Preparing older patients to manage their health after hospitalization is an urgent challenge for nurses and healthcare systems due to increasing longevity and age-related health conditions. So how do we, as nurses, wish to respond to this demographic change? What changes in care practice and culture are we prepared to make to meet the needs of older patients returning home? How can we contribute to a paradigm shift towards a more patient-centred model of preparation for discharge?
Research team: Dr.Sc Joanie Pellet, Prof. Cédric Mabire (supervisor), Prof. Marianne Weiss (Marquette University, co-supervisor), Prof. Franziska Zúñiga (University of Basel)
This project was funded by the VeluxStiftung
Although older and multimorbid inpatients represent the majority of patients, hospitals and care processes are still organized to treat acute episodes of illness. Short lengths of stay and increased patient flow limit the time available to address the complex needs related to the chronicity and frailty of these patients. High-quality teaching during hospitalization is a nursing intervention that can improve patient readiness for discharge and adherence to post-discharge care, as well as reduce mortality, readmissions, and costs. However, only a minority of older patients in Switzerland receive nursing discharge teaching during their hospital stay and most have significant information needs once they return home. The goal of this thesis is to develop knowledge for nursing practice about the design and implementation of nursing discharge teaching such that it could become a standard nursing intervention in routine clinical practice.
The objectives of this thesis conducted between 2018 and 2022 were to:
- Understand the mechanisms of how, why, and under what circumstances nursing discharge teaching can produce positive outcomes in older patients;
- Identify the barriers to successful implementation of quality teaching in the reality of clinical practice and strategies to address these barriers; and
- Develop and obtain preliminary data on the effect size of a novel discharge teaching intervention that takes into account the unique and complex needs and characteristics of multimorbid older patients.
Publications
