Elaine Siow1, Shuk Man Lo2, Kwai Lin Yeung3, Richard Sai Dat Yeung4, Kai Chow Choi5, Sek Ying Chair6. 1. The Nethersole School of Nursing, The Chinese University of Hong Kong, Esther Lee Building, Shatin, New Territories, Hong Kong. Electronic address: elainesiow@cuhk.edu.hk. 2. Accident and Emergency Department, Alice Ho Miu Ling Nethersole Hospital, Hospital Authority, Chuen On Road, Tai Po, New Territories, Hong Kong. Electronic address: losm1@ha.org.hk. 3. Accident and Emergency Department, Alice Ho Miu Ling Nethersole Hospital, Hospital Authority, Chuen On Road, Tai Po, New Territories, Hong Kong. Electronic address: yeungkl2@ha.org.hk. 4. Accident and Emergency Department, Alice Ho Miu Ling Nethersole Hospital, Hospital Authority, Chuen On Road, Tai Po, New Territories, Hong Kong. Electronic address: yeungsd@ha.org.hk. 5. The Nethersole School of Nursing, The Chinese University of Hong Kong, Esther Lee Building, Shatin, New Territories, Hong Kong. Electronic address: kchoi@cuhk.edu.hk. 6. The Nethersole School of Nursing, The Chinese University of Hong Kong, Esther Lee Building, Shatin, New Territories, Hong Kong. Electronic address: sychair@cuhk.edu.hk.
Abstract
BACKGROUND: Discharging patients with a self-reported low readiness for hospital discharge (RHD) may be challenging, as these patients may be vulnerable to risks and adaptation issues that can delay recovery. However, little is known about whether emergency medicine ward (EMW) patients are sufficiently prepared for discharge to home. Therefore, the aim of this study is to examine the factors and outcomes associated with patients' RHD in an EMW setting. METHODS: One hundred and eighty-four patients were recruited from the EMW of a tertiary hospital in Hong Kong. Cross-sectional data were collected from self-administered questionnaires and patients' medical records at the time of discharge and 1 month later. Descriptive statistics were obtained, and the variables were subjected to multivariable regression analyses. RESULTS: Seventy-three patients (40%) reported a low RHD at the time of discharge. Living with someone was a factor contributing to a patient's perceived RHD. A greater RHD was associated with a lower risk of 30-day emergency department readmission (odds ratio [OR] = 0.75; 95% confidence interval [CI] = 0.57-0.99) and hospital readmission (OR = 0.59; 95% CI = 0.38-0.91). However, patients who reported higher scores on the knowledge RHD subscale had a higher risk of hospital readmission (OR = 2.34; 95% CI = 1.38-3.98). CONCLUSION: These findings demonstrate the importance of paying careful attention to social support network of patients and the provision of patient education, as these may improve patients' RHD prior to discharge from the EMW. (242 words).
BACKGROUND: Discharging patients with a self-reported low readiness for hospital discharge (RHD) may be challenging, as these patients may be vulnerable to risks and adaptation issues that can delay recovery. However, little is known about whether emergency medicine ward (EMW) patients are sufficiently prepared for discharge to home. Therefore, the aim of this study is to examine the factors and outcomes associated with patients' RHD in an EMW setting. METHODS: One hundred and eighty-four patients were recruited from the EMW of a tertiary hospital in Hong Kong. Cross-sectional data were collected from self-administered questionnaires and patients' medical records at the time of discharge and 1 month later. Descriptive statistics were obtained, and the variables were subjected to multivariable regression analyses. RESULTS: Seventy-three patients (40%) reported a low RHD at the time of discharge. Living with someone was a factor contributing to a patient's perceived RHD. A greater RHD was associated with a lower risk of 30-day emergency department readmission (odds ratio [OR] = 0.75; 95% confidence interval [CI] = 0.57-0.99) and hospital readmission (OR = 0.59; 95% CI = 0.38-0.91). However, patients who reported higher scores on the knowledge RHD subscale had a higher risk of hospital readmission (OR = 2.34; 95% CI = 1.38-3.98). CONCLUSION: These findings demonstrate the importance of paying careful attention to social support network of patients and the provision of patient education, as these may improve patients' RHD prior to discharge from the EMW. (242 words).
Authors: Christina Østervang; Annmarie Touborg Lassen; Katrine Øelund; Elisabeth Coyne; Karin Brochstedt Dieperink; Charlotte Myhre Jensen Journal: BMJ Open Date: 2022-02-28 Impact factor: 2.692