Preparing safe discharge in a complex practice: A qualitative study of nurses' approach to patients with COPD's hospital discharge from two pulmonary medicinal wards.

Introduction: It remains unclear why 17% of patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) treated in Danish hospitals are readmitted within 30 days. Hospital discharge is multifaceted. However, the preparation process and nurses' efforts may be essential in ensuri...

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Publicado en:Scandinavian Journal of Caring Sciences Vol. 38; no. 3; pp. 756 - 767
Autores principales: Gregersen, Nanna Vendelboe, Refsgaard, Birgit, Sørensen, Dorthe
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Sep2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2024
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      pub: Wiley-Blackwell
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        atl: Preparing safe discharge in a complex practice: A qualitative study of nurses' approach to patients with COPD's hospital discharge from two pulmonary medicinal wards.
      aug:
        au:
          Gregersen, Nanna Vendelboe
          Refsgaard, Birgit
          Sørensen, Dorthe
        affil: Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
      sug:
        subj:
          Patient Safety
          Patient Discharge Methods
          Pulmonary Disease, Chronic Obstructive Nursing
          Pulmonary Medicine
          Hospital Units
          Nursing Role
          Nursing Process
          Human
          Qualitative Studies
          Empirical Research
          Grounded Theory
          Patient Satisfaction
          Personal Satisfaction
          Home Environment
          Interpersonal Relations
          Purposive Sample
          Adult
          Middle Age
          Denmark
          Descriptive Statistics
          Female
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
      ab: Introduction: It remains unclear why 17% of patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) treated in Danish hospitals are readmitted within 30 days. Hospital discharge is multifaceted. However, the preparation process and nurses' efforts may be essential in ensuring a successful discharge. Aim: To explore the process of preparing discharge for patients with COPD in a hospital setting. Method: Using constructivist grounded theory, we observed 11 nurses' work at two pulmonary medical wards using participant observation. Data collection and analysis were conducted using a constant comparative process encompassing three phases: initial, focused and theoretical. Results: We identified important perspectives influencing nurses when patients with COPD are discharged from two pulmonary medical wards. We generated a substantial theory of how nurses integrate various perspectives into their handling of hospital discharge. The theory contains three discharge approaches: co‐creating, hesitating and socialising. The co‐creating approach focuses on patient and relative involvement and systematic task solution, embedded in a biopsychosocial process, aiming to achieve a safe and sustainable discharge. In contrast, the hesitating approach focuses on discharging patients in line with system requirements and colleagues' expectations. Finally, the socialising approach focuses on creating a pleasant discharge experience for patients and colleagues alike. Conclusion: This study illuminates three distinct approaches adopted by nurses when discharging a patient with COPD. The co‐creating process encompasses patient involvement and systematic task resolution, incorporating a biopsychosocial process. In contrast, the other approaches are more limited in scope: the hesitating approach aims for harmony and collegial consensus, while the socialising approach focuses on ensuring a pleasant discharge experience for everyone. Nurses should therefore be mindful of the approach they adopt and the values associated with it in order to optimise their management of hospital discharge processes.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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