The Role Of The Pediatric Nurse In Discharge Planning; Identifying Gaps In Sri Lanka

Kalpana Jeewanthi Subasinghe, A.M. Shyama Deepanie Pathiranage

Abstract


Background: Pediatric discharge planning is a complex process, and that nurses need lengthy preparations. Role confusion among nurses will disrupt the smooth planning of the discharge. In Sri Lanka, although there is a possibility of reducing health costs through effective discharge planning led by pediatric nurses, it is questionable whether Sri Lankan nurses have clarified their role in this process.

Method: This systematic review was conducted to map the different roles of nurses in the pediatric discharge planning process. Electronic databases of PubMed and CINAHL were searched for peer-reviewed journal articles among the pediatric population from 2005-2019, using the keywords such as discharge planning, pediatric nurse, care transitions, transitional care, and Sri Lankan nurse.

Results: Articles that resulted in the word combination ‘Discharge planning and pediatric nursing (n=329) were used for screening. Two hundred and forty articles out of the nursing scope and sixty articles that do not describe an apparent nursing involvement in the discharge process were excluded, based on abstract review and full-text review, respectively. Sixteen studies were included in the final review. Few literature was found on the topic among Sri Lankan pediatric population. Four main categories of nurses’ roles were identified with the thematic analysis: discharge educator, discharge collaborator, post-discharge care coordinator, and family counselor. 

Conclusion: In Sri Lanka, no such defined roles of a nurse have been established yet in the discharge planning of pediatric patients. These roles may help nurses carry out discharge planning effectively, and future studies are needed on this topic in Sri Lanka.


Keywords


discharge planning; nurses’ role; pediatric nurse; Sri Lankan nursing

Full Text:

PDF

References


Alizadeh, V., Törnkvist, L., & Hylander I. (2011). Counselling Teenage Girls on Problems Related to the ‘protection of Family Honour’ from the Perspective of School Nurses and Counsellors. Health and Social Care in the Community, 19(5), 476–84.

https://doi.org/10.1111/j.1365-2524.2011.00993.x

De Alwis, A. C., & Shammika, K., (2015). The Nursing Shortage Impact on Job Outcome (The Case in Sri Lanka). Journal of Competitiveness, 7(3), 75–94.

https://doi.org/10.7441/joc.2015.03.06

Arad, I., Netzer, D., & Haramati, Z. (2007). The Impact of Nurses and Mothers Signing the Discharge Letter on Maternal Knowledge and Satisfaction after Discharge from a Neonatal Unit : A before and after Study. International Journal of Nursing Studies, 44(7), 1102–1108.

https://doi.org/10.1016/j.ijnurstu.2006.04.012

Aued, G. K., Bernardino, E., Lapierre, J., & Dallaire, C. (2019). Liaison Nurse Activities at Hospital Discharge: A Strategy for Continuity of Care*. Revista Latino-Americana de Enfermagem, 27.

https://doi.org/10.1590/1518-8345.3069.3162

Auger, K. A., Shah, S. S., Cooley, H. L. T., Sucharew, H. J., Gold, J. M., Murphy, S. W., Statile, A. M., Bell, K. D., Khoury, J. C., Mangeot, C., & Simmons, J. M. (2018). Effects of a 1-Time Nurse-Led Telephone Call After Pediatric Discharge The H2O II Randomized Clinical Trial. JAMA Pediatrics, 172(9), 1–8.

https://doi.org/10.1001/jamapediatrics.2018.1482

Auger, K. A., Simmons, J. M., Cooley, H. L. T., Sucharew, H. J., Statile, A. M., Pickler, R. H., Ford, H. S. S., Gold, J. M., Khoury, J. C., Beck, A. F., Murphy, S. M., Kuhnell, P., & Shah, S. S. (2018). Postdischarge Nurse Home Visits and Reuse: The Hospital to Home Outcomes (H2O) Trial. Pediatrics, 142(1).

https://doi.org/10.1542/peds.2017-3919

Baker, C. D., Martin, S., Thrasher, J., Moore, H. M., Baker, J., Abman, S. H., & Gien, J. (2016). A Standardized Discharge Process Decreases Length of Stay for Ventilator-Dependent Children. Pediatrics, 137(4).

https://doi.org/10.1542/peds.2015-0637.

