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Factors influencing practices among ward nurses that support ongoing independent community living after discharge: a cross-sectional study.

Contemporary Nurse 2019 Februrary 15
BACKGROUND: It is not clear which personal factors and experiences affect ward nurses' practice in supporting patients to return home after discharge.

AIMS: To explore the practices among ward nurses that help them support patients to continue to live independently in the community; and the influence on these of personal experience of providing home care, approaches to discharge planning, and understanding about patients after discharge.

DESIGN: Cross-sectional study Methods: The study included 178 ward nurses in three hospitals. We used a t-test to analyse differences in ward nursing practices focusing on community living by nurses' characteristics, experience in providing home-based care, discharge planning approaches, and understanding of patient situations after discharge, and a stepwise multi-regression analysis with ward nursing practices focusing on community living as the dependent variable.

RESULTS: Respondents included 167 female and 11 male nurses, with 34.8% in their 40s. Their mean length of nursing experience was 14.2 ± 9.8 years. Only 45.5% of the ward nurses recognized that discharge planning should commence on admission. The most common area of ward nursing practice focusing on community living was educating patients and their families. Cooperation with community healthcare workers was seen least frequently. The highest rate of contribution was observed in a model including recognition of the importance of discharge planning, number of conferences attended with community care service providers, experience of caring for a family member, and length of nursing experience (Adjusted R2  = 0.301). Impact statement: Improved ward nursing practice can help nurses to focus on enabling ongoing independent community living.

CONCLUSIONS: Nurses were most focused on educating patients and their families to help them to manage after discharge. Recognizing the importance of discharge planning, holding conferences with community care service providers, and experience in caring for a family member affected ward nursing practice supporting community living. Impact Statement: Our study results indicated that improved ward nursing practice can help nurses to focus on enabling ongoing independent community living.

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