Marianne E Weiss1, Kathleen J Sawin2, Karen Gralton3, Norah Johnson4, Carol Klingbeil5, Stacee Lerret6, Shelly Malin7, Olga Yakusheva8, Rachel Schiffman9. 1. College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI 53201-1881, United States. Electronic address: Marianne.weiss@marquette.edu. 2. College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States; Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: ksawin@chw.org. 3. College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States; Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: kgralton@chw.org. 4. College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI 53201-1881, United States. Electronic address: Norah.Johnson@marquette.edu. 5. Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: klingbei@uwm.edu. 6. Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States; Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, United States. Electronic address: slerret@chw.org. 7. Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: mmalin@ilstu.edu. 8. School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor, MI 48109, United States. Electronic address: yakushev@med.umich.edu. 9. College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States. Electronic address: schiffma@uwm.edu.
Abstract
PURPOSE: This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits). DESIGN/ METHODS: In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3weeks post-discharge (Post-Discharge Coping Difficulty Scale), and from electronic records (readmission, ED visits). RESULTS: Parent-reported quality of discharge teaching delivery (the way nurses teach), but not the amount of content, was positively associated with parent perception (B=0.54) and nurse assessment (B=0.16) of discharge readiness. Parent-reported discharge readiness was negatively associated with post-discharge coping difficulty (B=-0.52). Nurse assessment of discharge readiness was negatively associated with readmission; a one point increase in readiness (on a 10 point scale) decreased the likelihood of readmission by 52%. CONCLUSION: There is a sequential effect of quality of discharge teaching delivery on parent discharge readiness, which is associated with parent coping difficulty and child readmission. PRACTICE IMPLICATIONS: Efforts to improve discharge outcomes should include strategies to build nurse teaching skills for high-quality delivery of discharge teaching. In addition, routine nurse assessment of discharge readiness can be used to identify children at risk for readmission and trigger anticipatory interventions.
PURPOSE: This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits). DESIGN/ METHODS: In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3weeks post-discharge (Post-Discharge Coping Difficulty Scale), and from electronic records (readmission, ED visits). RESULTS: Parent-reported quality of discharge teaching delivery (the way nurses teach), but not the amount of content, was positively associated with parent perception (B=0.54) and nurse assessment (B=0.16) of discharge readiness. Parent-reported discharge readiness was negatively associated with post-discharge coping difficulty (B=-0.52). Nurse assessment of discharge readiness was negatively associated with readmission; a one point increase in readiness (on a 10 point scale) decreased the likelihood of readmission by 52%. CONCLUSION: There is a sequential effect of quality of discharge teaching delivery on parent discharge readiness, which is associated with parent coping difficulty and child readmission. PRACTICE IMPLICATIONS: Efforts to improve discharge outcomes should include strategies to build nurse teaching skills for high-quality delivery of discharge teaching. In addition, routine nurse assessment of discharge readiness can be used to identify children at risk for readmission and trigger anticipatory interventions.
Authors: Arti D Desai; Tamara D Simon; JoAnna K Leyenaar; Maria T Britto; Rita Mangione-Smith Journal: Acad Pediatr Date: 2018-08-02 Impact factor: 3.107
Authors: Arti D Desai; Elizabeth A Jacob-Files; Sarah J Lowry; Douglas J Opel; Rita Mangione-Smith; Maria T Britto; Waylon J Howard Journal: Health Serv Res Date: 2018-05-08 Impact factor: 3.402