Medical-surgical nurses' documentation of client teaching and discharge planning at a Jamaican hospital

Interaction mechanism of discharge readiness between discharge teaching and post-discharge outcomes in gynecological inpatients: a mediation analysis

BACKGROUND

With the rapid implementation of enhanced recovery after surgery, most gynecological patients are discharged without full recovery. Discharge planning is necessary for patients and their families to transition from hospital to home. Discharge teaching and discharge readiness are two core indicators used to evaluate the quality of discharge planning, which impacts the post-discharge outcomes. To improve post-discharge outcomes, the interaction mechanism of the three variables needs to be determined, but few studies have focused on it.

OBJECTIVES

Explore the mediating effect of discharge readiness between discharge teaching and post-discharge outcomes of gynecological inpatients.

METHODS

Discharge teaching and discharge readiness were measured by the Quality of Discharge Teaching Scale (QDTS) and Readiness for Hospital Discharge Scale (RHDS). Post-discharge outcomes on postoperative Day 7 (POF-D7) and postoperative Day 28 (POF-D28) were measured by a self-designed tool. Spearman correlations, Kruskal‒Wallis tests and Mann‒Whitney U tests were conducted to explore the correlation between post-discharge outcomes and other variables. Mediation analysis was used to explore the mediating effect of discharge readiness between discharge teaching and post-discharge outcomes.

RESULTS

QDTS and RHDS showed strong positive correlations with post-discharge outcomes. The mediation analyses verified that RHDS was a full mediator between QDTS and POF-D7, and the indirect effect accounted for 95.6% of the total direct effect. RHDS was a partial mediator between QDTS and POF-D28, and the indirect effect accounted for 50.0% of the total direct effect. RHDS was a full mediator between QDTS and total scores of post-discharge outcomes, and the indirect effect accounted for 88.9% of the total direct effect.

CONCLUSIONS

Discharge teaching can improve the post-discharge outcomes of gynecological inpatients through the intermediary role of discharge readiness. Doctors and nurses should value the quality of discharge teaching and the discharge readiness improving of gynecological inpatients. Future studies should note the interaction mechanism of the three variables to explore more efficient ways of improving post-discharge outcomes of gynecological inpatients.

The discharge conversation: a phenomenographic interview study

BACKGROUND

Studies have highlighted deficiencies in the information given by nurses to surgical patients. Studies also show that the role of the nurse in connection with the discharge of patients after surgery is unclear. The aim of the study was therefore to elicit and to explore registered nurses' conceptions of the phenomenon of nursing care information given to surgical patients in connection with hospital discharge.

METHOD

Semi-structured interviews were conducted with fifteen nurses at surgical unites at the southern parts of Sweden. The interviews were transcribed and then analysed according to the phenomenographic approach.

RESULT

The analysis resulted into three descriptive categories which conjointly may be said to express the general conceptions of the informants. Thus, according to the informants, the provision of nursing care information in connection with the discharge of surgical patients is: (i) not a nursing priority, (ii) adapted to the context of care, and (iii) a possible enhancement of the nursing process and the quality of care.

CONCLUSION

The result of the study implies that the discharge conversation may be seen as an opportunity for the nursing profession to formalise and to enhance the quality of care in connection with the discharge of surgical patients.