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The patient's vulnerability, dependence and exposed situation in the discharge process: experiences of district nurses, geriatric nurses and social workers.

Rydeman I, Törnkvist L

Neurotec Department, Center for Family and Community medicine, Karolinska Institutet, Stockholm, Sweden. Ing-britt.rydeman@sll.se

AIM: The aim of the study was to obtain a deeper understanding of the experiences of the discharge process among different professionals. BACKGROUND: An optimal discharge process for hospitalized elderly to other forms of care is of crucial importance, especially since health and medical policies encourages shorter hospital stays and increased healthcare service in outpatient care. METHODS: Nurses and social workers from inpatient care, outpatient care, municipal care and social services were interviewed. Eight focus-group interviews with a total of 31 persons were conducted. The subsequent analyses followed a phenomenological approach. RESULTS: The findings revealed three themes, Framework, Basic Values and Patient Resources, which influenced the professionals' actions in the discharge process. The overall emerging structure comprised the patient's vulnerability, dependence and exposed situation in the discharge process. CONCLUSION: In conclusion some factors are of special importance for the co-operation and the actions of professionals involved in the discharge process. Firstly, a distinct and common framework, with conscious and organizationally based values. Secondly the need to take the patient resources into consideration. Together these factors could contribute to secure the patients involvement in the discharge process and to design an optimal, safe and good care. RELEVANCE TO CLINICAL PRACTICE: Collaborative approaches among a range of professionals within a variety of organizations are common, especially in the care of the elderly. The role and support of both the organizations and the educational units are decisive factors in this area.

Published 13 September 2006 in J Clin Nurs, 15(10): 1299-307.
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