Bowles, J. D., Jnah, A. J., Newberry, D. M., Hubbard, C. A., & Roberston, T. (2016). Infants With Technology Dependence: Facilitating the Road to Home. Advances in neonatal care: official journal of the National Association of Neonatal Nurses, 16(6), 424–29.

https://doi.org/10.1097/ANC.0000000000000310

Brenner, M., Larkin, P. J., Hilliard, C., Cawley, D., Howlin, F., & Connolly, M. (2015). Parents’ Perspectives of the Transition to Home When a Child Has Complex Technological Health Care Needs. International Journal of Integrated Care, 15, 1–9.

https://doi.org/10.5334/ijic.1852

Chang, W., Goopy, S., Lin, C. C., Barnard, A., Liu, H. E., & Han, C. Y. (2016). Registered Nurses and Discharge Planning in a Taiwanese ED: A Neglected Issue?. Clinical Nursing Research, 25(5), 512–31.

https://doi.org/10.1177/1054773815584138.

Chiang, L. C., Chen, W. C., Dai, Y. T., & Ho, Y. I. (2012). International Journal of Nursing Studies The Effectiveness of Telehealth Care on Caregiver Burden, Mastery of Stress, and Family Function among Family Caregivers of Heart Failure Patients : A Quasi-Experimental Study. International Journal of Nursing Studies, 49(10), 1230–1242.

https://doi.org/10.1016/j.ijnurstu.2012.04.013

Chick, N., & Meleis, A. (1986). Transitions : A Nursing Concern. Peggy Chinn. Nursing Research Methodology - Issues and Implementation. New York : Aspen Publication. Nursing Research Methodology 237–57.

Coleman, E. A., Mahoney, E., & Parry, C. (2005). Assessing the Quality of Preparation for Posthospital Care from the Patient’s Perspective: The Care Transitions Measure. Medical Care, 43(3), 246–55.

https://doi.org/10.1097/00005650-200503000-00007

Dellenmark-Blom, M., & Wigert, H. (2014). Parents’ Experiences with Neonatal Home Care Following Initial Care in the Neonatal Intensive Care Unit: A Phenomenological Hermeneutical Interview Study. Journal of Advanced Nursing, 70(3), 575–586.

https://doi.org/10.1111/jan.12218

Driscoll, A. (2000). Managing Post-Discharge Care at Home: An Analysis of Patients’ and Their Carers’ Perceptions of Information Received during Their Stay in Hospital. Journal of Advanced Nursing, 31(5), 1165–1173.

https://doi.org/10.1046/j.1365-2648.2000.01372.x

Ekim, A., & Ocakci, A. F. (2016). Efficacy of a Transition Theory-Based Discharge Planning Program for Childhood Asthma Management. International Journal of Nursing Knowledge, 27(2), 70–78.

https://doi.org/10.1111/2047-3095.12077

Foust, J. B. (2007). Discharge Planning as Part of Daily Nursing Practice. Applied Nursing Research, 20(2), 72–77.

https://doi.org/10.1016/j.apnr.2006.01.005

Gallotto, M., Rosa, C. M., Takvorian-Bené, M., McClelland, J., Tascione, C., Carey, A., & Raphael, B. P. (2019). Caregiver Training for Pediatric Home Parenteral Nutrition, 42(3). 132–36.

https://doi.org/10.1097/NAN.0000000000000320

Góes, F. G. B., & Cabral, I. E. (2017). Discourses on Discharge Care for Children with Special Healthcare Needs. Revista Brasileira de Enfermagem, 70(1), 163–71.

https://doi.org/10.1590/0034-7167-2016-0248

Hettiarachchi, M., & Amarasena, S. (2014). Indicators of Newborn Screening for Congenital Hypothyroidism in Sri Lanka: Program Challenges and Way Forward. BMC Health Services Research, 14(1), 2–7.

