Communicating discharge instructions to patients: A survey of nurse, intern, and hospitalist practices1. Issue 1 (15th October 2012)

• Record Type: Journal Article
• Authors: Ashbrook, Liza; Mourad, Michelle; Sehgal, Niraj
• Is Part Of: Journal of hospital medicine. Volume 8:Issue 1(2013)
• Page Start: 36
• Page End: 41
• Publication Date: 2012-10-15
• Subjects: Hospital care -- Periodicals; Clinical medicine -- Periodicals; 610
• DOI: 10.1002/jhm.1986
• Languages: English
• ISSNs: 1553-5592

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="abs1-1" sec-type="section"> <title> <bold>BACKGROUND:</bold> </title> <p>Comprehensive discharge education can improve patient understanding and may reduce unnecessary rehospitalization.</p> </sec> <sec id="abs1-2" sec-type="section"> <title> <bold>OBJECTIVES:</bold> </title> <p>To understand nurse and physician communication practices around patient discharge education.</p> </sec> <sec id="abs1-3" sec-type="section"> <title> <bold>SETTING:</bold> </title> <p>University of California, San Francisco Medical Center (UCSFMC).</p> </sec> <sec id="abs1-4" sec-type="section"> <title> <bold>PARTICIPANTS:</bold> </title> <p>Nurses, interns, and hospitalists caring for hospitalized medicine patients.</p> </sec> <sec id="abs1-5" sec-type="section"> <title> <bold>MEASUREMENTS:</bold> </title> <p>Participants were surveyed regarding discharge education practices. The survey asked respondents about 13 elements of discharge education found in the literature. For each element, participants were queried regarding: 1) the provider responsible for this element of patient education; 2) the frequency with which they communicate this teaching to patients; 3) how often they directly communicate with the nurse or physician caring for the patient about each element; and 4) tools to improve nurse–physician communication.</p> </sec> <sec id="abs1-6" sec-type="section"> <title> <bold>RESULTS:</bold> </title> <p>A total of 129/184 (70%) nurses, interns, and hospitalists responded to the survey. The majority of respondents in all 3 groups felt that 9 of 13 elements were a combined responsibility. Nurses reported educating patients on these 9 items significantly more often than physicians (<italic>P</italic> < 0.05). All groups also agreed that instruction on 2 of the elements, summary of hospital findings and pending results, should be primarily the physicians' responsibility; these were the elements least often discussed by any provider. Despite the majority of items being agreed upon as a shared responsibility, communication between nurses and physicians regarding discharge education was low<bold>.</bold> Standardized verbal communication on the day of discharge was supported most strongly by all providers.</p> </sec> <sec id="abs1-7" sec-type="section"> <title> <bold>CONCLUSIONS:</bold> </title> <p>Ambiguous responsibility for providing discharge education and poor communication between nurses and physicians offers an opportunity for improvement. Journal of Hospital Medicine 2013. © 2012 Society of Hospital Medicine</p> </sec> </abstract>