Transitional care has garnered significant attention since INQRI's own Mary Naylor conducted her ground-breaking research into the care older patients with multiple chronic conditions received during the transition from acute care to home or another care setting and developed the Transitional Care Model. Now, a study led by nurse researcher Barbara King and geriatrician Amy Kind reveals that the transition from hospital to nursing home is often difficult because of poor communication between staff at those institutions.
The study, published in the Journal of the American Geriatrics Society, reveals that nurses in skilled nursing facilities report that difficult transitions are the norm because they receive little information about their incoming patients. Adverse consequences that were a result of this poor communication included: increased risk of medication errors, delayed efforts to mobilize patients, and time wasted trying to obtain information that should have been shared. The nurses who participated in focus groups and surveys for this study reported that they felt their credibility and the credibility of the nursing home were undermined because of communications failures.
Several INQRI studies have examined the ways nurses can improve transitional care, including a study by Cynthia Corbett and Stephen Setter exploring the role of the home health care nurse in medication management; and a translational study by Nancy Hanrahan and Phyllis Solomon adapting the Transitional Care Model for people with serious mental illness in public managed care.
Read more about the King/Kind study here.
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This sad news is becoming an echoing sound of reality. I have seen this happen too many times with my grandparents when they were released to a nursing home from the hospital only to end up back in a week later. The nursing home caregivers always seemed clueless as to what went on in the hospital. As I begin to search for nursing homes for my own parents now I am looking into at-home care. I like the visiting angels program at NJ Senior Care because it offers the option of occasional visits to live-in care. If I had to I think I could make that transition with the same visiting angel which I think would avoid many of the communication pitfalls seen with hospitals and nursing homes.
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