https://doi.org/10.1186/1472-6963-14-385

Holland, D. E., Conlon, P, M., Rohlik, G. M., Gillard, K. L., Messner, P. K., & Mundy, L. M. (2015). Identifying Hospitalized Pediatric Patients for Early Discharge Planning: A Feasibility Study. Journal of Pediatric Nursing, 30(3), 454–462.

https://doi.org/10.1016/j.pedn.2014.12.011

Holland, D. E., Conlon, P. M., Rohlik, G. M., Gillard, K. L., Tomlinson, A. L., Raadt, D. M., Finseth, O. R., & Rhudy, L. M. (2014). Developing and Testing a Discharge Planning Decision Support Tool for Hospitalized Pediatric Patients. Journal for Specialists in Pediatric Nursing: JSPN, 19(2), 149–161.

https://doi.org/10.1111/jspn.12064

Jack, B. W., Chetty, V. K., Anthony, D., Greenwald, J. L., Sanchez, G. M., Johnson, A. E., Forsythe, S. R., O'Donnell, J. K., Paasche-Orlow, M. K., Manasseh, C., Martin, S., & Culpepper, L. (2009). A Reengineered Hospital Discharge Program to Decrease Rehospitalization. Annals of Internal Medicine, 50(3), 178–187.

https://doi.org/10.7326/0003-4819-150-3-200902030-00007

Koné, I., Zimmermann, B., Wangmo, T., Richner, S., Weber, M., & Elger, B. (2018). Hospital Discharge of Patients with Ongoing Care Needs: A Cross-Sectional Study Using Data from a City Hospital under SwissDRG. Swiss Medical Weekly, 148, 14575.

https://doi.org/10.4414/smw.2018.14575

Kripalani, S., Jackson, A. T., Schnipper, J. L., & Coleman, E. A. (2007). Promoting Effective Transitions of Care at Hospital Discharge: A Review of Key Issues for Hospitalists. Journal of Hospital Medicine, 2(5), 314–323.

https://doi.org/10.1002/jhm.228

Lerret, S. M., Johnson, N. L., & Haglund, K. A. (2017). Parents’ Perspectives on Caring for Children after Solid Organ Transplant. Journal for Specialists in Pediatric Nursing, 22(3), 1–8.

https://doi.org/10.1111/jspn.12178

Lin, C. J., Cheng, S. J., Shih, S. C., Chu, C. H., & Tjung, J, J. (2012). Discharge Planning. International Journal of Gerontology, 6(4), 237–40.

https://doi.org/10.1016/j.ijge.2012.05.001

Maguire, P., & Faulkner, A. (1988). Improve the Counselling Skills of Doctors and Nurses in Cancer Care. British Medical Journal, 297(6652), 847–849.

https://doi.org/10.1136/bmj.297.6652.847

Meerlo-Habing, A. E., Kosters-Boes, E. A., Klip, H., & Brand, P. L. P. (2009). Early Discharge with Tube Feeding at Home for Preterm Infants Is Associated with Longer Duration of Breast Feeding. Archives of Disease in Childhood: Fetal and Neonatal Edition 94(4), 294–97.

http://dx.doi.org/10.1136/adc.2008.146100

Ministry of Health., Nutrition and Indigenous medicine. (2019). “Annual Health Statistics-2017.” 1–44.

Naylor, M. D., Brooten, D., Campbell, R., Jacobsen, B. S., Mezey, M. D., Pauly, M, V., & Schwartz, J, S. (1999). Comprehensive Discharge Planning and Home Follow-up of Hospitalized Elders: A Randomized Clinical Trial. Journal of the American Medical Association, 281(7), 613–20.

https://doi.org/10.1001/jama.281.7.613

Ofoma, U. R., Dong, Y., Gajic, O., & Pickering, B. W. (2018). A Qualitative Exploration of the Discharge Process and Factors Predisposing to Readmissions to the Intensive Care Unit. BMC Health Services Research, 18(1), 6.

