness for discharge. Three weeks postdischarge, mothers were contacted by telephone to collect coping difficulty and health care utilization data. Main Outcome Measures: Readiness for …

Readiness For Discharge In Parents Of Hospitalized Children, Marianne E. Weiss, Norah Louise Johnson, Shelly Malin, Teresa A. Jerofke, Cecilia Lang, Eileen Sherburne

College of Nursing Faculty Research and Publications

Parental preparation for a child's discharge from the hospital sets the stage for successful transitioning to care and recovery at home. In this study of 135 parents of hospitalized children, the quality of discharge teaching, particularly the nurses' skills in “delivery” of parent teaching, was associated with increased parental readiness for discharge, which was associated with less coping difficulty during the first 3 weeks postdischarge. Parental coping difficulty was predictive of greater utilization of posthospitalization health services. These results validate the role of the skilled nurse as a teacher in promoting positive outcomes at discharge and beyond the hospitalization.