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A Congregation Transition of Care Program Using Faith Community Nurses and Volunteer Faith-Based Nurses. J Christ Nurs 2019; 36:158-165. [PMID: 31180960 DOI: 10.1097/cnj.0000000000000625] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Transition of Care Models can reduce the 30-day hospital readmission rate up to 67% by offering coordination and continuity of care. The purpose of this project was to evaluate a Congregation Transition of Care (CTOC) program in faith-based communities with the use of a faith community nurse and volunteer faith-based registered nurses. Descriptive statistics were used to describe findings, revealing a CTOC program can be effective in reducing 30-day readmissions in the faith community.
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Freeman S, Bishop K, Spirgiene L, Koopmans E, Botelho FC, Fyfe T, Xiong B, Patchett S, MacLeod M. Factors affecting residents transition from long term care facilities to the community: a scoping review. BMC Health Serv Res 2017. [PMID: 28978324 DOI: 10.1186/s12913‐017‐2571‐y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Long-term care facilities (LTCFs) are often places where persons with complex health needs that cannot be met in a community setting, reside and are cared for until death. However, not all persons experience continuous declines in health and functioning. For some residents who experience improvement in personal abilities and increased independence, transition from the LTCF to the community may be an option. This scoping review aimed to synthetize the existing evidence regarding the transition process from discharge planning to intervention and evaluation of outcomes for residents transitioning from LTCFs to the community. METHODS This review followed a five-stage scoping review framework to describe the current knowledge base related to transition from LTCFs to community based private dwellings as the location of the discharge (example: Person's own home or shared private home with a family member, friend, or neighbour). Of the 4221 articles retrieved in the search of 6 databases, 36 articles met the criteria for inclusion in this review. RESULTS The majority of studies focussed on an older adult population (aged 65 years or greater), were conducted in the USA, and were limited to small geographic regions. There was a lack of consistency in terminology used to describe both the facilities as well as the transition process. Literature consisted of a broad array of study designs; sample sizes ranged from less than 10 to more than 500,000. Persons who were younger, married, female, received intense therapy, and who expressed a desire to transition to a community setting were more likely to transition out of a LTCF while those who exhibited cognitive impairment were less likely to transition out of a LTCF to the community. CONCLUSIONS Findings highlight the heterogeneity and paucity of research examining transition of persons from LTCFs to the community. Overall, it remains unclear what best practices support the discharge planning and transition process and whether or not discharge from a LTCF to the community promotes the health, wellbeing, and quality of life of the persons. More research is needed in this area before we can start to confidently answer the research questions.
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Affiliation(s)
- Shannon Freeman
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada.
| | - Kristen Bishop
- Faculty of Health Sciences, Health and Rehabilitation Sciences, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | - Lina Spirgiene
- Department of Nursing and Care, Lithuanian University of Health Sciences, Mickevičiaus 9, -44307, Kaunas, LT, Lithuania
| | - Erica Koopmans
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Fernanda C Botelho
- School of Public Health, University of Sao Paulo, Dr. Arnaldo Street 715, Sao Paulo, SP, 01246-904, Brazil
| | - Trina Fyfe
- Northern Medical Program, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Beibei Xiong
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada.,School of Nursing, Jilin University, 965 XinJiang Street, ChangChun, JiLin, 130012, China
| | - Stacey Patchett
- Department of Quality, Planning and Information, Northern Health, 543 Front Street, Quesnel, BC, V2J 5K7, Canada
| | - Martha MacLeod
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
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Freeman S, Bishop K, Spirgiene L, Koopmans E, Botelho FC, Fyfe T, Xiong B, Patchett S, MacLeod M. Factors affecting residents transition from long term care facilities to the community: a scoping review. BMC Health Serv Res 2017; 17:689. [PMID: 28978324 PMCID: PMC5628420 DOI: 10.1186/s12913-017-2571-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 08/25/2017] [Indexed: 11/23/2022] Open
Abstract
Background Long-term care facilities (LTCFs) are often places where persons with complex health needs that cannot be met in a community setting, reside and are cared for until death. However, not all persons experience continuous declines in health and functioning. For some residents who experience improvement in personal abilities and increased independence, transition from the LTCF to the community may be an option. This scoping review aimed to synthetize the existing evidence regarding the transition process from discharge planning to intervention and evaluation of outcomes for residents transitioning from LTCFs to the community. Methods This review followed a five-stage scoping review framework to describe the current knowledge base related to transition from LTCFs to community based private dwellings as the location of the discharge (example: Person’s own home or shared private home with a family member, friend, or neighbour). Of the 4221 articles retrieved in the search of 6 databases, 36 articles met the criteria for inclusion in this review. Results The majority of studies focussed on an older adult population (aged 65 years or greater), were conducted in the USA, and were limited to small geographic regions. There was a lack of consistency in terminology used to describe both the facilities as well as the transition process. Literature consisted of a broad array of study designs; sample sizes ranged from less than 10 to more than 500,000. Persons who were younger, married, female, received intense therapy, and who expressed a desire to transition to a community setting were more likely to transition out of a LTCF while those who exhibited cognitive impairment were less likely to transition out of a LTCF to the community. Conclusions Findings highlight the heterogeneity and paucity of research examining transition of persons from LTCFs to the community. Overall, it remains unclear what best practices support the discharge planning and transition process and whether or not discharge from a LTCF to the community promotes the health, wellbeing, and quality of life of the persons. More research is needed in this area before we can start to confidently answer the research questions.
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Affiliation(s)
- Shannon Freeman
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada.
| | - Kristen Bishop
- Faculty of Health Sciences, Health and Rehabilitation Sciences, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | - Lina Spirgiene
- Department of Nursing and Care, Lithuanian University of Health Sciences, Mickevičiaus 9, -44307, Kaunas, LT, Lithuania
| | - Erica Koopmans
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Fernanda C Botelho
- School of Public Health, University of Sao Paulo, Dr. Arnaldo Street 715, Sao Paulo, SP, 01246-904, Brazil
| | - Trina Fyfe
- Northern Medical Program, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Beibei Xiong
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada.,School of Nursing, Jilin University, 965 XinJiang Street, ChangChun, JiLin, 130012, China
| | - Stacey Patchett
- Department of Quality, Planning and Information, Northern Health, 543 Front Street, Quesnel, BC, V2J 5K7, Canada
| | - Martha MacLeod
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
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