https://doi.org/10.1186/s12913-017-2821-z

Page, J. S., Lederman, L., Kelly, J., Barry, M. M., & James, T. A. (2016). Teams and Teamwork in Cancer Care Delivery: Shared Mental Models to Improve Planning for Discharge and Coordination of Follow-up Care. Journal of Oncology Practice, 12(11), 1053–1058.

https://doi.org/10.1200/JOP.2016.013888

Pfeil, M., Mathur, A., Singh, S., Morris, C., Green, G., & Kulkarni, M. (2007). Home next Day: Early Discharge of Children Following Appendicectomy. Journal of Child Health Care, 11(3), 208–20.

https://doi.org/10.1177/1367493507079565

Pickler, R., Murphy, S, W., Gold, J., Cooley, H. T., White, C. M., Statile, A., Hoying, C., Ford, H. S., Shah, S. S., & Simmons, J. (2016). A Nurse Transitional Home Visit Following Pediatric Hospitalizations. Journal of Nursing Administration, 46(12), 642–47.

https://doi.org/10.1097/NNA.0000000000000420.

Popejoy, L. L., Galambos, C., Moylan, K., & Madsen, R. (2012). Challenges to Hospital Discharge Planning for Older Adults. Clinical Nursing Research, 21(4), 431–49.

https://doi.org/10.1177/1054773812436373

Purdy, I. B., Craig, J, W., & Zeanah, P. (2015). NICU Discharge Planning and beyond: Recommendations for Parent Psychosocial Support. Journal of Perinatology, 35, 24–28.

https://doi.org/10.1038/jp.2015.146

Rosenbek, S., & Coleman, E, A. (2013). The Care Transitions Intervention. Comprehensive Care Coordination for Chronically III Adults, 166, 261–75.

https://doi.org/10.1038/jp.2015.14610.1002/9781118785775.ch13

Sanders, L. M., Shaw, J, S., Guez, G., Baur, C., & Rudd, R. (2009). Health Literacy and Child Health Promotion: Implications for Research, Clinical Care, and Public Policy. Pediatrics 124(3).

https://doi.org/10.1038/jp.2015.14610.1542/peds.2009-1162G

Schuh, M., Schendel, S., Islam, S., Klassen, K., Morrison, L., Rankin, K, N., Robert, C., & Mackie, A, S. (2016). Parent Readiness for Discharge from a Tertiary Care Pediatric Cardiology Unit. Journal for Specialists in Pediatric Nursing, 21(3), 139–46.

https://doi.org/10.1038/jp.2015.14610.1542/peds.2009-1162G 10.1111/jspn.12148.

https://doi.org/10.1093/tropej/fml080.

De Silva, B. S. S., & Rolls, C. (2010). Health-Care System and Nursing in Sri Lanka: An Ethnography Study. Nursing and Health Sciences, 12(1), 33–38.

https://doi.org/10.1111/j.1442-2018.2009.00482.x

Thomas, D. R. (2006). A General Inductive Approach for Analyzing Qualitative Evaluation Data. American Journal of Evaluation, 27(2), 237–246.

https://doi.org/10.1177/1098214005283748

Turrell, S. L., Davis, R., Graham, H., & Weiss, I. (2005). Adolescents with Anorexia Nervosa: Multiple Perspectives of Discharge Readiness. 18(3), 16-126.

https://doi.org/10.1111/j.1744-6171.2005.00021.x

Uspal, N. G., Rutman, L. E., Kodish, I., Moore, A., & Migita, R. T. (2016). Use of a Dedicated, Non-Physician-Led Mental Health Team to Reduce Pediatric Emergency Department Lengths of Stay. Academic Emergency Medicine, 23(4), 440–47.

https://doi.org/10.1111/acem.12908

Watts, R., & Gardner, H. (2005). Nurses’ Perceptions of Discharge Planning. Nursing and Health Sciences, 7(3), 175–183.

