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Abstract
Research spanning 30 years has highlighted discharge planning as a complex area of practice. Discharge co-ordinators are part of the support provided to improve the patient's journey from acute to community settings. The aim of this study was to explore and describe the role of discharge co-ordinators in a healthcare setting. Using an exploratory descriptive research design a convenience sample of discharge co-ordinator nurses (n=6) across a variety of acute care settings in the Republic of Ireland, were interviewed. Thematic analysis revealed that the role of the discharge co-ordinators was multifaceted and a number of factors affected their role. Recommendations for practice include improved discharge planning processes and education.
Key words
* Home care services
* Multidisciplinary teams
* Patients: discharge
These key words are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review.
Continuity of care in discharge is an important quality issue, yet the literature suggests there are recurring problems in the interface between hospitals and primary care (Bull and Roberts 2001, Cannaby ef a/ 2003). Changes in processes of care and in patient populations have contributed to the emergence of discharge planning as a complex area of practice (Bull and Roberts 2001, Atwal 2002, Cannaby ef a/ 2003, Central Statistics Office 2006). Securing timely discharge is a key feature of policy documents (Department of Health (DH) 2001, 2003, 2004a, Department of Health and Children (DoHC) 2003, Health Service Executive (HSE) 2008) and a consequence of delayed discharge is the inappropriate occupancy of acute beds (Procter ef a/ 2001).
Essential elements of effective discharge planning include: effective communication, a multidisciplinary approach and early and coordinated assessment of patient's needs and home circumstances (Victor ef al 2000, Bull and Roberts 2001, Atwal 2002). However, gaps and delays in communication between healthcare teams and poor discharge documentation (McKenna ef a/2000, Atwal 2002, Watts and Gardner 2005, Helleso 2006) continue to be issues. Recent research again highlights poor liaison strategies between emergency departments and community care (Dunnion and Kelly 2005, 2007, 2008). Evidence suggests that patients and carers are neither prepared for discharge nor receive adequate pre-discharge information (Heaton ef al 1999, Procter ef al 2001, Theobald and McMurray 2004, Efraimsson ef al 2006). Audits...