https://doi.org/10.1111/j.1442-2018.2005.00229.x

Weiss, M. E., Costa, L. L., Yakusheva, O., & Bobay, K. L. (2014). Validation of Patient and Nurse Short Forms of the Readiness for Hospital Discharge Scale and Their Relationship to Return to the Hospital. Health Services Research, 49(1), 304–317.

https://doi.org/10.1111/1475-6773.12092

Weiss, M. E., Sawin, K. J., Gralton, K., Johnson, N., Klingbeil, C., Lerret, S., Malin, S., Yakusheva, O., & Schiffman, R. (2017). Discharge Teaching, Readiness for Discharge, and Post-Discharge Outcomes in Parents of Hospitalized Children. Journal of Pediatric Nursing, 34, 58–64.

https://doi.org/10.1016/j.pedn.2016.12.021

Weiss, M. E., Yakusheva, O., & Bobay, K. L. (2011). Quality and Cost Analysis of Nurse Staffing, Discharge Preparation, and Postdischarge Utilization. Health Services Research, 46(5), 1473–1494.

https://doi.org/10.1111/j.1475-6773.2011.01267.x

Wells, S., Neill, M. O., Rogers, J., Blaine, K., Hoffman, A., Mcbride, S., Tschudy, M. M., Shumskiy, I., Mauskar, S., & Berry, J. G. (2017). Journal of Pediatric Nursing Nursing-Led Home Visits Post-Hospitalization for Children with Medical Complexity. Journal of Pediatric Nursing, 34, 10-16.

https://doi.org/10.1016/j.pedn.2017.03.003

Wilkins, K. L., & Woodgate, R. L. (2016). A Review of Qualitative Research on the Childhood Cancer Experience From the Perspective of Siblings : A Need to Give Them a Voice, 22(6), 305–19.

https://doi.org/10.1177/1043454205278035

Smith, M. G, W., Sachse, K., & Perry, M. T. (2018). Road to Home Program: A Performance Improvement Initiative to Increase Family and Nurse Satisfaction With the Discharge Education Process for Newly Diagnosed Pediatric Oncology Patients. Journal of Pediatric Oncology Nursing, 35(5), 368–74.

https://doi.org/10.1177/1043454218767872

Wong, E. L., Yam, C. H., Cheung, A. W., Leung, M. C., Chan, F. W., Wong, F. Y., & Yeoh, E. K. (2011). Barriers to Effective Discharge Planning: A Qualitative Study Investigating the Perspectives of Frontline Healthcare Professionals. BMC Health Services Research 11(1), 242.

https://doi.org/10.1186/1472-6963-11-242

Yakusheva, O., Weiss, M. E., Bobay, K. L., Costa, L., Hughes, R. G., Hamilton, M., Bang, J., & Buerhaus, P. I. (2019). Individual Nurse Productivity in Preparing Patients for Discharge Is Associated with Patient Likelihood of 30-Day Return to Hospital. Medical Care, 57(9), 688–694.

https://doi.org/10.1097/MLR.0000000000001170

Zhu, Q. M., Liu, J., Hu, H. Y., & Wang, S. (2015). Effectiveness of Nurse-Led Early Discharge Planning Programmes for Hospital Inpatients with Chronic Disease or Rehabilitation Needs: A Systematic Review and Meta-Analysis. Journal of Clinical Nursing, 24(19–20), 2993–3005.

https://doi.org/10.1111/jocn.12895




DOI: https://doi.org/10.18196/ijnp.v5i1.10748

Refbacks



Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

IJNP (Indonesian Journal of Nursing Practices) are indexed by:

        

Office:

School of Nursing, Faculty of Medicine and Health Science, Universitas Muhammadiyah Yogyakarta
Siti Walidah Building F3, 4th floor.
JL. Brawijaya, Tamantirto, Kasihan, Bantul, Yogyakarta 55183
Email: IJNP@umy.ac.id
Web: http://journal.umy.ac.id/index.php/ijnp

Creative Commons License
Indonesian Journal of Nursing Practice is licensed under an Attribution 4.0 International (CC BY 4.0) license.

View My Stats